RELAZIONE TRA ENDOTELINA-1 PLASMATICA E STIFFNESS AORTICA IN PAZIENTI IPERTESI CON MALATTIA RENALE CRONICA

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Abstract

[automatically translated] Various studies have shown that arterial stiffness increases with the progressive deterioration of renal function. An inverse correlation has also been demonstrated between the plasma levels of endothelin-1 (ET-1) and the glomerular filtration rate (GFR). Experimental data have shown that infusion of ET-1 is followed by an increase of arterial stiffness and the treatment with ET-A receptor antagonists of ET-1 in renal patients has resulted in a reduction of aortic stiffness, in part independently of the effects on blood pressure. Few data exist in the literature on the relationship between aortic distensibility and plasma concentrations of ET-1 in patients with chronic kidney disease (CKD). The purpose of our study was to evaluate the relationship between circulating levels of ET-1 and wave pulse wave velocity (PWV), aortic in a group of hypertensive patients with CKD. Have enrolled 107 hypertensive patients (mean age 58 ± 13 years, 56% men, mean GFR 44 mL / min / 1.73 m2), with CKD stages 1-4 (classified according to the NKF guidelines). The ET-1 in plasma were measured by enzyme immunoassay. The aortic PWV was measured by computerized automatic oscillometric method (arteriograph). The GFR was estimated using the MDRD Study equation to 4 variables. Patients (n = 46) with higher values of PWV (> 12 m / sec) showed higher plasma concentrations of ET-1 compared to subjects with PWV <12 m / sec (4.3 ± 0.9 vs 3.9 ± 0.8 pg / ml ; p = 0.01 and p = 0.02, before and after adjustment for age, sex, and mean arterial pressure). A statistically significant correlation was found between ET-1 and PWV (r = 0:34; p <0.001). This association remained significant even after adjusting for various confounding factors to 'analyzes of multiple stepwise regression (beta = 0:29; p = 0.001). Our results seem to suggest that the unfavorable influence exerted by the reduction of renal function on elasticity of large arteries may, at least in part, be mediated by an increase in levels of ET-1 This association remained significant even after adjusting for various confounding factors to 'analyzes of multiple stepwise regression (beta = 0:29; p = 0.001). Our results seem to suggest that the unfavorable influence exerted by the reduction of renal function on elasticity of large arteries may, at least in part, be mediated by an increase in levels of ET-1 This association remained significant even after adjusting for various confounding factors to 'analyzes of multiple stepwise regression (beta = 0:29; p = 0.001). Our results seem to suggest that the unfavorable influence exerted by the reduction of renal function on elasticity of large arteries may, at least in part, be mediated by an increase in levels of ET-1
Original languageItalian
Pages143-143
Number of pages1
Publication statusPublished - 2012

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