Damage to blood vessel lining may account for kidney failure patients' heart risks

October 18, 2012

Highlights Washington, DC (October 18, 2012) -- Individuals with kidney failure often develop heart problems, but it's not clear why. A study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN) provides evidence that their kidneys' inability to excrete waste products in the urine, which leads to build-up of these products in the blood, may damage the sugary lining of blood vessels and lead to heart troubles.

Carmen Vlahu (an MD/PhD student at the Academic Medical Center Amsterdam, in the Netherlands) and her colleagues wondered whether the "glycocalyx," a sugar layer coating the insides of blood vessels, is damaged in patients with kidney failure and is responsible for their increased risks of heart problems. To investigate, they used a newly developed imaging method to look at 40 patients' and 21 healthy individuals' blood vessels. They also measured participants' blood levels of glycocalyx constituents.

Compared with healthy individuals, kidney failure patients had lost some of the glycocalyx coating the insides of their blood vessels, and they had high levels of glycocalyx constituents in their blood, consistent with increased shedding of glycocalyx from blood vessel walls.

"Impaired glycocalyx barrier properties, together with shedding of its constituents into the blood, probably contribute to the aggressive vascular pathology present in this group of patients," said Vlahu. "The state of endothelial glycocalyx and its circulating components could provide valuable tools to monitor vascular vulnerability, to detect early stages of disease, to evaluate risk, and to judge the response of patients with kidney disease to treatment," she added.
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Study co-authors include Bregtje A. Lemkes, MD, PhD, Dirk G. Struijk, MD, PhD, Marion G. Koopman, MD, PhD, Raymond T. Krediet, MD, PhD, and Hans Vink, PhD.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Damage of the Endothelial Glycocalyx in Dialysis Patients," will appear online at http://jasn.asnjournals.org/ on October 18, 2012, doi: 10.1681/ASN.2011121181.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

American Society of Nephrology

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