The Relationship between Oxidative Stress and Coronary Artery Calcification in Patients Undergoing Peritoneal Dialysis or Hemodialysis

Fatih Mehmet Erdur,Halil Zeki Tonbul,Fatih Ozcicek,Kultigin Turkmen,Suleyman Turk,Orhan Ozbek,Aysun Toker,Hatice Kayikcioglu

doi:10.15197/sabad.1.12.09

Abstract

Vascular calcification and increased oxidative stress are commonly seen in patients with end-stage renal disease (ESRD). Nitrotyrosine is one of the end products of nitric oxide metabolism and is accepted as an indicator of oxidative stress. Nitrotyrosine levels have been found to be high in ESRD patients. The aim of our study is to investigate the relation between coronary artery calcification and oxidative stress in peritoneal dialysis (PD) and hemodialysis (HD) patients. 46 PD and 34 HD patients are included in the study. Coronary artery calcification scoring (CACS) is made by multi slice computed tomography. Patients are divided into 4 groups according to their CACS values as Group 1 (CACS: 0), Group 2 (CACS:1-99), Group 3 (CACS:100-399) and Group 4 (CACS: ≥400). Serum nitrotyrosine levels were measured. Nitrotyrosine levels were significantly increased in HD patients compared to PD patients. Nitrotyrosine levels were found to be elevated in accordance with increased CACS in PD patients. However, we could not find this relationship in HD patients. There might be an important relationship between CACS and oxidative stress in PD patients.

Highlights

Cardiovascular diseases (CVD) are the most common causes of mortality in patients with chronic kidney diseases (CKD) [1]
We investigated the relationship between nitrotyrosine, an indicator of oxidative stress and vascular calcification in patients with end-stage renal disease (ESRD) undergoing either peritoneal dialysis (PD) or HD treatment
The main consequences of our study can be summarized as follows: i) the nitrotyrosine levels of HD patients were significantly higher in comparison of PD patients, ii) when PD and HD patients were divided into subgroups depending on their calcification scoring (CACS), nitrotyrosine levels increased as CACS became greater in PD patients, but this association was not found in HD patients

Summary

Introduction

Cardiovascular diseases (CVD) are the most common causes of mortality in patients with chronic kidney diseases (CKD) [1]. In the etiology of atherosclerotic CVD that have an increased frequency in this population, classical risk factors, such as diabetes mellitus, hypertension, dyslipidemia, obesity, etc., as well as increased inflammation, oxidative stress, anemia, and dysregulated bone and mineral metabolism play an important role [2]. Vascular calcification is a condition that is frequently encountered in diseases such as chronic kidney failure, diabetes, hypertension, atherosclerosis, in which endothelial damage occurs and is associated with increased morbidity and mortality in even younger ages [5]. The patients with ESRD are exposed to increased oxidative stress bearing [10] In this population, the defects in nitric oxide (NO) metabolism are considered to be a part of excessive atherosclerosis [11]. In a study describing the autopsy results of the patients with ESRD, when the aorta specimens were dyed with immunologic stains, TNF-α and nitrotyrosine were found in the majority of these patients in comparison with the control group [12]

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