title: Effect of erythropoietin stimulating agents on vascular endothelial growth factor levels in patients with end stage renal disease.
abstract: BACKGROUND
  End stage renal disease (ESRD) is a debilitating disease that not only impacts quality of life, but also increases the risk of cardiovascular disease, stroke, and overall mortality. By improving our understanding of the molecular patterns seen in progression of chronic renal disease (CRD), we may be able to slow down and possibly even prevent progression renal failure. The vascular endothelial growth factor (VEGF) has been implicated as a major contributor to CRD disease progression, thus our aim was to profile the VEGF levels in patients with ESRD and to determine the effects of the erythropoietin stimulating agents (ESAs).
  
  
  METHODS
  Under institution review board (IRB) approval, plasma samples were collected from 77 patients prior to hemodialysis and heparin administration. Normal human plasma samples (female & male, 18-35 years old) were purchased from George King Biomedical Inc (Overland Park, KS). All samples were stored at -80 °C. Inflammatory biochips were purchased from RANDOX (Co. Antrim, Northern Ireland) to test VEGF on 77 ESRD and 48 normal samples.
  
  
  RESULTS
  The VEGF was significantly elevated in ESRD vs. normal (P<0.0001), ESRD+ESA vs. normal (P<0.0001), and ESRD-ESA vs. normal (P<0.0001). No difference was seen between ESRD+ESA and ESRD-ESA. Hemoglobin and free iron were significantly elevated in ESRD-ESA compared to ESRD+ESA (PHemoglobin=0.0007, PIron<0.0001).
  
  
  CONCLUSIONS
  Our finding that VEGF was significantly elevated in ESRD vs. normal, aligns with the literature and suggests that VEGF may in fact play a key role in CRD progression. However, further studies to evaluate VEGF isomer levels are needed. While we saw lack of difference in VEGF levels between ESRD+ESA and ESRD-ESA, this may be due to the treatment algorithm used. Further investigation is warranted to determine whether the ESAs and hemoglobin levels show any influence on or crosstalk with the VEGF levels.
authors.affiliation: Stritch School of Medicine, Loyola University of Chicago, Maywood, IL, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Saluk
authors.affiliation: Unit of Nephrology, Department of Internal Medicine, Loyola University Medical Centre, Maywood, IL, USA.
authors.forename: Vinoid K
authors.initials: VK
authors.lastname: Bansal
authors.affiliation: Unit of Hemostasis and Thrombosis, Department of Pathology, Loyola University Medical Centre, Maywood, IL, USA.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Hoppensteadt
authors.affiliation: Unit of Hemostasis and Thrombosis, Department of Pathology, Loyola University Medical Centre, Maywood, IL, USA.
authors.forename: Daneyal A
authors.initials: DA
authors.lastname: Syed
authors.affiliation: Unit of Hemostasis and Thrombosis, Department of Pathology, Loyola University Medical Centre, Maywood, IL, USA.
authors.forename: Schuarazad
authors.initials: S
authors.lastname: Abro
authors.affiliation: Unit of Hemostasis and Thrombosis, Department of Pathology, Loyola University Medical Centre, Maywood, IL, USA - jfareed@luc.edu.
authors.forename: Jawed
authors.initials: J
authors.lastname: Fareed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007501:Iron / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis; D014481:United States; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D006493:Heparin; D007501:Iron