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Cepoi MR, Duca ST, Chetran A, Costache AD, Spiridon MR, Afrăsânie I, Leancă SA, Dmour BA, Matei IT, Miftode RS, Miftode L, Prepeliuc CS, Haba MȘC, Bădescu MC, Costache II. Chronic Kidney Disease Associated with Ischemic Heart Disease: To What Extent Do Biomarkers Help? Life (Basel) 2023; 14:34. [PMID: 38255650 PMCID: PMC10817293 DOI: 10.3390/life14010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Chronic kidney disease represents a complex and multifaceted pathology characterized by the presence of structural or functional renal anomalies associated with a persistent reduction in renal function. As the disease progresses, complications arise due to the chronic inflammatory syndrome, hydro-electrolytic disorders, and toxicity secondary to the uremic environment. Cardiovascular complications are the leading cause of death for these patients. Ischemic cardiac pathology can be both a consequence and complication of chronic kidney disease, highlighting the need to identify specific cardiorenal dysfunction biomarkers targeting pathophysiological mechanisms common to both conditions. This identification is crucial for establishing accurate diagnoses, prognoses, and risk stratifications for patients. This work is intended to elucidate the intricate relationship between chronic kidney disease and ischemic heart disease and to investigate the roles of cardiorenal biomarkers, including cardiac troponin, natriuretic peptides, galectin-3, copeptin, fibroblast growth factor 23 and its co-receptor Klotho, soluble suppression of tumorigenicity 2, and plasma growth differentiation factor 15.
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Affiliation(s)
- Maria-Ruxandra Cepoi
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Stefania Teodora Duca
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Adriana Chetran
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Alexandru Dan Costache
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iași, Romania
| | - Marilena Renata Spiridon
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Irina Afrăsânie
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Sabina Andreea Leancă
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Bianca-Ana Dmour
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of III Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Iulian Theodor Matei
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Radu Stefan Miftode
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Larisa Miftode
- Department of Infectious Diseases, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (L.M.); (C.S.P.)
- “St. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iași, Romania
| | - Cristian Sorin Prepeliuc
- Department of Infectious Diseases, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (L.M.); (C.S.P.)
- “St. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iași, Romania
| | - Mihai Ștefan Cristian Haba
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
| | - Minerva Codruța Bădescu
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of III Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Irina Iuliana Costache
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (M.-R.C.); (S.T.D.); (A.C.); (I.A.); (S.A.L.); (B.-A.D.); (I.T.M.); (R.S.M.); (M.Ș.C.H.); (M.C.B.); (I.I.C.)
- Department of Cardiology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania;
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Bernardor J, De Mul A, Bacchetta J, Schmitt CP. Impact of Cinacalcet and Etelcalcetide on Bone Mineral and Cardiovascular Disease in Dialysis Patients. Curr Osteoporos Rep 2023; 21:193-204. [PMID: 36848027 DOI: 10.1007/s11914-023-00782-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
PURPOSES OF REVIEW With chronic kidney disease (CKD) progression, secondary hyperparathyroidism (sHPT) and mineral and bone metabolism disease (MBD) almost inevitably develop and result in renal osteodystrophy and cardiovascular disease (CVD). Together with active vitamin D, calcimimetics are the main therapy for sHPT in CKD. This review provides an overview of the therapeutic effects of oral cinacalcet and intravenous etelcalcetide on CKD-MBD and vascular disease, with a focus on pediatric dialysis patients. RECENT FINDINGS Randomized controlled trials in adults and children demonstrate efficient lowering of parathyroid hormone (PTH) by the calcimimetics together with a reduction in serum calcium and phosphate when combined with low-dose active vitamin D, while therapy with active vitamin D analogs alone increases serum calcium and phosphate. Cinacalcet and etelcalcetide both improve bone formation and correct adynamic bone, i.e., have a direct bone anabolic effect. They decrease serum calciprotein particles, which are involved in endothelial dysfunction, atherogenesis, and vascular calcification. Clinical trials in adults suggest a modest slowing of the progression of cardiovascular calcification with cinacalcet. Calcimimetic agents represent a major pharmacological tool for improved control of CKD-MBD, by efficiently counteracting sHPT and allowing for better control of calcium/phosphate and bone homeostasis. Albeit definite evidence is lacking, the beneficial effects of calcimimetics on CVD are promising. Routine use of cinacalcet has been suggested in children.
