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2022, Número 4

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Rev Nefrol Dial Traspl 2022; 42 (4)


La disfunción vascular endotelial en las distintas terapias de reemplazo renal

Yuruk YZN, Aksu B, Gedikbasi A, Agbas A, Pehlivanoglu C, Nisa TO, Nayir A, Emre S, Yilmaz A

Idioma: Ingles.
Referencias bibliográficas: 49
Paginas: 307-319
Archivo PDF: 265.13 Kb.


RESUMEN

Introducción: La disfunción vascular endotelial (DVE) es una causa importante de morbilidad y mortalidad cardiovascular en la fase final de enfermedades renales (ESRD). La endotelina 1 (ET-1) y el óxido nítrico (NO) son sustancias vasoactivas que son afectadas en la ESRD. El objetivo de este estudio es comparar los niveles de suero ET-1 y NO entre receptores de trasplantes de riñón (grupo RTx) y en pacientes que reciben hemodiálisis (grupo HD), hemodiafiltración on line (grupo HDF) así como diálisis peritoneal (grupo PD). Material y métodos: Cuarenta y un pacientes, así como veinticinco niños sanos participaron en este estudio. Los niveles del suero ET-1 y NO fueron medidos por ELISA para todos los pacientes en cada control. Los síntomas intradialíticos y el monitoreo ambulatorio de la presión sanguínea fueron evaluados en los grupos HD y HDF. Resultados: Cuando los grupos de pacientes fueron comparados de forma separada con el grupo de control, los niveles de ET-1 y NO fueron más elevados en estos grupos de pacientes (p=0.0001). El nivel medio de ET-1 era más bajo en el grupo RTx que en el HDF (p=0.02) mientras que no eran diferentes a aquellos relativos a los grupos PD y HD (343.555ng/l, 593.717ng/l, 546.343ng/l and 589.944ng/l; respectivamente). El grupo RTx tuvo el nivel más bajo en suero de ET-1 y NO en comparación con los grupos PD y HD/HDF, aunque la diferencia no reviste importancia estadística. Los niveles séricos medios de NO no presentaban diferencias entre los grupos HD, HDF, PD y RTx (590.237µmol/l, 563.084µmol/l, 582.433µmol/l, 438.268µmol/l; respectivamente). Los niveles de ET-1 estaban correlacionados negativamente con los niveles de eGFR, hemoglobina y de calcio sérico, así como correlacionados positivamente con los niveles de PTH. Conclusión: Los resultados de este estudio sugieren que la DVE continúa en aquellos pacientes receptores de diferentes terapias de reemplazo renal. Por tanto, concluimos que el trasplante de riñón es una mejor opción comparado con otras modalidades de tratamiento dado que el grupo RTx ha presentado niveles más bajos de ET-1 y NO.


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