Background: Cardiovascular disease in chronic kidney disease (CKD) has peculiar characteristics. The aim of this study was to analyze atherosclerosis, vascular calcification and nitration in arteries from CKD patients. Methods: External iliac and renal artery segments from 27 stage 5 CKD patients and 25 donor controls, respectively, were collected during the transplantation procedure. Results: CKD patients presented a significantly higher degree of lesion. In a large proportion (72%) of CKD patients, we observed vascular calcifications. Immunohistochemistry for nitrotyrosine revealed a significant increase in nitrotyrosine production in arteries from CKD patients compared with control donors. In addition, within CKD patients, nitrotyrosine staining was significantly stronger in arteries with media calcification when compared with arteries without media calcification. Conclusion: The arteriopathy in the CKD patients appears in an early age and seems to be distinct from the arteriopathy of the general population, especially due to intense calcification and vascular oxidative stress.

1.
Foley RN, Parfrey PS, Sarnak MJ: Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32:S112–S119.
2.
Pecoits-Filho R, Lindholm B, Stenvinkel P: The malnutrition, inflammation, and atherosclerosis (MIA) syndrome – the heart of the matter. Nephrol Dial Transplant 2002;17(suppl 11):28–31.
3.
Derici U, El Nahas AM: Vascular calcifications in uremia: old concepts and new insights. Semin Dial 2006;19:60–68.
4.
Shao JS, Cai J, Towler DA: Molecular mechanisms of vascular calcification: lessons learned from the aorta. Arterioscler Thromb Vasc Biol 2006;26:1423–1430.
5.
Buzello M, Tornig J, Faulhaber J, et al: The apolipoprotein e knockout mouse: a model documenting accelerated atherogenesis in uremia. J Am Soc Nephrol 2003;14:311–316.
6.
Yoshii T, Iwai M, Li Z, et al: Regression of atherosclerosis by amlodipine via anti-inflammatory and anti-oxidative stress actions. Hypertens Res 2006;29:457–466.
7.
Cheung AK, Sarnak MJ, Yan G, et al: Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients. Kidney Int 2000;58:353–362.
8.
Schwarz U, Buzello M, Ritz E, et al: Morphology of coronary atherosclerotic lesions in patients with end-stage renal failure. Nephrol Dial Transplant 2000;15:218–223.
9.
Stary HC: The Evolution of Human Atherosclerotic Lesions. West Point, Merck, 1993, pp 1–84.
10.
Seron D, Moreso F, Fulladosa X, et al: Reliability of chronic allograft nephropathy diagnosis in sequential protocol biopsies. Kidney Int 2002;61:727–733.
11.
Qunibi WY: Cardiovascular calcification in nondialyzed patients with chronic kidney disease. Semin Dial 2007;20:134–138.
12.
Goodman WG, Goldin J, Kuizon BD, et al: Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000;342:1478–1483.
13.
Beckman JS, Koppenol WH: Nitric oxide, superoxide, and peroxynitrite: the good, the bad, and ugly. Am J Physiol 1996;271:C1424–C1437.
14.
Cai H, Harrison DG: Endothelial dysfunction in cardiovascular diseases: the role of oxidant stress. Circ Res 2000;87:840–844.
15.
Kinlay S, Libby P, Ganz P: Endothelial function and coronary artery disease. Curr Opin Lipidol 2001;12:383–389.
16.
Ignarro LJ, Napoli C, Loscalzo J: Nitric oxide donors and cardiovascular agents modulating the bioactivity of nitric oxide: an overview. Circ Res 2002;90:21–28.
17.
Moncada S: Nitric oxide: discovery and impact on clinical medicine. J R Soc Med 1999;92:164–169.
18.
Peluffo G, Radi R: Biochemistry of protein tyrosine nitration in cardiovascular pathology. Cardiovasc Res 2007;75:291–302.
19.
Vaziri ND, Ni Z, Oveisi F, et al: Enhanced nitric oxide inactivation and protein nitration by reactive oxygen species in renal insufficiency. Hypertension 2002;39:135–141.
20.
Massy ZA, Borderie D, Nguyen-Khoa T, et al: Increased plasma S-nitrosothiol levels in chronic haemodialysis patients. Nephrol Dial Transplant 2003;18:153–157.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.