ABSTRACT
INTRODUCTION: Although arteriovenous fistula (AVF) is the recommended access for hemodialysis (HD), it carries a high risk for stenosis. Since osteopontin (OPN) is implicated in the process of vascular calcification in HD patients, OPN may be a marker for AVF stenosis. The present study evaluated OPN as a potential marker of AVF stenosis in HD patients. METHODS: Diagnosing a stenotic lesion was made by combining B mode with color and pulse wave Doppler imaging. Criteria for diagnosis of stenotic AVF included 50% reduction in diameter in B mode in combination with a 2-3-fold increase of peak systolic velocity compared with the unaffected segment. RESULTS: The present study included 60 HD patients with stenotic AVF and 60 patients with functional AVF. Comparison between the two groups revealed that patients in the former group had significantly higher serum OPN levels [median (IQR): 17.1 (12.1-30.4) vs 5.8 (5.0-10.0) ng/mL, p<0.001]. All patients were classified into those with low (< median) and with high (≥ median) OPN levels. Comparison between these groups revealed that the former group had a significantly lower frequency of stenotic AVF (31.7 vs 68.3%, p<0.001) and a longer time to AVF stenosis [mean (95% CI): 68.4 (54.7-82.1) vs 46.5 (39.6-53.4) months, p=0.001]. CONCLUSION: OPN levels in HD patients may be useful markers for predicting and detecting AVF stenosis.
Subject(s)
Arteriovenous Shunt, Surgical , Kidney Failure, Chronic , Vascular Diseases , Humans , Arteriovenous Shunt, Surgical/adverse effects , Constriction, Pathologic , Osteopontin , Renal Dialysis/adverse effects , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/therapyABSTRACT
Systemic Lupus Erythematosus is systematic auto-immune disease characterized by abnormal activation of B cell with production of autoantibodies. Due to its heterogeneous course, there is a need for new markers to help in diagnosing and monitoring disease activity. The aim of this study was to identify the immunopathological role of CD19 and CD81 expression in patients with SLE and their correlation with the disease activity. Peripheral blood (PB) was collected from 40 SLE patients (20 active and 20 inactive) and 20 controls. All were subjected to CBC, Anti-ds DNA, Redial immunodiffusion (RID) for C3 and C4 as activity markers, and detection of CD19 and CD81 surface expression using flow cytometry. CD19 and CD81 were significantly reduced and correlated with disease activity. It is concluded that CD 19 and CD 81 are potential markers for diagnosing and monitoring SLE patients.