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Affiliation(s)
- Julie Bernardor
- UMR 1033, Faculté de Médecine Lyon Est, INSERM, Université Claude Bernard Lyon1, Lyon, France.
- Centre de Référence Des Maladies Rares du Calcium Et du Phosphate, Filière Maladies Rares OSCAR, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.
- Centre de Référence Des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Filières Maladies Rares ORKID Et ERK-Net, Bron, France.
- Faculté de Médecine, Université de Nice Côte d'Azur, Nice, France.
- Unité d'hémodialyse Pédiatrique, CHU de Nice, Archet 2, 06202, Nice, France.
| | - Aurélie De Mul
- Centre de Référence Des Maladies Rares du Calcium Et du Phosphate, Filière Maladies Rares OSCAR, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- Centre de Référence Des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Filières Maladies Rares ORKID Et ERK-Net, Bron, France
- Pediatric Nephrology Unit, Geneva University Hospital, Geneva, Switzerland
| | - Justine Bacchetta
- UMR 1033, Faculté de Médecine Lyon Est, INSERM, Université Claude Bernard Lyon1, Lyon, France
- Centre de Référence Des Maladies Rares du Calcium Et du Phosphate, Filière Maladies Rares OSCAR, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- Centre de Référence Des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Filières Maladies Rares ORKID Et ERK-Net, Bron, France
- Faculté de Médecine Lyon Est, Université Claude Bernard, Lyon 1, Lyon, France
| | - Claus Peter Schmitt
- Department of Pediatrics I, University Children's Hospital, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany
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Szlagor M, Dybiec J, Młynarska E, Rysz J, Franczyk B. Chronic Kidney Disease as a Comorbidity in Heart Failure. Int J Mol Sci 2023; 24:ijms24032988. [PMID: 36769308 PMCID: PMC9918100 DOI: 10.3390/ijms24032988] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023] Open
Abstract
Heart failure (HF) is one of the greatest problems in healthcare and it often coexists with declining renal function. The pathophysiology between the heart and the kidneys is bidirectional. Common mechanisms leading to the dysfunction of these organs result in a vicious cycle of cardiorenal deterioration. It is also associated with difficulties in the treatment of aggravating HF and chronic kidney disease (CKD) and, as a consequence, recurrent hospitalizations and death. As the worsening of renal function has an undeniably negative impact on the outcomes in patients with HF, searching for new treatment strategies and identification of biomarkers is necessary. This review is focused on the pathomechanisms in chronic kidney disease in patients with HF and therapeutic strategies for co-existing CKD and HF.
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Affiliation(s)
- Magdalena Szlagor
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Jill Dybiec
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
- Correspondence: ; Tel.: +48-(042)-6393750
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Żeromskiego 113, 90-549 Łódź, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
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Calcium-Sensing Receptor (CaSR)-Mediated Intracellular Communication in Cardiovascular Diseases. Cells 2022; 11:cells11193075. [PMID: 36231037 PMCID: PMC9562006 DOI: 10.3390/cells11193075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/31/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
The calcium-sensing receptor (CaSR), a G-protein-coupled receptor (GPCR), is a cell-surface-located receptor that can induce highly diffusible messengers (IP3, Ca2+, cAMP) in the cytoplasm to activate various cellular responses. Recently, it has also been suggested that the CaSR mediates the intracellular communications between the endoplasmic reticulum (ER), mitochondria, nucleus, protease/proteasome, and autophagy-lysosome, which are involved in related cardiovascular diseases. The complex intracellular signaling of this receptor challenges it as a valuable therapeutic target. It is, therefore, necessary to understand the mechanisms behind the signaling characteristics of this receptor in intracellular communication. This review provides an overview of the recent research progress on the various regulatory mechanisms of the CaSR in related cardiovascular diseases and the heart-kidney interaction; the associated common causes are also discussed.
