title: Endothelial progenitor cells and cardiovascular events in patients with chronic kidney disease--a prospective follow-up study.
abstract: BACKGROUND
  Endothelial progenitor cells (EPCs) mediate vascular repair and regeneration. Their number in peripheral blood is related to cardiovascular events in individuals with normal renal function.
  
  
  METHODS
  We evaluated the association between functionally active EPCs (cell culture) and traditional cardiovascular risk factors in 265 patients with chronic kidney disease stage V receiving hemodialysis therapy. Thereafter, we prospectively assessed cardiovascular events, e.g. myocardial infarction, percutaneous transluminal coronary angioplasty (including stenting), aorto-coronary bypass, stroke and angiographically verified stenosis of peripheral arteries, and cardiovascular death in this cohort.
  
  
  RESULTS
  In our patients EPCs were related only to age (r=0.154; p=0.01). During a median follow-up period of 36 months 109 (41%) patients experienced a cardiovascular event. In a multiple Cox regression analysis, we identified EPCs (p=0.03) and patient age (p=0.01) as the only independent variables associated with incident cardiovascular events. Moreover, a total of 70 patients died during follow-up, 45 of those due to cardiovascular causes. Log rank test confirmed statistical significance for EPCs concerning incident cardiovascular events (p=0.02).
  
  
  CONCLUSIONS
  We found a significant association between the number of functionally active EPCs and cardiovascular events in patients with chronic kidney disease. Thus, defective vascular repair and regeneration may be responsible, at least in part, for the enormous cardiovascular morbidity in this population.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Johan
authors.initials: J
authors.lastname: Lorenzen
authors.forename: Sascha
authors.initials: S
authors.lastname: David
authors.forename: Ferdinand H
authors.initials: FH
authors.lastname: Bahlmann
authors.forename: Kirsten
authors.initials: K
authors.lastname: de Groot
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bahlmann
authors.forename: Jan T
authors.initials: JT
authors.lastname: Kielstein
authors.forename: Hermann
authors.initials: H
authors.lastname: Haller
authors.forename: Danilo
authors.initials: D
authors.lastname: Fliser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002318:Cardiovascular Diseases / Q000401:mortality / Q000473:pathology*; D001026:Coronary Artery Bypass; D042783:Endothelial Cells / Q000166:cytology / Q000502:physiology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D011446:Prospective Studies; D006435:Renal Dialysis; D013234:Stem Cells / Q000166:cytology / Q000502:physiology*