Assessment of the role of transforming growth factor-beta1, sialic acid, and C-reactive protein in end-stage renal disease premature atherosclerosis

Abstract

Atherogenesis is accelerated in patients with end stage renal disease. Multiple risk factors for atherosclerosis in patients with end stage renal disease may play an important role in the development and progression of the lesion.

The aim of the present work was to elucidate any possible relationship of transforming growth factor-beta₁ (TGF-β₁), C-reactive protein (CRP), and sialic acid to the development of end stage renal disease atherosclerosis. To achieve this goal, this study included 10 end stage renal disease patients on bicarbonate hemodialysis three times weekly for less than 5 years (group I), 10 end stage renal disease patients on conservative treatment (group II), in addition to the 10 healthy volunteers (group III). All studied patients and controls were evaluated clinically and biochemically. Serum TGF-β₁, CRP, and sialic acid were estimated by ELISA, Radial immunodiffusion plates and chemical method, respectively. Echo-Doppler study of the common and the internal carotid arteries was performed for the detection of the late as well as the trivial atherosclerotic changes.

Statistical analysis of the results of the present study showed significantly higher serum levels of TGF-β₁, CRP and sialic acid in patients with end-stage renal disease atherosclerosis whether on hemodialysis or not- compared to end stage renal disease patients without atherosclerosis and healthy volunteers.

From this study we can conclude that elevated serum TGF-β₁ level in ESRD patients with atherosclerosis correlates with the atherogenesis process and probably plays a role in induction of atherosclerosis. Also, serum CRP is elevated in ESRD atherosclerosis and it may be considered as a marker for atherosclerosis in these patients provided that other causes of inflammation are excluded. Serum sialic acid level is also elevated in patients with ESRD atherosclerosis suggesting a possible role in the pathogenesis of the disease.