The level of endothelin-1 and reactivity of skin microvessels in patients with early stages of chronic kidney disease


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Abstract

Aim. To evaluate endothelin-1 (ET-1) levels and to characterize reflex vasomotor reactions of skin vessels in distant exposure to cold in patients with chronic kidney disease (CKD) of stage I and II.
Material and methods. Glomerular filtration rate (GFR) was calculated by MDRD formula for 40 healthy subjects (mean age 39.2±2.0 years) and 147 CKD patients (mean age 41.4±1.8 years). All the patients were also exposed to the cold test (a modified variant).
Results. Patients with CKD stage I demonstrated a 35.1% fall in blood flow rate (Qas) in response to cold stimulus, patients of stage II - a 42.2% fall, healthy patients - a 19.3%. CKD patients of stage I and II retained a Qas fall for 3 min after exposure to cold, while healthy subjects resumed skin blood circulation immediately after exposure to cold. Blood plasma ET-1 concentration in healthy subjects was 0.239±0.055 fmol/ml, in stage I CKD patients - 0.334±0.066 fmol/l, in stage II CKD patients - 0.422±0.041 fmol/l. Relationships were found between ET-1 level and GFR (Rs = 0.242; p < 0.05), 24 h proteinuria (Rs = 0.375; p < 0.003) and Qas% in the cold test (Rs = -0.389; p < 0.003) as well as time of recovery of the background Qas (Rs = -0.311; p < 0.003).
Conclusion. Dysfunction of autonomic nervous system at early stages of CKD may arise by means of activation of ET-1 synthesis in response to enhancement of sympathetic impacts.

About the authors

Aleksey Vladimirovich Smirnov

Email: smirnov@nephrolog.ru

Nikolay Nikolaevich Petrishchev

Email: lasmed@yandex.ru

Iraida Yur'evna Panina

Email: i.u.panina@mail.ru

Marina Mikhaylovna Mnuskina

Email: marina-gkdc@rambler.ru

Vera Vladimirovna Achkasova

Email: kirjasha@mail.ru

Aleksandr Shalikovich Rumyantsev

Email: rash.56@mail.ru

Mariya Alekseevna Menshutina

Email: menshutina@mail.ru

A V Smirnov

I.P. Pavlov State Medical University, St. Petersburg

I.P. Pavlov State Medical University, St. Petersburg

N N Petrischev

I.P. Pavlov State Medical University, St. Petersburg

I.P. Pavlov State Medical University, St. Petersburg

I Yu Panina

I.P. Pavlov State Medical University, St. Petersburg

I.P. Pavlov State Medical University, St. Petersburg

M M Mnuskina

I.P. Pavlov State Medical University, St. Petersburg

I.P. Pavlov State Medical University, St. Petersburg

V V Achkasova

I.P. Pavlov State Medical University, St. Petersburg

I.P. Pavlov State Medical University, St. Petersburg

A Sh Rumyantsev

I.P. Pavlov State Medical University, St. Petersburg

I.P. Pavlov State Medical University, St. Petersburg

M A Menshutina

I.P. Pavlov State Medical University, St. Petersburg

I.P. Pavlov State Medical University, St. Petersburg

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