Microcirculatory function deteriorates with advancing stages of chronic kidney disease independently of arterial stiffness and atherosclerosis

Schoina, Maria; Loutradis, Charalampos; Memmos, Evangelos; Dimitroulas, Theodoros; Pagkopoulou, Eleni; Doumas, Michael; Karagiannis, Asterios; Garyfallos, Alexandros; Papagianni, Αikaterini; Sarafidis, Pantelis

doi:10.1038/s41440-020-0525-y

Cited by 20 publications

(26 citation statements)

References 39 publications

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“…Finally, in a very recent study of our group in 96 CKD stage 2–4 patients, we have demonstrated that both structural and functional capillary density progressively decreased with advancing CKD stages (Fig. 3); reduced eGFR, diabetes, and increased PTH levels are independently and inversely associated with functional capacity density [76].…”

Section: Assessment Of Endothelial Dysfunction In Ckd: Functional Metmentioning

confidence: 95%

“…The reduction in the density of capillaries in any given visual field is called capillary rarefaction and is categorized into 2 types: structural (i.e., decrease in overall number of capillaries) and functional (i.e., reduction in the number of perfused capillaries) rarefaction (Fig. 2) [74, 76]. Video capillaroscopy offers the advantage of evaluation of capillary density in 3 phases: baseline, during hyperemia after arterial occlusion (postocclusive reactive hyperemia), and after venous congestion (Table 1) [76].…”

Section: Assessment Of Endothelial Dysfunction In Ckd: Functional Metmentioning

confidence: 99%

“…2) [74, 76]. Video capillaroscopy offers the advantage of evaluation of capillary density in 3 phases: baseline, during hyperemia after arterial occlusion (postocclusive reactive hyperemia), and after venous congestion (Table 1) [76]. Capillary density during venous congestion is considered the best method to objectively assess the anatomic capillary number, as it can expose nonperfused capillaries that are missed with simple capillaroscopy.…”

Section: Assessment Of Endothelial Dysfunction In Ckd: Functional Metmentioning

confidence: 99%

“… Capillary density during baseline, after postocclusive reactive hyperemia, and during venous congestion among different stages of CKD (reprinted with permission from Schoina et al [76], Hypertens Res. 2020).…”

Section: Assessment Of Endothelial Dysfunction In Ckd: Functional Metmentioning

confidence: 99%

“…Nailfold capillaroscopy is an easily applicable, noninvasive technique used to evaluate microcirculation and endothelial function [74][75][76]. It provides information for multiple microcirculatory parameters, including capillary morphology and density and flow velocity [74,76].…”

Section: Nailfold Capillaroscopymentioning

confidence: 99%

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Assessment of Endothelial and Microvascular Function in CKD: Older and Newer Techniques, Associated Risk Factors, and Relations with Outcomes

Theodorakopoulou

Schoina

Sarafidis³

2020

Am J Nephrol

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Background: Endothelium is the inner cellular lining of the vessels that modulates multiple biological processes including vasomotor tone, permeability, inflammatory responses, hemostasis, and angiogenesis. Endothelial dysfunction, the basis of atherosclerosis, is characterized by an imbalance between endothelium-derived relaxing factors and endothelium-derived contracting factors. Summary: Starting from the semi-invasive venous occlusion plethysmography, several functional techniques have been developed to evaluate microvascular function and subsequently used in patients with CKD. Flow-mediated dilatation of the forearm is considered to be the “gold standard,” while in the last years, novel, noninvasive methods such as laser speckle contrast imaging and near-infrared spectroscopy are scarcely used. Moreover, several circulating biomarkers of endothelial function have been used in studies in CKD patients. This review summarizes available functional methods and biochemical markers for the assessment of endothelial and microvascular function in CKD and discusses existing evidence on their associations with comorbid conditions and outcomes in this population. Key Messages: Accumulated evidence suggests that endothelial dysfunction occurs early in CKD and is associated with target organ damage, progression of renal injury, cardiovascular events, and mortality. Novel methods evaluating microvascular function can offer a detailed, real-time assessment of underlying phenomena and should be increasingly used to shed more light on the role of endothelial dysfunction on cardiovascular and renal disease progression in CKD.

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Section: Assessment Of Endothelial Dysfunction In Ckd: Functional Metmentioning

confidence: 95%

Section: Assessment Of Endothelial Dysfunction In Ckd: Functional Metmentioning

confidence: 99%

Section: Assessment Of Endothelial Dysfunction In Ckd: Functional Metmentioning

confidence: 99%

Section: Assessment Of Endothelial Dysfunction In Ckd: Functional Metmentioning

confidence: 99%

Section: Nailfold Capillaroscopymentioning

confidence: 99%

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Assessment of Endothelial and Microvascular Function in CKD: Older and Newer Techniques, Associated Risk Factors, and Relations with Outcomes

Theodorakopoulou

Schoina

Sarafidis³

2020

Am J Nephrol

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Endothelial dysfunction: molecular mechanisms and clinical implications

Wang,

2024

MedComm

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Cardiovascular disease (CVD) and its complications are a leading cause of death worldwide. Endothelial dysfunction plays a crucial role in the initiation and progression of CVD, serving as a pivotal factor in the pathogenesis of cardiovascular, metabolic, and other related diseases. The regulation of endothelial dysfunction is influenced by various risk factors and intricate signaling pathways, which vary depending on the specific disease context. Despite numerous research efforts aimed at elucidating the mechanisms underlying endothelial dysfunction, the precise molecular pathways involved remain incompletely understood. This review elucidates recent research findings on the pathophysiological mechanisms involved in endothelial dysfunction, including nitric oxide availability, oxidative stress, and inflammation‐mediated pathways. We also discuss the impact of endothelial dysfunction on various pathological conditions, including atherosclerosis, heart failure, diabetes, hypertension, chronic kidney disease, and neurodegenerative diseases. Furthermore, we summarize the traditional and novel potential biomarkers of endothelial dysfunction as well as pharmacological and nonpharmacological therapeutic strategies for endothelial protection and treatment for CVD and related complications. Consequently, this review is to improve understanding of emerging biomarkers and therapeutic approaches aimed at reducing the risk of developing CVD and associated complications, as well as mitigating endothelial dysfunction.

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Nailfold videocapillaroscopic changes in patients with pulmonary arterial hypertension associated with connective tissue diseases

et al. 2021

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Microcirculatory function deteriorates with advancing stages of chronic kidney disease independently of arterial stiffness and atherosclerosis

Cited by 20 publications

References 39 publications

Assessment of Endothelial and Microvascular Function in CKD: Older and Newer Techniques, Associated Risk Factors, and Relations with Outcomes

Assessment of Endothelial and Microvascular Function in CKD: Older and Newer Techniques, Associated Risk Factors, and Relations with Outcomes

Endothelial dysfunction: molecular mechanisms and clinical implications

Nailfold videocapillaroscopic changes in patients with pulmonary arterial hypertension associated with connective tissue diseases

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