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Bartosova M, Zarogiannis SG, Schmitt CP. How peritoneal dialysis transforms the peritoneum and vasculature in children with chronic kidney disease-what can we learn for future treatment? Mol Cell Pediatr 2022; 9:9. [PMID: 35513740 PMCID: PMC9072612 DOI: 10.1186/s40348-022-00141-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/09/2022] [Indexed: 01/04/2023] Open
Abstract
Children with chronic kidney disease (CKD) suffer from inflammation and reactive metabolite-induced stress, which massively accelerates tissue and vascular aging. Peritoneal dialysis (PD) is the preferred dialysis mode in children, but currently used PD fluids contain far supraphysiological glucose concentrations for fluid and toxin removal and glucose degradation products (GDP). While the peritoneal membrane of children with CKD G5 exhibits only minor alterations, PD fluids trigger numerous molecular cascades resulting in major peritoneal membrane inflammation, hypervascularization, and fibrosis, with distinct molecular and morphological patterns depending on the GDP content of the PD fluid used. PD further aggravates systemic vascular disease. The systemic vascular aging process is particularly pronounced when PD fluids with high GDP concentrations are used. GDP induce endothelial junction disintegration, apoptosis, fibrosis, and intima thickening. This review gives an overview on the molecular mechanisms of peritoneal and vascular transformation and strategies to improve peritoneal and vascular health in patients on PD.
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Affiliation(s)
- Maria Bartosova
- Center for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Sotirios G Zarogiannis
- Center for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany.,Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Claus Peter Schmitt
- Center for Pediatric and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany.
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Labissiere X, Zigmond ZM, Challa A, Montoya C, Manzur-Pineda K, Abraham A, Tabbara M, Salama A, Pan Y, Salman LH, Yang X, Vazquez-Padron RI, Martinez L. Vein morphometry in end-stage kidney disease: Teasing out the contribution of age, comorbidities, and vintage to chronic wall remodeling. Front Cardiovasc Med 2022; 9:1005030. [PMID: 36419492 PMCID: PMC9676677 DOI: 10.3389/fcvm.2022.1005030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a highly comorbid condition with significant effects on vascular health and remodeling. Upper extremity veins are important in end-stage kidney disease (ESKD) due to their potential use to create vascular accesses. However, unlike arteries, the contribution of CKD-associated factors to the chronic remodeling of veins has been barely studied. Methods We measured morphometric parameters in 315 upper extremity veins, 131 (85% basilic) from stage 5 CKD/ESKD patients and 184 (89% basilic) from non-CKD organ donors. Associations of demographic and clinical characteristics with intimal hyperplasia (IH) and medial fibrosis were evaluated using multivariate regression models. Results The study cohort included 33% females, 30% blacks, 32% Hispanics, and 37% whites. Over 60% had hypertension, and 25% had diabetes independent of CKD status. Among kidney disease participants, 26% had stage 5 CKD, while 22 and 52% had ESKD with and without history of a previous arteriovenous fistula/graft (AVF/AVG), respectively. Intimal hyperplasia was associated with older age (β = 0.13 per year, confidence interval [CI] = 0.002-0.26), dialysis vintage > 12 months (β = 0.22, CI = 0.09-0.35), and previous AVF/AVG creation (β = 0.19, CI = 0.06-0.32). Upper quartile values of IH were significantly associated with diabetes (odds ratio [OR] = 2.02, CI = 1.08-3.80), which demonstrated an additive effect with previous AVF/AVG history and longer vintage in exacerbating IH. Medial fibrosis also increased as a function of age (β = 0.17, CI = 0.04-0.30) and among patients with diabetes (β = 0.15, CI = 0.03-0.28). Age was the predominant factor predicting upper quartile values of fibrosis (OR = 1.03 per year, CI = 1.01-1.05) independent of other comorbidities. Conclusion Age and diabetes are the most important risk factors for chronic development of venous IH and fibrosis independent of CKD status. Among kidney disease patients, longer dialysis vintage, and history of a previous AVF/AVG are strong predictors of IH.
