EVALUATION OF TEMPORAL CHANGES IN ENDOTHELIAL DYSFUNCTION AND ITS ASSOCIATION WITH VISFATIN, YKL-40, AND ADIPONECTIN KINETICS IN PERITONEAL DIALYSIS PATIENTS

 

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EVALUATION OF TEMPORAL CHANGES IN ENDOTHELIAL DYSFUNCTION AND ITS ASSOCIATION WITH VISFATIN, YKL-40, AND ADIPONECTIN KINETICS IN PERITONEAL DIALYSIS PATIENTS

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Galip
GUZ
Taha Enes CETİN tahaenes23@gmail.com Gazi University Nephrology Ankara Turkey -
Beyza Hilal KINDAN beyzahilalkindan@gmail.com Gazi University Internal Medicine Ankara Turkey -
Irem PAMUK irempamuk95@gmail.com Gazi University Internal Medicine Ankara Turkey -
Omer Faruk AKCAY omerfaruk_akcay@yahoo.com Gazi University Nephrology Ankara Turkey -
Saliha YILDIRIM dr.saliha@gmail.com Sincan Training and Research Hospital Nephrology Ankara Turkey -
Halit Nahit SENDUR hsendur@gazi.edu.tr Gazi University Radiology Ankara Turkey -
Mahi Nur CERIT m.cerit@gazi.edu.tr Gazi University Radiology Ankara Turkey -
Sevim GONEN segonen@gazi.edu.tr Gazi University Division of Pediatric Nephrology and Tissue Typing Laboratory Ankara Turkey -
Galip GUZ galipguz@hotmail.com Gazi University Nephrology Ankara Turkey *
Ulver DERICI ulver@gazi.edu.tr Gazi University Nephrology Ankara Turkey -
Ozant HELVACI drozant@hotmail.com Gazi University Nephrology Ankara Turkey -
 
 
 
 

Chronic kidney disease (CKD) is a significant public health problem worldwide, and cardiovascular mortality rates are markedly high in the end-stage renal disease (ESRD) population. Increased inflammation and oxidative stress in CKD lead to endothelial dysfunction and acceleration of the atherosclerotic process. Adipokines play an important role in this process. The aim of this study is to prospectively evaluate the time-dependent changes in endothelial dysfunction and its relationship with visfatin, YKL-40, and adiponectin levels in peritoneal dialysis (PD) patients.

This prospective cohort study included 30 patients followed at the PD center of the Department of Nephrology at Gazi University who had received at least 12 months of PD treatment. In the study, serum visfatin, YKL-40, and adiponectin levels were measured using the ELISA method at 0 and 1 years, and carotid intima-media thickness (CIMT) was evaluated simultaneously using ultrasonography. The relationships between biomarkers and CIMT changes were examined using Pearson correlation analysis.

The mean age of the included patients was 55.8 years, and 16 (53.3%) patients were male. The average PD duration was 4.9 years, and the most common comorbid condition was HT (80%). Hemoglobin levels averaged 11.3 ± 1.44 g/dl, and the average residual renal function was 810 ± 766 ml. A statistically significant increase was detected in right and left CIMT values at the end of one year (p<0.001 and p=0.002). While no significant change was observed in IL-40 levels, the positive correlation between IL-40 and CIMT was noteworthy. A significant decrease was observed in adiponectin levels (p<0.001), and a negative correlation with CIMT was found. Visfatin levels increased significantly (p<0.001) and showed a positive correlation with CIMT. In addition, a strong positive correlation was found between visfatin and YKL-40. 

Table 1. Effect of Baseline Biomarker Levels on One-Year CIMT Values

  n = 30                                                    Right CIMT (1st year)                                                                                                              Left CIMT (1st year)

Biomarker (Baseline)>10 mm (n = 12)<10 mm (n = 18)p>10 mm (n = 14)<10 mm (n = 16)p
YKL-4089.25 ± 15.9062.98 ± 21.120.00182.95 ± 22.0465.21 ± 21.080.032
Adiponectin14.54 ± 6.5826.31 ± 13.760.00416.76 ± 7.9025.84 ± 14.760.043
Visfatin31.51 ± 9.3720.39 ± 11.310.00931.20 ± 12.0419.27 ± 8.490.004

Our study is the first known study to prospectively evaluate YKL-40, visfatin, and adiponectin levels in PD patients and their relationship with CIMT from year 0 to year 1. Increased YKL-40 and visfatin levels in PD patients have been found to be associated with endothelial dysfunction and the development of atherosclerosis. The decrease in adiponectin levels is associated with an increased cardiovascular risk. The combined use of YKL-40 and visfatin may enable more effective determination of cardiovascular risk in PD patients. These results may contribute to the development of new approaches to reduce mortality and morbidity in the PD population.

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