Damage to Blood Vessel Lining May Account for Kidney Failure Patients’ Heart Risks

Released: 10/12/2012 9:00 AM EDT
Embargo expired: 10/18/2012 5:00 PM EDT
Source Newsroom: American Society of Nephrology (ASN)
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Citations Journal of the American Society of Nephrology (doi: 10.1681/ASN.2011121181)

Kidney failure patients have less sugar coating the insides of their blood vessels

Highlights
• Kidney failure patients have less sugar coating along the insides of their blood vessels, and they have high levels of the coating’s constituents in the blood, consistent with increased shedding.
• Damage to this sugar coating may be responsible for kidney failure patients’ increased risks of heart problems.

Heart disease is the number one killer of individuals with kidney disease.

Newswise — Washington, DC (October 18, 2012) — Individuals with kidney failure often develop heart problems, but it’s not clear why. A study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN) provides evidence that their kidneys’ inability to excrete waste products in the urine, which leads to build-up of these products in the blood, may damage the sugary lining of blood vessels and lead to heart troubles.

Carmen Vlahu (an MD/PhD student at the Academic Medical Center Amsterdam, in the Netherlands) and her colleagues wondered whether the “glycocalyx,” a sugar layer coating the insides of blood vessels, is damaged in patients with kidney failure and is responsible for their increased risks of heart problems. To investigate, they used a newly developed imaging method to look at 40 patients’ and 21 healthy individuals’ blood vessels. They also measured participants’ blood levels of glycocalyx constituents.

Compared with healthy individuals, kidney failure patients had lost some of the glycocalyx coating the insides of their blood vessels, and they had high levels of glycocalyx constituents in their blood, consistent with increased shedding of glycocalyx from blood vessel walls.

“Impaired glycocalyx barrier properties, together with shedding of its constituents into the blood, probably contribute to the aggressive vascular pathology present in this group of patients,” said Vlahu. “The state of endothelial glycocalyx and its circulating components could provide valuable tools to monitor vascular vulnerability, to detect early stages of disease, to evaluate risk, and to judge the response of patients with kidney disease to treatment,” she added.

Study co-authors include Bregtje A. Lemkes, MD, PhD, Dirk G. Struijk, MD, PhD, Marion G. Koopman, MD, PhD, Raymond T. Krediet, MD, PhD, and Hans Vink, PhD.

Disclosures: The authors reported no financial disclosures.

The article, entitled “Damage of the Endothelial Glycocalyx in Dialysis Patients,” will appear online at http://jasn.asnjournals.org/ on October 18, 2012, doi: 10.1681/ASN.2011121181.

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Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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