Novel links between the long pentraxin 3, endothelial dysfunction, and albuminuria in early and advanced chronic kidney disease

Clin J Am Soc Nephrol. 2008 Jul;3(4):976-85. doi: 10.2215/CJN.03960907. Epub 2008 Apr 16.

Abstract

Background and objectives: Albuminuria and inflammation predict cardiovascular events. Pentraxin 3, an inflammatory mediator produced by, among others, endothelial cells, may have a role in atherogenesis.

Design, setting, participants, & measurements: In 207 Swedish patients with stage 5 chronic kidney disease and 79 Turkish patients with type 2 diabetes and proteinuria and normal renal function, whether serum pentraxin 3 levels are associated with albuminuria and endothelial dysfunction was studied.

Results: Patients with stage 5 chronic kidney disease and a high degree of albuminuria more often had diabetes and higher levels of pentraxin 3, vascular cellular adhesion molecule-1, and blood pressure. Moreover, pentraxin 3 was independently associated with 24-h urinary albumin excretion. In patients with type 2 diabetes, pentraxin 3 was significantly higher than in control subjects. Patients with type 2 diabetes and more proteinuria had higher pentraxin 3, C-reactive protein, glycosylated hemoglobin, insulin, and homeostasis model assessment index as well as lower flow-mediated dilation and serum albumin. Pentraxin 3 was positively correlated with C-reactive protein, homeostasis model assessment index, and carotid intima-media thickness and negatively with flow-mediated dilation. Pentraxin 3 and glomerular filtration rate were independently associated with 24-h urinary protein excretion. Only pentraxin 3 and proteinuria were significantly and independently associated with flow-mediated dilation.

Conclusions: In two different renal cohorts, one of stage 5 chronic kidney disease and one of type 2 diabetes and normal renal function, pentraxin 3 was independently associated with proteinuria. Moreover, both pentraxin 3 and proteinuria were associated with endothelial dysfunction in patients with type 2 diabetes.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria / etiology*
  • Albuminuria / metabolism
  • Albuminuria / pathology
  • Albuminuria / physiopathology
  • Blood Pressure
  • C-Reactive Protein / metabolism*
  • Carotid Arteries / diagnostic imaging
  • Chronic Disease
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / pathology
  • Diabetes Mellitus, Type 2* / physiopathology
  • Disease Progression
  • Endothelium, Vascular / metabolism
  • Endothelium, Vascular / pathology
  • Endothelium, Vascular / physiopathology*
  • Female
  • Glomerular Filtration Rate
  • Glycated Hemoglobin / metabolism
  • Humans
  • Insulin / blood
  • Kidney Diseases* / complications
  • Kidney Diseases* / metabolism
  • Kidney Diseases* / pathology
  • Kidney Diseases* / physiopathology
  • Male
  • Middle Aged
  • Serum Amyloid P-Component / metabolism*
  • Severity of Illness Index
  • Sweden
  • Turkey
  • Ultrasonography
  • Vascular Cell Adhesion Molecule-1 / blood
  • Vasodilation*

Substances

  • Glycated Hemoglobin A
  • Insulin
  • Serum Amyloid P-Component
  • Vascular Cell Adhesion Molecule-1
  • PTX3 protein
  • C-Reactive Protein