Inflammation and endothelial dysfunction biomarkers in Chronic Kidney Disease (CKD) patients in Sokoto State, Nigeria

Abstract

Introduction: Inflammation and endothelial dysfunction have been known to be involved in the pathogenesis of cardiovascular diseases. As such, examining the levels of inflammation and endothelial dysfunction isverycritical to the prevention of cardiovascular diseases among chronic kidney disease (CKD) patients. This study aims to investigate the progression of inflammation and endothelial dysfunction among CKD patients in Sokoto.

Methods: A total of 67 CKD patients were divided into 5 groups based on the stages of their kidney disease calculated using the MDRD (Modification of Diet in Renal Disease) 4-variable equation for estimated glomerular filtration rate (eGFR). The presence of inflammation was determined by C-Reactive Protein (CRP) and Tumor Necrosis Factor alpha (TNF-α), while endothelial dysfunction was determined by the levels of Asymmetric dimethylarginine (ADMA) using ELISA kits.

Results: The mean eGFR of the patients was 49.97 ± 4.69 ml/min/1.73m². There was significant increase (p<0.05) in CRP, TNF-α and ADMA of the CKD patients across the stages as compared to the non-CKD subjects. It was observed that as the CRP, TNF-α and ADMA increase, the eGFR significantly (p<0.05) decreases. Both CRP and TNF-α indicated a significantly positive correlation (p<0.05) with ADMA.

Conclusion: The results indicated progressive increase in inflammation and endothelial dysfunction as CKD deteriorates. In addition, increased levels of inflammation could directly affect endothelial dysfunction, thereby aggravating cardiovascular morbidity and mortality among CKD patients in Sokoto.

Keywords: Cardiovascular disease, Chronic kidney disease, Endothelial dysfunction, Glomerular filtration rate, Inflammation