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NDT Advance Access published online on July 23, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp358
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Dialysis modality is independently associated with circulating endothelial progenitor cells in end-stage renal diseases patients

Hiroki Ueno1, Hidenori Koyama1, Shinya Fukumoto1, Shinji Tanaka1, Takuhito Shoji1, Tetsuo Shoji1, Masanori Emoto1, Hideki Tahara1, Yoshihiro Tsujimoto2, Tsutomu Tabata2 and Yoshiki Nishizawa1

1 Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka 545-8585 2 Division of Internal Medicine, Inoue Hospital, Suita 564-0053, Japan

Correspondence and offprint requests to: Hidenori Koyama; E-mail: hidekoyama{at}med.osaka-cu.ac.jp



  Abstract

Background. Numbers of endothelial progenitor cells (EPC) have been shown to be decreased in subjects with end-stage renal disease (ESRD). It is not clear, however, whether dialysis modality affects circulating EPCs in ESRD subjects.

Methods. We examined the number of circulating EPCs in 67 continuous ambulatory peritoneal dialysis (CAPD) patients and age- and gender-matched 142 haemodialysis (HD) patients, and 78 subjects without chronic kidney disease. Arterial stiffness was analysed as pulse-wave velocity (PWV) for these patients, and their mutual relationship with circulating EPCs was examined. EPCs were measured as CD34+ CD133+ CD45low VEGFR2+ cells determined by flow cytometry.

Results. The EPC numbers exhibited a strong correlation (R2 = 0.866) with endothelial-colony forming units on culture assay. The levels of EPCs in HD or CAPD subjects were significantly lower than those in control subjects. Among ESRD subjects, the levels of EPC were significantly higher in CAPD subjects than those in HD subjects. In ESRD subjects, PWV levels tended to be associated with EPCs (Rs = –0.131, P = 0.058). However, the significant relationship between dialysis modality and circulating EPCs was independent of the levels of PWV. The association of circulating EPCs with dialysis modality was significant even after adjusting for other potential confounders, including age, gender, blood pressure, history of cardiovascular diseases, presence of diabetes, blood haemoglobin level and treatments with angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker or statin.

Conclusions. CAPD treatment could be a positive regulator of number of circulating EPCs in subjects with ESRD, with the relationship independent of the status of arteriosclerosis.

Keywords: arteriosclerosis; diabetes mellitus; endothelial cells; haemodialysis; peritoneal dialysis

Received for publication: 25.11.08
Accepted in revised form: 29. 6.09


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