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NDT Advance Access published online on November 28, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl665
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Influence of haemodialysis and left ventricular failure on peripheral A2A adenosine receptor expression

Louis Carrega1,2, Emmanuel Fenouillet1, Philippe Giaime1,3, Annie Charavil2, Laurence Mercier2, Victoria Gerolami2, Jean-Louis Berge-Lefranc2, Yvon Berland3,5, Jean Ruf6, Alain Saadjian4, Bertrand Dussol3 and Regis Guieu1,2

1FRE2738, CNRS/Université de la Méditerranée, Faculté de Médecine Nord, Bd P. Dramard, 13015 Marseille, 2Laboratoire de Biochimie et Biologie Moléculaire du Secteur Centre, CHU Timone, 264, Rue Saint-Pierre, 13385 Marseille Cedex 05, 3Service de Néphrologie, CHU Conception, Bd Baille, 13005 Marseille, 4Service de Cardiologie, CHU Nord, Chemin des Bourrellys, 13015 Marseille, 5Centre d’Investigation Clinique, Hôpital Sainte Marguerite, Bd Sainte Marguerite 13009 Marseille and 6INSERM U 555, Faculté de Médecine, Universitée de la Méditerranée, Marseille, France

Correspondence and offprint requests to: R. Guieu, FRE2738 CNRS/Université de la Méditerranée, Faculté de Médecine Nord, Bd P. Dramard, 13015 Marseille, France. Email: guieu.regis{at}numericable.fr



  Abstract

Background. Haemodialysis (HD) sometimes accelerates left ventricular failure (LVF). As adenosine (ADO) is strongly implicated in cardiovascular functions, particularly via A2A receptor activation and as changes of peripheral A2A receptors mirror changes occurring in the cardiovascular system, we examined the influence of HD and LVF on both ADO plasma concentration and the expression of A2A receptors (i.e. Bmax, KD and mRNA amount) of peripheral blood mononuclear cells.

Methods. This cross-sectional study included 61 chronic renal failure (CRF) patients: 41 without LVF (24 haemodialysed and 17 undialysed) and 20 with LVF (9 haemodialysed and 11 undialysed). Ten LVF patients without CRF and 10 healthy subjects were also examined.

Results. (i) Bmax values of CRF patients without LVF were significantly decreased in undialysed patients compared with haemodialysed patients, and compared with controls (69 ± 25 vs 98 ± 33 vs 180 ± 60 fmol/mg of protein, P < 0.05). Bmax values of CRF patients with LVF were lower in undialysed patients than in haemodialysed patients (60 ± 27 vs 101 ± 27 fmol/mg of protein, P < 0.05). Bmax values of LVF patients without CRF were lower than in controls (51 ± 19 vs 180 ± 60 fmol/mg of protein). (ii) A2A mRNA expression was increased in haemodialysed patients compared with controls (20.2 ± 0.75 vs 17.6 ± 1.3, P < 0.05). (iii) ADO plasma levels were high in haemodialysed patients and further increased during the HD sessions.

Conclusion. The number of A2A receptors was decreased by CRF with or without LVF. However, this decrease was less important in haemodialysed patients. The changes in peripheral A2A receptor expression suggest a significant inflammatory response to HD and heart or kidney failure. Whether these changes do reflect alterations in cardiomyocytes needs further investigation.

Keywords: adenosine; cardiac failure; chronic renal failure; haemodialysis


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