ABSTRACT
Objective To study the relationship between the medial artery calcification and expression of core-binding factor alpha 1 (Cbf α-1) and collagen Ⅱ (Col Ⅱ) in chronic kidney disease (CKD) stage 5 patients.Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation.Ten patients with subtotal gastrectomy and normal renal function were chosen as control.The vessels were examined for calcification by von Kossa stain and for the presence of Cbfα-1 and Col Ⅱ by immunohistochemistry.According to von Kossa stain,CKD stage 5 patients were divided into no calcification group,mild-moderate calcification group and severe calcification group.Other related factors including serum calcium,phosphate,intact parathyroid hormone (iPTH),C-reactive protein (CRP),triglyceride(TG),cholesterol(TC) and lowdensity lipoproteins(LDL) were also detected.Results Seventeen (42.5％) of CKD Stage 5 patients showed vascular calcification,while calcification was not found in controls.Most calcification occurred in medial layer.Positive immunohistochemical staining of core-binding factor and Col Ⅱ was found in the smooth muscular cell plasma of medial layer in the vessels with calcification.However,above positive staining was also observed in 78.3％ of no calcification group.But there was little staining in control group.Positive staining score of Cbfα-1 and Col Ⅱ in severe calcification group was significantly higher than that in no calcification group.Same findings were obtained in mild-moderate calcification group,but the difference between them was not statistically significant.CRP and Ca × P were positively correlated with staining score of Cbfα-1 and Col Ⅱ.Serum phosphate was positively correlated with Cbfα-1 (r=0.786,P＜0.01) and Col Ⅱ (r=0.785,P＜0.01) respectively.Conclusions 42.5％ of CKD stage 5 patients in our group shows vascular calcification,which occurrs mainly in medial layer.High expression of Cbfα-1 and Col Ⅱ can be observed in vascular calcification of radial arteries,which is earlier than vascular histological changes.Cbfα-1 and Col Ⅱ may be involved in the development of vascular calcification.