hsCRP, sICAM-1 and TAFI in Hemodialysis Patients: Linking Inflammation and Hypofibrinolysis to Cardiovascular Events

Mohamed Z. Gad, Hala O. El-Mesallamy, Eman F. Sanad
2008 Kidney & Blood Pressure Research  
Conclusion: This study demonstrates the association of inflammation and hypofibrinolysis with hemodialysis especially in patients with CVD. We found no added therapeutic value for L -arginine at the used dose and duration to ameliorate these cascades of events. Abstract Background/Aims: Growing evidence suggests that inflammation, oxidative stress and hypofibrinolysis may have a pivotal role in the high prevalence of cardiovascular disease (CVD) in chronic kidney disease (CKD) patients. This
more » ... ) patients. This study aims to investigate the association of these processes with the incidence of CVD in hemodialysis (HD) patients and to examine the modulating effect of oral L -arginine in HD patients having CVD. Methods: Blood malondialdehyde (MDA), highly sensitive C-reactive protein (hsCRP), soluble intracellular adhesion molecule-1 (sICAM-1) and thrombin-activatable fibrinolysis inhibitor (TAFI) levels were measured in 12 healthy controls and in 62 CKD patients divided into 15 renal impairment, 21 HD, and 26 HD+CVD. Of the latter, 15 patients received oral L -arginine (15 g/day, 5 g t.i.d.) for 1 month. Results: MDA, hsCRP, sICAM-1 and TAFI were significantly elevated in renal impairment patients. HD and HD+CVD experienced higher levels, but only MDA and TAFI were significantly higher in HD+CVD than HD patients. Only MDA was significantly reduced by 41% after L -arginine intake.
doi:10.1159/000179476 pmid:19052466 fatcat:yfncxelngjcqhlvetne2isknce