title: NFκB in the development of endothelial activation and damage in uremia: an in vitro approach.
abstract: Impaired hemostasis coexists with accelerated atherosclerosis in patients with chronic kidney disease (CKD). The elevated frequency of atherothrombotic events has been associated with endothelial dysfunction. The relative contribution of the uremic state and the impact of the renal replacement therapies have been often disregarded. Plasma markers of endothelial activation and damage were evaluated in three groups of patients with CKD: under conservative treatment (predialysis), on hemodialysis, and on peritoneal dialysis. Activation of p38 MAPK and the transcription factor NFκB was assessed in endothelial cell (EC) cultures exposed to pooled sera from each group of patients. Most of the markers evaluated (VCAM-1, ICAM-1, VWF, circulating endothelial cells) were significantly higher in CDK patients than in controls, being significantly more increased in the group of peritoneal dialysis patients. These results correlated with the activation of both p38 MAPK and NFκB in EC cells exposed to the same sera samples, and also to the peritoneal dialysis fluids. Hemodialysis did not further contribute to the endothelial damage induced by the uremic state observed in predialysis patients, probably due to the improved biocompatibility of the hemodialysis technique in recent years, resulting in lower cellular activation. However, peritoneal dialysis seemed to exert a significant proinflammatory effect on the endothelium that could be related to the high glucose concentrations and glucose degradation products present in the dialysis fluid. Although peritoneal dialysis has been traditionally considered a more physiological technique, our results raise some doubts with respect to inflammation and EC damage.
authors.affiliation: Hemotherapy-Hemostasis Department, Centre de Diagnòstic Biomèdic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Caballo
authors.forename: Marta
authors.initials: M
authors.lastname: Palomo
authors.forename: Aleix
authors.initials: A
authors.lastname: Cases
authors.forename: Ana M
authors.initials: AM
authors.lastname: Galán
authors.forename: Patricia
authors.initials: P
authors.lastname: Molina
authors.forename: Manel
authors.initials: M
authors.lastname: Vera
authors.forename: Xavier
authors.initials: X
authors.lastname: Bosch
authors.forename: Gines
authors.initials: G
authors.lastname: Escolar
authors.forename: Maribel
authors.initials: M
authors.lastname: Diaz-Ricart
mesh_terms: D000368:Aged; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000097:blood* / Q000378:metabolism*; D019007:P-Selectin / Q000097:blood; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000097:blood; D014511:Uremia / Q000097:blood* / Q000378:metabolism / Q000473:pathology*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D019040:E-Selectin; D016328:NF-kappa B; D019007:P-Selectin; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1