Patients with stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (REDinREN, Madrid): 80 patients with diabetes mellitus (DM) and 80 patients without DM who were matched for clinical and demographic criteria. MVs from plasma and several monocyte subpopulations (CD14++/CD16+, CD14+/CD16++) were analyzed by flow cytometry, and the plasma concentrations of angiopoietin (Ang)1 and Ang2 were quantified by ELISA. Data on cardiovascular disease were gathered over the 5.5 years after these samples were obtained. MV level, monocyte subpopulations (CD14+/CD16++ and CD14++/CD16+), and Ang2/Ang1 ratios increased in HD patients with DM compared with non-DM patients. Moreover, MV level above the median (264 MVs/µl) were associated independently with greater mortality. MVs, monocyte subpopulations, and Ang2/Ang1 ratio can be used as predictors for CVD. In addition, MV level have potential predictive value in the prevention of CVD in HD patients. These parameters undergo more extensive changes in patients with DM.
- Chronic kidney disease
- diabetes mellitus
- Copyright © 2016, American Journal of Physiology-Renal Physiology