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Affiliation(s)
- Xochilt Labissiere
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Zachary M Zigmond
- Bruce W. Carter Veterans Affairs Medical Center, Miami, FL, United States
| | - Akshara Challa
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Christopher Montoya
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Karen Manzur-Pineda
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Amalia Abraham
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Marwan Tabbara
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Alghidak Salama
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Yue Pan
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Loay H Salman
- Division of Nephrology, Albany Medical College, Albany, NY, United States
| | - Xiaofeng Yang
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Roberto I Vazquez-Padron
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States.,Bruce W. Carter Veterans Affairs Medical Center, Miami, FL, United States
| | - Laisel Martinez
- DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
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Rapp N, Brandenburg VM, Kaesler N, Bakker SJL, Stöhr R, Schuh A, Evenepoel P, Schurgers LJ. Hepatic and Vascular Vitamin K Status in Patients with High Cardiovascular Risk. Nutrients 2021; 13:3490. [PMID: 34684491 PMCID: PMC8539359 DOI: 10.3390/nu13103490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/17/2021] [Accepted: 09/28/2021] [Indexed: 01/17/2023] Open
Abstract
Vitamin K dependent proteins (VKDP), such as hepatic coagulation factors and vascular matrix Gla protein (MGP), play key roles in maintaining physiological functions. Vitamin K deficiency results in inactive VKDP and is strongly linked to vascular calcification (VC), one of the major risk factors for cardiovascular morbidity and mortality. In this study we investigated how two vitamin K surrogate markers, dephosphorylated-undercarboxylated MGP (dp-ucMGP) and protein induced by vitamin K absence II (PIVKA-II), reflect vitamin K status in patients on hemodialysis or with calcific uremic arteriolopathy (CUA) and patients with atrial fibrillation or aortic valve stenosis. Through inter- and intra-cohort comparisons, we assessed the influence of vitamin K antagonist (VKA) use, vitamin K supplementation and disease etiology on vitamin K status, as well as the correlation between both markers. Overall, VKA therapy was associated with 8.5-fold higher PIVKA-II (0.25 to 2.03 AU/mL) and 3-fold higher dp-ucMGP (843 to 2642 pM) levels. In the absence of VKA use, non-renal patients with established VC have dp-ucMGP levels similar to controls (460 vs. 380 pM), while in HD and CUA patients, levels were strongly elevated (977 pM). Vitamin K supplementation significantly reduced dp-ucMGP levels within 12 months (440 to 221 pM). Overall, PIVKA-II and dp-ucMGP showed only weak correlation (r2 ≤ 0.26) and distinct distribution pattern in renal and non-renal patients. In conclusion, VKA use exacerbated vitamin K deficiency across all etiologies, while vitamin K supplementation resulted in a vascular VKDP status better than that of the general population. Weak correlation of vitamin K biomarkers calls for thoughtful selection lead by the research question. Vitamin K status in non-renal deficient patients was not anomalous and may question the role of vitamin K deficiency in the pathogenesis of VC in these patients.
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Affiliation(s)
- Nikolas Rapp
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
| | | | - Nadine Kaesler
- Department of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, 52074 Aachen, Germany;
- Institute of Experimental Medicine and Systems Biology, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Stephan J. L. Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - Robert Stöhr
- Department of Cardiology, University Hospital of the RWTH Aachen, 52074 Aachen, Germany; (R.S.); (A.S.)
| | - Alexander Schuh
- Department of Cardiology, University Hospital of the RWTH Aachen, 52074 Aachen, Germany; (R.S.); (A.S.)
| | - Pieter Evenepoel
- Department of Microbiology, Immunology and Transplantation, Laboratory of Nephrology, KU Leuven and University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Leon J. Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Institute of Experimental Medicine and Systems Biology, RWTH Aachen University Hospital, 52074 Aachen, Germany
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Selma-Soriano E, Casillas-Serra C, Artero R, Llamusi B, Navarro JA, Redón J. Rabphilin silencing causes dilated cardiomyopathy in a Drosophila model of nephrocyte damage. Sci Rep 2021; 11:15287. [PMID: 34315987 PMCID: PMC8316431 DOI: 10.1038/s41598-021-94710-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/14/2021] [Indexed: 11/10/2022] Open
Abstract
Heart failure (HF) and the development of chronic kidney disease (CKD) have a direct association. Both can be cause and consequence of the other. Many factors are known, such as diabetes or hypertension, which can lead to the appearance and/or development of these two conditions. However, it is suspected that other factors, namely genetic ones, may explain the differences in the manifestation and progression of HF and CKD among patients. One candidate factor is Rph, a gene expressed in the nervous and excretory system in mammals and Drosophila, encoding a Rab small GTPase family effector protein implicated in vesicular trafficking. We found that Rph is expressed in the Drosophila heart, and the silencing of Rph gene expression in this organ had a strong impact in the organization of fibers and functional cardiac parameters. Specifically, we observed a significant increase in diastolic and systolic diameters of the heart tube, which is a phenotype that resembles dilated cardiomyopathy in humans. Importantly, we also show that silencing of Rabphilin (Rph) expression exclusively in the pericardial nephrocytes, which are part of the flies' excretory system, brings about a non-cell-autonomous effect on the Drosophila cardiac system. In summary, in this work, we demonstrate the importance of Rph in the fly cardiac system and how silencing Rph expression in nephrocytes affects the Drosophila cardiac system.
