Study of endothelial vascular growth factor, markers of inflammation and vascular stiffness in chronic kidney disease
I.T. Murkamilov, K.A. Aitbaev, V.V. Fomin, Zh.A. Murkamilova, F.A. Yusupov, N.A. Redzhapova, Z.R. Rayimzhanov, A.I. Schastlivenko
1) Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek, Kyrgyzstan;
2) Kyrgyz Russian slavic university, Bishkek, Kyrgyzstan;
3) Scientific and research Institute of molecular biology and medicine, Bishkek, Kyrgyzstan;
4) FSAEI HE First Moscow State Medical University named after I.M. Sechenov, Moscow, Russia;
5) Osh State University, Osh, Kyrgyzstan;
6) Vitebsk State Order of Peoples Friendship Medical University, Vitebsk, Belarus
Purpose of the study. Assessment of the levels of vascular endothelial growth factor, markers of inflammation and their relationship with vascular stiffness indices in chronic kidney disease. Material and methods. 261 patient with chronic kidney disease (CKD) of stages 1–5 were examined, the average age was 51.3±15.8 years. Depending on the cause of the development of CKD, the entire sample was divided into several groups: 1st – arterial hypertension (AH) – 59 (22.6%); 2nd – diabetes mellitus (DM) – 46 patients (17.6%); 3rd – coronary heart disease (CHD) – 48 (18.4%); 4th – chronic obstructive pulmonary disease (COPD) – 23 (8.8%); 5th – chronic glomerulonephritis (CGN) – 38 (14.6%); 6th – chronic tubulointerstitial nephritis (ChTIN) – 47 (18.0%) and the 7th group – comorbid pathology – 97 (37.1%) cases. All participants underwent clinical, instrumental and laboratory studies. Vascular stiffness parameters, markers of inflammation, and the concentration of endothelial vascular growth factor (VEGF, pg/ml) were evaluated. Glomerular filtration rate (GFR) was calculated using the formula CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration).
Results. Levels of central blood pressure were significantly higher in individuals with CP. The highest stiffness index and alternative stiffness index were characteristic for patients with CGN and COPD. A significant increase in augmentation index and increase index at a pulse rate of 75 per minute was recorded in the groups of hypertension, type 2 diabetes and CP. Higher levels of the vascular wall reflection index were observed in patients with hypertension and CP. Median levels of total cholesterol (Ch), triglycerides and low density lipoproteins Ch (LDL Ch) in blood plasma were significantly higher in individuals with hypertension. The concentration of high density lipoprotein cholesterol was the lowest among patients with CGN. The proportion of patients with a high content of C-reactive protein (CRP) in blood plasma significantly prevailed in the groups of hypertension (81.3%) and coronary heart disease (79.1%). The median fibrinogen content was significantly higher in individuals with CP. The highest levels of phosphorus were observed among patients with type 2 diabetes and CGN, and calcium in the group of individuals with hypertension. Blood plasma VEGF concentration was significantly higher in the groups of CGN: 202.08 (91.42–356.48) pg/ml, ChTIN: 208.85 (113.11–355.09) pg/ml and KP: 213,54 (95.04–372.71) pg/ml, which was accompanied by an increase in blood plasma creatinine. The calculated GFR was significantly lower in individuals with type 2 diabetes: 46.5 (33.2–62.6) ml/min and CP: 62.0 (27.0–78.0) ml/min. A direct correlation relationship between the VEGF concentration and the value of the alternative vascular stiffness index (r=0.440; p<0.001) and fibrinogen (r=0.239; p<0.05) blood was established, and the feedback was correlated with the estimated GFR (r=-0.491; p<0.001). CRP levels positively correlated with an alternative vascular stiffness index (r=0.434; p<0.001).
Conclusions. A significant increase in the level of vascular endothelial growth factor was observed in patients with chronic tubulointerstitial nephritis and glomerulonephritis, as well as in individuals with comorbid pathology, which was accompanied by an increase in blood plasma creatinine. In chronic kidney disease, the level of endothelial vascular growth factor is a risk factor for a decrease in glomerular filtration rate and vascular stiffness. An increase in the content of C-reactive protein is associated with an increase in the rigidity of the vascular wall, and a concentration of endothelial vascular growth factor is associated with hyperfibrinogenemia.
About the Autors
Ilkhom T. Murkamilov – PhD in Medical Sciences, Nephrologist, Deputy Associate Professor at the Department of Faculty Therapy I.K. Akhunbaev KSMA, Kyrgyz-Russian Slavic University; Bishkek, Kyrgyzstan. E-mail: email@example.com, ORCID: 0000-0001-8513-9279
Kuvanych A. Aitbaev – Doctor of Medical Sciences, Professor, Head of the Laboratory of Pathological Physiology, Research Institute of Molecular Biology and Medicine; Bishkek, Kyrgyzstan. E-mail: firstname.lastname@example.org
Victor V. Fomin – Doctor of Medical Sciences, Professor, Corresponding Member of the Russian Academy of Sciences, Vice-Rector for Clinical Work and Postgraduate Professional Education, Director of the V.N. Vinogradov Faculty Therapy Clinic, Head of the Faculty Therapy Department № 1, Sechenov First MSMU; Moscow, Russia.
E-mail: email@example.com, ID: 34769949900
Zhamila A. Murkamilova – correspondence post-graduate student of the Department of Therapy № 2 of the specialty "General Medicine" Kyrgyz-Russian Slavic University n.a. the First President of the Russian Federation B.N. Yeltsin; Bishkek, Kyrgyzstan. Е-mail: firstname.lastname@example.org; ORCID:org/0000-0002-7653-0433
Furkat A. Yusupov – Doctor of Medical Sciences, Professor, Head of the Department of Neurology and Psychiatry, Faculty of Medicine, Osh State University; Osh, Kyrgyzstan. E-mail: email@example.com
Nodira A. Regzhapova – Postgraduate Student at the Department of Neurology and Psychiatry, Faculty of Medicine, Osh State University; Osh, Kyrgyzstan.
Zafarbek R. Rayimzhanov – correspondence graduate student of I.K. Akhunbaev KSMA, Kyrgyz-Russian Slavic University; Bishkek, Kyrgyzstan. E-mail: firstname.lastname@example.org; ORCID:org/0000-0001-5746-6731
Andrey I. Schastlivenko – PhD in Medical Sciences, associate professor of the department of general practitioner with a course of outpatient therapy, Vitebsk State Order of Friendship of Peoples Medical University; Vitebsk, Russia.