PP.41.17

Abstract

Objective: Transforming growth factor β-1 (TGF-β1) is involved nowadays in atherosclerosis and proteinuria. Albuminuria is considered to be one of the most importantagents for the onset and progression of renal dysfunction in chronic kidney disease (CKD) and more recently, it has also been implicated in cardiovascular disease (CVD) and peripheral vascular disease. Conflicting studies cannot establish at present a clear role for TGF-β1 in the pathogenesis of diabetic albuminuria and atherosclerosis. This fibrogenic cytokine, stimulated by the diabetic state, induces diabetic renal hypertrophy, mesangial matrix expansion, and the development of renal insufficiency. Interleukine-6 (IL-6) is considered to be pro-inflammatory lipocytokine. The aim of the present study was to determine the serum levels of TGF-β1 and IL-6 and to investigate their potential correlation with hypertension, atherosclerotic markers and albuminuria in early stages of CKD and primary chronic glomerulonephritis (CGN). Design and method: CKD patients of stages 1 and 2 with CGN (n = 50) were included. As controls, there were healthy individuals (n = 40). Clearance of creatinine (Clcr) and albumin excretion were examined in the 24 h urine. TGF-β1 and IL-6 levels were measured by an ELISA method. Blood pressure (BP) was taken using a manual sphygmomanometer. Intima media thickness (IMT) of carotid and femoral arteries and atheromatic plaque were evaluated by a high resolution ultrasonography. Results: There was a statistically significant difference between TGF-β1 (10000 ± 1200, p < 0.0001), IL-6 (4 ± 0.5, p < 0.0001), BP (20 ± 5 p < 0.0001) and IMT (0.3 ± 0.09, p < 0.0001) between patients and controls. There was a statistically significant positive strong correlation between levels of TGF-β1 and IL-6 (r = 0.65, p < 0.0001), TGF-β1 and BP (r = 0.7, p < 0.0001), such as between TGF-β1 and IMT (r = 0.65, p < 0.0001) in the patient group. There was also a statistically positive correlation between IL-6 and IMT (r = 0.7, p < 0.0001) in the patient group. Further, TGF-β1 and IL-6 levels were independently correlated with BP, IMT and atheromatic plaque. Conclusions: Our study suggests that serum levels of TGF-β1 and IL-6 might present independent risk factors of blood pressure, atherosclerosis and albuminuria, at least in the early stages of CGN to the progression of CKD.