Arterial Atherosclerosis in Patients With Chronic Kidney Disease and Its Relationship With Serum and Tissue

Instruction: We investigated the correlation between atherosclerosis and tissue and serum levels of endothelin-1 in patients with chronic kidney disease (CKD). Arterial samples were obtained from 35 patients with CKD during arteriovenous fistula placement. Thirty-one patients with cardiovascular disease who underwent coronary artery bypass graft (CABG) were selected as the atherosclerotic group, and a piece of their aorta punched during CABG was obtained. Also, a small piece of the renal artery was dissected during donation in 24 kidney donors (control group). Tissue endothelin-1 level was measured and atherosclerosis grading was determined by pathologic examination. Serum levels of endothelin-1 were also measured in the three groups. The mean tissue endothelin-1 levels were 10.73±7.57 pg/mL, 12.16 ± 3.95 pg/mL, and 0.93 ± 1.06 pg/mL in the patients with CKD, those with CABG, and donors, respectively (P <. 001). The mean serum endothelin-1 level was 25.23 ± 15.15 pg/mL in the patients with CKD, 21.13 ± 17.22 pg/mL in the patients with CABG, and 2.66 ± 1.51 pg/mL in the donors (P <. 001). Atherosclerosis grades correlated with tissue endothelin-1 level (r = 0.823, P <. 001) and serum endothelin-1 level (r = 0.608, P <. 001) in the patients with CKD. Multiple regression analysis showed tissue endothelin-1 level as the main predicting factor of atherosclerosis (P <. 001). Tissue endothelin-1 concentration is more important than serum endothelin-1 or lipids levels in prediction of atherosclerosis. Thus, blockade of tissue endothelin-1 receptors with its antagonists may prevent atherosclerosis progression.