Biomarkers of Uremic Cardiotoxicity.

Nada Dimkovic,Sandra Dragicevic,Aleksandra Nikolic,Sreten Budisavljevic,Bojan Stopic,Branislava Medic-Brkic,Marko Stojanovic

doi:10.3390/toxins13090639

Nada Dimkovic, Sandra Dragicevic + Show 5 more

Open Access

https://doi.org/10.3390/toxins13090639

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Abstract

Cardiovascular (CV) morbidity and mortality increase along with the progression of chronic kidney disease (CKD). The potential novel biomarkers of cardiotoxicity have been tested with the aim of the early detection of patients at high CV risk, and among them are markers of inflammation, oxidative stress, acute renal injury, and microRNAs. The study analyzed biomarkers in non-dialysis-dependent (NDD; stage 3a–4 CKD) and dialysis-dependent (DD) CKD patients. The prospective cohort study included 87 patients who were followed for 18 months, during which period newly occurred CV events were recorded. Cox regression analysis confirmed serum albumin, urea, interventricular septum thickness diameter (IVST), the use of calcium antagonist, and erythropoiesis-stimulating agent to be significant predictors of CV outcome. No significant difference was observed in biomarkers of inflammation, oxidative stress, acute kidney injury (IL-18, CRP, ferritin, IMA, SOD, NGAL, and KIM-1), and miR-133a, in regards to the presence/absence of CV event, CV death, and left ventricular hypertrophy. Serum albumin, urea, IVST, and the use of calcium antagonist and erythropoiesis-stimulating agents were confirmed to be factors associated with CV events in CKD patients. Apart from traditional risk factors, new research is needed to define novel and reliable biomarkers of cardiotoxicity in CKD patients.

Highlights

Chronic kidney disease (CKD) has a great impact on global health, as a direct cause of global morbidity and mortality, especially for the occurrence of cardiovascular (CV) diseases, and chronic kidney disease (CKD) is recognized as an independent and strong risk factor for their occurrence [1]
This paper analyzed patients with CKD who had or did not have CV events and, at the same time, we put into context various biomarkers, including traditional ones and some of the most recent
Cox regression analysis confirmed that only albumin, urea, interventricular septum thickness, the use of calcium antagonists and erythropoiesis-stimulating agents proved to be factors associated with de novo CV events during the 18-month follow-up period

Summary

Introduction

Chronic kidney disease (CKD) has a great impact on global health, as a direct cause of global morbidity and mortality, especially for the occurrence of cardiovascular (CV) diseases, and CKD is recognized as an independent and strong risk factor for their occurrence [1]. CV morbidity and mortality increase along with a decrease in the estimated glomerular filtration rate (eGFR), and the pathophysiological process of CV damage in patients with CKD occurs much earlier, before the onset of end-stage renal disease (ESRD) [2]. Patients with ESRD have a 20 to 30 times higher risk of CV death compared to the general population, a large number of earlier studies have shown that CV risk is increased in all CKD stages [3]. A large number of biomarkers, potential markers of cardiotoxicity, have been tested and used with the aim of early detection of patients at high risk, and among them are markers of inflammation, oxidative stress, and markers of acute renal injury

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