Endothelial dysfunction is associated with visfatin and oxidative stress in hemodialysis patients

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Article Title:	Endothelial dysfunction is associated with visfatin and oxidative stress in hemodialysis patients
Authors:	Remus Aurel Orasan, Simona Racasan, Raza Awon, Ioan Mihai Patiu, Ina Kacso, Diana Moldovan, Gabriel Samasca, Doina Daicoviciu, Adriana Muresan, Mirela Gherman Caprioara
Affiliation:	Nefromed Dialysis Centers Cluj “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Nephrology Department “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Pediatrics Department “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Physiology Department
Abstract:	Background: Endothelial dysfunction (ED) is marker of atherosclerosis in chronic renal failure. In uremia, visfatin was associated with inflammation and endothelial dysfunction. Materials and methods: We evaluated 32 chronic hemodialysis patients (group 1), divided in 2 subgroups (with and without diabetes mellitus) and 20 volunteers-control group (group 2). Plasma visfatin, endothelial-dependent flow-mediated vasodilatation and nitroglycerin-induced endothelium independent vasodilatation (NMD) were assessed for all groups. Malondialdehyde (MDA), hemoglobin, Kt/V, parathormone, C-reactive protein (CRP), albumin, ferritin, transferin saturation, cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, calcium, phosphorus and body mass index (BMI) were determined in group 1. Results: FMD (p=0.02) and NMD (p=0.01) were significantly higher in group 2 than in group 1. In group 1, FMD negatively correlated with visfatin (p=0.007) and MDA (=0.03) and positively correlated with LDL-cholesterol (p=0.0007). BMI, CRP and HDL-cholesterol were significantly higher (p=0.009, =0.001, =0.01 respectively) in diabetes patients compared to patients with no diabetes, while NMD, albumin and calcium were significantly lower (p=0.04, =0.003, =0.04 respectively). Conclusions: Endothelial dysfunction, measured by FMD, is increased in HD patients compared to controls and is associated with visfatin and oxidative stress. Diabetes mellitus is associated with NMD, but it does not influence FMD and visfatin, even if inflammation is enhanced in these patients.
Keywords:	endothelial dysfunction, flow mediated dilatation, visfatin, hemodialysis, diabetes mellitus
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*Correspondence:	ORASAN REMUS AUREL, CENTRUL DE DIALIZA NEFROMED CLUJNAPOCA, STR. ANA ASLAN NR 40, COD POSTAL 400528, CLUJ-NAPOCA, Tel. 0744646831, Email: remusorasan@yahoo.com