Role Of Pentraxin 3 And Doppler Ultrasound in Assessing the Severity of Endothelial Dysfunction in Patients on Regular Hemodialysis in Comparison with Chronic Kidney Disease Patients Stage 5 Not on Renal Replacement Therapy

Abstract

Background: One of the main causes of the pro-inflammatory condition is endothelial dysfunction (ED), causing subclinical atherosclerosis and cardiovascular disease, which is the most common reason of death for those with end-stage renal illness. Pentraxin3 (PTX3) is an interesting indicator of vascular inflammation in addition to measuring Flow mediated dilatation (FMD)of brachial artery %, its flow volume as novel measurement of FMD and carotid intima media thickness (CIMT) are noninvasive techniques in assessing endothelial dysfunction.

Methods: cross-sectional study with 150 individuals overall, classified into 3 groups: 50 individuals for each group: i) Control group ii) chronic kidney disease CKD group (stage 5 not on renal replacement therapy); and iii) Dialysis group. All of them were subjected to clinical assessment, laboratory measurements of lipid profile, calcium, phosphorus, PTH and serum PTX3. Using Doppler ultrasonography, CIMT, FMD%, and volume flow were evaluated.

Results: PTX3 level and CIMT was substantially greater in CKD and dialysis cases in contrast to controls; its level is higher in CKD in contrast to dialysis cases with p <0.001.while  The FMD% was significantly lower; ROC curve and its area under curve showed that  PTX3, FMD% had a high sensitivity (82% and 80% respectively) and high specificity (75%, and 85%respectively)

Conclusion: High levels of PTX3, low FMD%, and increased CIMT have a crucial function in assessing endothelial dysfunction in CKD and dialysis cases. Furthermore, we hypothesized that dialysis may improve the endothelial dysfunction, which is confirmed by higher PTX3 and lower FMD% in CKD compared to dialysis patients.