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Affiliation(s)
- Estela Selma-Soriano
- INCLIVA Biomedical Research Institute, 46010, Valencia, Spain.,Department of Genetics, University of Valencia, 46100, Burjassot, Spain
| | - Carlos Casillas-Serra
- INCLIVA Biomedical Research Institute, 46010, Valencia, Spain.,Department of Genetics, University of Valencia, 46100, Burjassot, Spain
| | - Rubén Artero
- INCLIVA Biomedical Research Institute, 46010, Valencia, Spain. .,Institute for Biotechnology and Biomedicine (BIOTECMED), University of Valencia, 46100, Burjassot, Spain. .,CIPF-INCLIVA Joint Unit, Valencia, Spain.
| | - Beatriz Llamusi
- INCLIVA Biomedical Research Institute, 46010, Valencia, Spain.,Institute for Biotechnology and Biomedicine (BIOTECMED), University of Valencia, 46100, Burjassot, Spain.,CIPF-INCLIVA Joint Unit, Valencia, Spain
| | - Juan Antonio Navarro
- INCLIVA Biomedical Research Institute, 46010, Valencia, Spain.,Department of Genetics, University of Valencia, 46100, Burjassot, Spain
| | - Josep Redón
- INCLIVA Biomedical Research Institute, 46010, Valencia, Spain.,Hypertension Unit, Hospital Clínico Universitario, 46010, Valencia, Spain.,CIBERObn, Health Institute Carlos III, Madrid, Spain
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9
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Querfeld U. Cardiovascular disease in childhood and adolescence: Lessons from children with chronic kidney disease. Acta Paediatr 2021; 110:1125-1131. [PMID: 33080082 DOI: 10.1111/apa.15630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 11/26/2022]
Abstract
Children suffering from chronic kidney disease (CKD) have the apparent highest risk for the development of cardiovascular disease (CVD) at a young age. While symptoms of CVD are characteristically absent in childhood and adolescence, remodelling of the myocardium, medium and large-sized arteries and of the microcirculation is clinically significant and can be assessed with non-invasive technology. Kidney disease and its progression are the driver of CVD, mediated by an unparalleled accumulation of risk factors converging on several comorbid conditions including hypertension, anaemia, dyslipidaemia, disturbed mineral metabolism and chronic persistent inflammation. Large prospective paediatric cohorts studies have provided valuable insights into the pathogenesis and the progression of CKD-induced cardiovascular comorbidity and have characterised the cardiovascular phenotype in young patients. They have also provided the rationale for close monitoring of risk factors and have defined therapeutic targets. Recently discovered new biomarkers could help identify the individual risk for CVD. Prevention of CVD by aggressive therapy of modifiable risk factors is essential to enable long-term survival of young patients with CKD.
