title: Decreased serum level and increased urinary excretion of vascular endothelial growth factor-C in patients with chronic kidney disease.
abstract: BACKGROUND
  Interstitial tonicity increases vascular endothelial growth factor-C (VEGF-C), a lymphangiogenic factor in salt-induced hypertension. Therefore, it can be assumed that changes of serum VEGF-C level may be associated with increasing blood pressure. However, there is no report about the changes of serum VEGF-C levels in patients with chronic kidney disease (CKD). The aims of this study were to investigate the changes of serum and urine VEGF-C levels in patients with CKD stage 3-4 and to evaluate the relationship between blood pressure and serum VEGF-C levels in the patients with CKD stage 5 and hemodialysis.
  
  
  METHODS
  Glomerular filtration rate (GFR) was assessed by the Modification of Diet in Renal Disease equation. Blood pressure and VEGF-C levels (serum and urine) were measured by enzyme-linked immunosorbent assay (ELISA) in nine patients with stage 3-4 CKD, 41 hemodialysis patients, and eight healthy individuals.
  
  
  RESULTS
  The median serum level of VEGF-C in patients with stage 3-4 CKD and stage 5 hemodialysis significantly decreased in comparison with healthy individuals. Urinary VEGF-C excretion increased in patients with stage 3-4 CKD compared with healthy control patients. For 41 hemodialysis patients, the serum level of VEGF-C in patients with stage 1 or stage 2 hypertension with hemodialysis did not significantly increase when compared with prehypertension hemodialysis patients.
  
  
  CONCLUSIONS
  We demonstrated that circulating levels of VEGF-C were decreased in patients with CKD, and the decrease of VEGF-C in patients with stage 3-4 CKD coincided with an increase in the urinary excretion of VEGF-C.
authors.affiliation: Department of Internal Medicine and Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine and Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Kyung Pyo
authors.initials: KP
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine and Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Sik
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine and Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Sung Kwang
authors.initials: SK
authors.lastname: Park
authors.affiliation: Department of Preventive Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Ju-Hyung
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Kwangju, Korea.
authors.forename: Nam Ho
authors.initials: NH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine and Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Kim
keywords: Chronic kidney disease; Hemodialysis; Hypertension; VEGF-C