Original investigation
Dialysis therapy
History of Cardiovascular Disease Is Associated With Endothelial Progenitor Cells in Peritoneal Dialysis Patients

https://doi.org/10.1053/j.ajkd.2005.05.015Get rights and content

Background: It is unknown whether traditional cardiovascular disease risk factors influence the number of endothelial progenitor cells (EPCs) and whether numbers of EPCs correlate with endothelial function in patients with end-stage renal disease. Methods: In a cross-sectional study of 38 peritoneal dialysis patients, we examined numbers of circulating CD34+/KDR+/CD133+ cells, CD34+ hematopoietic stem cells, and EPCs cultured from peripheral blood. We also assessed conventional cardiovascular disease risk factors, such as history of vascular disease, diabetes, hypercholesterolemia, hypertension, and smoking. We determined endothelial function by measurement of endothelium-dependent and endothelium-independent reactivity of forearm resistance arteries by using strain-gauge plethysmography. Results: Numbers of EPCs cultured from peripheral blood and forearm blood flow reactivity did not differ between erythropoietin-treated peritoneal dialysis patients and healthy individuals. A history of vascular disease was associated with number of cultured EPCs, but other cardiovascular disease risk factors showed no association. Furthermore, there was no association of endothelial-dependent and endothelial-independent forearm blood flow reactivity with EPCs in peritoneal dialysis patients. Conclusion: In this first study of EPCs in peritoneal dialysis patients, we found an association between history of vascular disease and EPCs, but no association of EPCs with endothelial function or other cardiovascular disease risk factors.

Section snippets

Design and Patients

We performed a cross-sectional study of 38 consecutive peritoneal dialysis patients at the University Hospital of Vienna, Austria. The Ethical Review Board at the University of Vienna approved the study. All patients provided written informed consent.

Participants had to be clinically stable, older than 18 years, treated with peritoneal dialysis for at least 3 months, and free from peritonitis within 2 months before the study began. Exclusion criteria were overtreatment with erythropoietin

Patients and Cardiovascular Disease Risk Factors

Important demographic and clinical characteristics, as well as biochemical data for the 38 patients, are listed in Table 1. Four patients had a failed kidney graft. Thirty-six patients were treated for arterial hypertension (8 patients, angiotensin II receptor blockers; 16 patients, angiotensin-converting enzyme inhibitors; 6 patients, both classes of antihypertensives), 21 patients had uncontrolled hypertension (systolic and/or diastolic blood pressure ≥ 130 mm Hg and/or ≥ 80 mm Hg), and 35

Discussion

In this first study of the association of EPCs with cardiovascular disease risk factors in patients with end-stage renal disease, we found an inverse association of history of vascular disease with EPC number in erythropoietin-treated peritoneal dialysis patients, whereas this was not the case for other conventional cardiovascular disease risk factors. We observed no association of endothelial-dependent and endothelial-independent forearm blood flow reactivity with either circulating or

References (40)

  • J. Zimmermann et al.

    Inflammation enhances cardiovascular risk and mortality in hemodialysis patients

    Kidney Int

    (1999)
  • R.N. Foley et al.

    Epidemiology of cardiovascular disease in chronic renal disease

    J Am Soc Nephrol

    (1998)
  • U.N. Khot et al.

    Prevalence of conventional risk factors in patients with coronary heart disease

    JAMA

    (2003)
  • D.G. Hackam et al.

    Emerging risk factors for atherosclerotic vascular diseaseA critical review of the evidence

    JAMA

    (2003)
  • C. Zoccali et al.

    Novel cardiovascular risk factors in end-stage renal disease

    J Am Soc Nephrol

    (2004)
  • J.A. Vita et al.

    Endothelial functionA barometer for cardiovascular risk?

    Circulation

    (2002)
  • C. van Guldener et al.

    Endothelium-dependent vasodilatation and distensibility of large arteries in chronic haemodialysis patients

    Nephrol Dial Transplant

    (1997)
  • A. Rosenzweig

    Endothelial progenitor cells

    N Engl J Med

    (2003)
  • C. Urbich et al.

    Endothelial progenitor cells. Characterization and role in vascular biology

    Circ Res

    (2004)
  • M. Vasa et al.

    Number and migratory activity of circulating endothelial progenitor cells inversely correlate with risk factors for coronary artery disease

    Circ Res

    (2001)
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    Originally published online as doi:10.1053/j.ajkd.2005.05.015 on July 22, 2005.

    Supported in part by a research grant from the Major of Vienna and institutional revenue.

    S.S., A.V., M.W., and G.S.-P. created the concept and design of this study; S.S., J.G., and C.W.K. performed endothelial progenitor cell measurements; G.S. performed forearm blood flow measurements and statistical analyses; H.P. and M.F. were responsible for collection of patient and laboratory data; S.S., G.S., M.F., M.W., and G.S.-P. took part in analysis and interpretation of data; S.S. and G.S.-P. contributed to drafting of the manuscript; and S.S., G.S., M.F., A.V., M.W., E.M., W.H.H., and G.S.-P. performed critical revision of the manuscript for important intellectual content.

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