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Affiliation(s)
- Uwe Querfeld
- Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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10
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Ortega MA, Asúnsolo Á, Pekarek L, Alvarez-Mon MA, Delforge A, Sáez MA, Coca S, Sainz F, Mon MÁ, Buján J, García-Honduvilla N. Histopathological study of JNK in venous wall of patients with chronic venous insufficiency related to osteogenesis process. Int J Med Sci 2021; 18:1921-1934. [PMID: 33850461 PMCID: PMC8040408 DOI: 10.7150/ijms.54052] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/11/2021] [Indexed: 12/14/2022] Open
Abstract
Chronic venous insufficiency (CVI) is one of the most common vascular pathologies worldwide. One of the risk factors for the development of CVI is aging, which is why it is related to senile changes. The main trigger of the changes that occur in the venous walls in CVI is blood flow reflux, which produces increased hydrostatic pressure, leading to valve incompetence. The cellular response is one of the fundamental processes in vascular diseases, causing the activation of cell signalling pathways such as c-Jun N-terminal kinase (JNK). Metabolic changes and calcifications occur in vascular pathology as a result of pathophysiological processes. The aim of this study was to determine the expression of JNK in venous disease and its relationship with the role played by the molecules involved in the osteogenic processes in venous tissue calcification. This was a cross-sectional study that analyzed the greater saphenous vein wall in 110 patients with (R) and without venous reflux (NR), classified according to age. Histopathological techniques were used and protein expression was analysed using immunohistochemistry techniques for JNK and markers of osteogenesis (RUNX2, osteocalcin (OCN), osteopontin (OPN)). Significantly increased JNK, RUNX2, OCN, OPN and pigment epithelium-derived factor (PEDF) protein expression and the presence of osseous metaplasia and amorphous calcification were observed in younger patients (<50 years) with venous reflux. This study shows for the first time the existence of an osteogenesis process related to the expression of JNK in the venous wall.
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Affiliation(s)
- Miguel A Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Ramón y Cajal Institute of Healthcare Research (IRYCIS), Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Ángel Asúnsolo
- Ramón y Cajal Institute of Healthcare Research (IRYCIS), Madrid, Spain
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Leonel Pekarek
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Miguel A Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Arnaud Delforge
- UFR of pharmacy, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Miguel A Sáez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Pathological Anatomy Service, Central University Hospital of Defence-UAH Madrid, Spain
| | - Santiago Coca
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Felipe Sainz
- Ramón y Cajal Institute of Healthcare Research (IRYCIS), Madrid, Spain
- Angiology and Vascular Surgery Service, Central University Hospital of Defence-UAH Madrid, Spain
| | - Melchor Álvarez- Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service and Internal Medicine, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Julia Buján
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain
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11
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Unterschemmann K, Ehrmann A, Herzig I, Andreevski AL, Lustig K, Schmeck C, Eitner F, Grundmann M. Pharmacological inhibition of Vanin-1 is not protective in models of acute and chronic kidney disease. Am J Physiol Renal Physiol 2021; 320:F61-F73. [PMID: 33196323 DOI: 10.1152/ajprenal.00373.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/08/2020] [Indexed: 12/31/2022] Open
Abstract
Oxidative stress is a key concept in basic, translational, and clinical research to understand the pathophysiology of various disorders, including cardiovascular and renal diseases. Although attempts to directly reduce oxidative stress with redox-active substances have until now largely failed to prove clinical benefit, indirect approaches to combat oxidative stress enzymatically have gained further attention as potential therapeutic strategies. The pantetheinase Vanin-1 is expressed on kidney proximal tubular cells, and its reaction product cysteamine is described to negatively affect redox homeostasis by inhibiting the replenishment of cellular antioxidative glutathione stores. Vanin-1-deficient mice were shown to be protected against oxidative stress damage. The aim of this study was to elucidate whether pharmacological inhibition of Vanin-1 protects mice from oxidative stress-related acute or chronic kidney injury as well. By studying renal ischemia-reperfusion injury in Col4α3-/- (Alport syndrome) mice and in vitro hypoxia-reoxygenation in human proximal tubular cells we found that treatment with a selective and potent Vanin-1 inhibitor resulted in ample inhibition of enzymatic activity in vitro and in vivo. However, surrogate parameters of metabolic and redox homeostasis were only partially and insufficiently affected. Consequently, apoptosis and reactive oxygen species level in tubular cells as well as overall kidney function and fibrotic processes were not improved by Vanin-1 inhibition. We thus conclude that Vanin-1 functionality in the context of cardiovascular diseases needs further investigation and the biological relevance of pharmacological Vanin-1 inhibition for the treatment of kidney diseases remains to be proven.
