title: Arterial and Cellular Inflammation in Patients with CKD.
abstract: CKD associates with a 1.5- to 3.5-fold increased risk for cardiovascular disease. Both diseases are characterized by increased inflammation, and in patients with CKD, elevated C-reactive protein level predicts cardiovascular risk. In addition to systemic inflammation, local arterial inflammation, driven by monocyte-derived macrophages, predicts future cardiovascular events in the general population. We hypothesized that subjects with CKD have increased arterial and cellular inflammation, reflected by18F-fluorodeoxyglucose (18F-FDG) positron emission tomography computed tomography (PET/CT) of the arterial wall and a migratory phenotype of monocytes. We assessed18F-FDG uptake in the arterial wall in 14 patients with CKD (mean±SD age: 59±5 years, mean±SD eGFR: 37±12 ml/min per 1.73 m2) but without cardiovascular diseases, diabetes, or inflammatory conditions and in 14 control subjects (mean age: 60±11 years, mean eGFR: 86±16 ml/min per 1.73 m2). Compared with controls, patients with CKD showed increased arterial inflammation, quantified as target-to-background ratio (TBR) in the aorta (TBRmax: CKD, 3.14±0.70 versus control, 2.12±0.27;P=0.001) and the carotid arteries (TBRmax: CKD, 2.45±0.65 versus control, 1.66±0.27;P<0.001). Characterization of circulating monocytes using flow cytometry revealed increased chemokine receptor expression and enhanced transendothelial migration capacity in patients with CKD compared with controls. In conclusion, this increased arterial wall inflammation, observed in patients with CKD but without overt atherosclerotic disease and with few traditional risk factors, may contribute to the increased cardiovascular risk associated with CKD. The concomitant elevation of monocyte activity may provide novel therapeutic targets for attenuating this inflammation and thereby preventing CKD-associated cardiovascular disease.
authors: Departments of *Vascular Medicine.
authors: Sophie J
authors: SJ
authors: Bernelot Moens
authors: Departments of *Vascular Medicine.
authors: Simone L
authors: SL
authors: Verweij
authors: Departments of *Vascular Medicine.
authors: Fleur M
authors: FM
authors: van der Valk
authors: Departments of *Vascular Medicine.
authors: Julian C
authors: JC
authors: van Capelleveen
authors: Departments of *Vascular Medicine.
authors: Jeffrey
authors: J
authors: Kroon
authors: Experimental Vascular Medicine.
authors: Miranda
authors: M
authors: Versloot
authors: Nuclear Medicine.
authors: Hein J
authors: HJ
authors: Verberne
authors: Radiology.|Biomedical Engineering and Physics, and.
authors: Henk A
authors: HA
authors: Marquering
authors: Departments of *Vascular Medicine.|Department of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Raphaël
authors: R
authors: Duivenvoorden
authors: Department of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Liffert
authors: L
authors: Vogt
authors: Departments of *Vascular Medicine, e.s.stroes@amc.nl.
authors: Erik S G
authors: ES
authors: Stroes
mesh_terms: D001167:Arteritis / Q000000981:diagnostic imaging* / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D002477:Cells; D003430:Cross-Sectional Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Chronic inflammation; cardiovascular disease; chemokine receptor; chronic kidney disease