Arterial atherosclerosis in patients with chronic kidney disease and its relationship with serum and tissue

We investigated the correlation between atherosclerosis and tissue and serum levels of endothelin-1 in patients with chronic kidney disease [CKD]. Arterial samples were obtained from 35 patients with CKD during arteriovenous fistula placement. Thirty-one patients with cardiovascular disease who underwent coronary artery bypass graft [CABG] were selected as the atherosclerotic group, and a piece of their aorta punched during CABG was obtained. Also, a small piece of the renal artery was dissected during donation in 24 kidney donors [control group]. Tissue endothelin-1 level was measured and atherosclerosis grading was determined by pathologic examination. Serum levels of endothelin-1 were also measured in the three groups. The mean tissue endothelin-1 levels were 10.73 +/- 7.57 pg/ mL, 12.16 +/- 3.95 pg/mL, and 0.93 +/- 1.06 pg/mL in the patients with CKD, those with CABG, and donors, respectively [P < .001]. The mean serum endothelin-1 level was 25.23 +/- 15.15 pg/mL in the patients with CKD, 21.13 +/- 17.22 pg/mL in the patients with CABG, and 2.66 +/- 1.51 pg/mL in the donors [P < .001]. Atherosclerosis grades correlated with tissue endothelin-1 level [r = 0.823, P < .001] and serum endothelin-1 level [r = 0.608, P < .001] in the patients with CKD. Multiple regression analysis showed tissue endothelin-1 level as the main predicting factor of atherosclerosis [P < .001]. Tissue endothelin-1 concentration is more important than serum endothelin-1 or lipids levels in prediction of atherosclerosis. Thus, blockade of tissue endothelin-1 receptors with its antagonists may prevent atherosclerosis progression

Postnephrectomy changes in doppler indexes of remnant kidney in unrelated kidney donors

We aimed to evaluate the intralobar renal arteries indexes using the Doppler ultrasonography indexes, which have become the established method of kidney monitoring, in living unrelated kidney donors during the postnephrectomy period. In this prospective study, we evaluated and followed up 34 living unrelated kidney donors. The Doppler ultrasonography indexes, including resistive index, pulsatility index, and peak systolic velocity, along with the grey-scale ultrasonographic indexes of cortical thickness, length, and anteroposterior diameter of the kidney were determined before nephrectomy, and then, 1 week and 3 months after nephrectomy. In addition, glomerular filtration rate were assessed simultaneously. The resistive index and pulsatility index did not change 1 week and 3 months after nephrectomy [P = .66 and P = .38, respectively]. The peak systolic velocity at 1 week was significantly higher than its prenephrectomy value [P = .02]. Also, the peak systolic velocity at 3 months was significantly higher than that prior to nephrectomy [P < .00 1]. Indexes of the kidney size all increased during the follow-up period. The estimated glomerular filtration rate increased decreased 1 week after nephrectomy, but it reach to a level comparable with its preoperative values after 3 months. Results of the present study showed an increased peak systolic velocity in association with unaltered resistive index and pulsatility index in the remnant kidney of donors, during the short-term follow-up. This finding indicates the increased blood flow and kidney size in the remnant kidney of donors, following nephrectomy