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MESH Headings
- Acute Kidney Injury/enzymology
- Acute Kidney Injury/genetics
- Acute Kidney Injury/pathology
- Acute Kidney Injury/prevention & control
- Amidohydrolases/antagonists & inhibitors
- Amidohydrolases/genetics
- Amidohydrolases/metabolism
- Animals
- Apoptosis/drug effects
- Autoantigens/genetics
- Autoantigens/metabolism
- Cell Line
- Collagen Type IV/genetics
- Collagen Type IV/metabolism
- Disease Models, Animal
- Enzyme Inhibitors/pharmacokinetics
- Enzyme Inhibitors/pharmacology
- Fibrosis
- GPI-Linked Proteins/antagonists & inhibitors
- GPI-Linked Proteins/genetics
- GPI-Linked Proteins/metabolism
- Humans
- Kidney Tubules, Proximal/drug effects
- Kidney Tubules, Proximal/enzymology
- Kidney Tubules, Proximal/pathology
- Male
- Mice, Inbred C57BL
- Mice, Knockout
- Nephritis, Hereditary/enzymology
- Nephritis, Hereditary/genetics
- Nephritis, Hereditary/pathology
- Nephritis, Hereditary/prevention & control
- Oxidative Stress/drug effects
- Renal Insufficiency, Chronic/enzymology
- Renal Insufficiency, Chronic/genetics
- Renal Insufficiency, Chronic/pathology
- Renal Insufficiency, Chronic/prevention & control
- Reperfusion Injury/enzymology
- Reperfusion Injury/genetics
- Reperfusion Injury/pathology
- Reperfusion Injury/prevention & control
- Mice
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Affiliation(s)
| | | | - Ina Herzig
- Drug Discovery Sciences, Bayer Pharmaceuticals, Wuppertal, Germany
| | | | - Klemens Lustig
- Research and Early Development, Bayer Pharmaceuticals, Wuppertal, Germany
| | - Carsten Schmeck
- Drug Discovery Sciences, Bayer Pharmaceuticals, Wuppertal, Germany
| | - Frank Eitner
- Research and Early Development, Bayer Pharmaceuticals, Wuppertal, Germany
| | - Manuel Grundmann
- Research and Early Development, Bayer Pharmaceuticals, Wuppertal, Germany
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12
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Kaesler N, Babler A, Floege J, Kramann R. Cardiac Remodeling in Chronic Kidney Disease. Toxins (Basel) 2020; 12:toxins12030161. [PMID: 32150864 PMCID: PMC7150902 DOI: 10.3390/toxins12030161] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/19/2022] Open
Abstract
Cardiac remodeling occurs frequently in chronic kidney disease patients and affects quality of life and survival. Current treatment options are highly inadequate. As kidney function declines, numerous metabolic pathways are disturbed. Kidney and heart functions are highly connected by organ crosstalk. Among others, altered volume and pressure status, ischemia, accelerated atherosclerosis and arteriosclerosis, disturbed mineral metabolism, renal anemia, activation of the renin-angiotensin system, uremic toxins, oxidative stress and upregulation of cytokines stress the sensitive interplay between different cardiac cell types. The fatal consequences are left-ventricular hypertrophy, fibrosis and capillary rarefaction, which lead to systolic and/or diastolic left-ventricular failure. Furthermore, fibrosis triggers electric instability and sudden cardiac death. This review focuses on established and potential pathophysiological cardiorenal crosstalk mechanisms that drive uremia-induced senescence and disease progression, including potential known targets and animal models that might help us to better understand the disease and to identify novel therapeutics.
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Affiliation(s)
- Nadine Kaesler
- Clinic for Renal and Hypertensive Disorders, Rheumatological and Immunological Disease, University Hospital of the RWTH Aachen, 52074 Aachen, Germany
| | - Anne Babler
- Clinic for Renal and Hypertensive Disorders, Rheumatological and Immunological Disease, University Hospital of the RWTH Aachen, 52074 Aachen, Germany
| | - Jürgen Floege
- Clinic for Renal and Hypertensive Disorders, Rheumatological and Immunological Disease, University Hospital of the RWTH Aachen, 52074 Aachen, Germany
| | - Rafael Kramann
- Clinic for Renal and Hypertensive Disorders, Rheumatological and Immunological Disease, University Hospital of the RWTH Aachen, 52074 Aachen, Germany
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
- Correspondence:
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