Variation Of Circulating Platelet Microparticles And Endothelial Microparticles In Patients With Chronic Kidney Disease

Objective Compare the levels of PMPs,GMP140,EMPs and vWF in patients with chronic kidney disease and in normal control group, to explore the significance of the PMPs and EMPs in chronic kidney disease.Methods From February 2007 to June 2008, 72 cases of patients with chronic kidney disease who were hospitalized in the First Affiliated Hospital of Suzhou University were enrolled in this study (Definition and phases were based on K / DOQI chronic kidney disease clinical practice guidelines) ,20 cases of healthy controls were also enrolled. Circulating PMPs and EMPs were numerated by flow cytometry;GMP140 and vWF were measured by the enzyme-linked immunosorbent assay; The blood pressure, height and weight of all subjects were measured also.The Cockcroft-Gault formula to calculate creatinine clearance (Ccr (ml / min) = [(140 - age)×weight×(0.85 for women)] / (72×Scr))was used; Fasting venous blood samples were extracted to detect hemoglobin, serum creatinine, blood cholesterol, blood glucose; Urinary protein was detected by radioimmunoassay.Results1 Plasma levels of PMPs and GMP140 were significantly higher in CKD patients than that of in controls(P<0.05).2 Plasma levels of PMPs and GMP140 in CKD patients among different clinical classification groups: The levels of PMPs in nephritic syndrome group and chronic glomerulonephritis group were significantly higher than that of in control group(P<0.01,P<0.05),The level of PMPs in nephritic syndrome group was significantly higher than that of in hypertensive renal disease group(P <0.05),Other groups had no significant difference(P>0.05).The levels of GMP140 in all groups were significantly higher than that of in control group(P<0.01),The level of GMP140 in nephritic syndrome group was significantly higher than that of in Lupus nephropathy group, Diabetic Nephropathy group and hypertensive renal disease group(P<0.01,P<0.05), The level of GMP140 in chronic glomerulonephritis group was significantly higher than that of in Diabetic Nephropathy group(P<0.01).3 Plasma levels of PMPs and GMP140 in different stages of CKD: The level of PMPs in stage I was significantly higher than stage IV(P <0.05); Other stages had no significant difference(P >0.05). The level of GMP140 in different stages had no significant difference(P >0.05).4 As for PMPs, a positive correlation was found with blood pressure(r=0.39,P <0.05), no correlation was found among creatinine clearance(r=-0.15,P >0.05), 24h urinary protein(r=0.18,P >0.05), hemoglobin(r=-0.21,P >0.05), cholesterol(r=0.10,P >0.05),GMP140 has a positive correlation with PMPs(r=0.31,P <0.05).5 Plasma levels of EMPs and vWF were significantly higher in CKD patients than that of in controls(P<0.01).6 Plasma levels of EMPs and vWF in different clinical classification groups were significantly higher than that of in control group(P<0.01,P<0.05); The level of EMPs in nephritic syndrome group was significantly higher than that of in hypertensive renal disease group(P<0.05).Meanwhile, the level of vWF in nephritic syndrome group was remarkable higher than that of in hypertensive renal disease group and chronic glomerulonephritis group.Other groups had no significant difference(P >0.05).7 In different stages of CKD, the level of EMPs in stage I was significantly higher than stage IV(P<0.05), The level of vWF in different stages had no significant difference(P>0.05).8 As for EMPs, a positive correlation was found with blood pressure(r=0.52,P <0.01), no correlation was found among creatinine clearance(r=-0.12,P>0.05), 24h urinary protein(r=0.15,P>0.05), hemoglobin(r=-0.22,P>0.05), cholestero(lr=0.07,P>0.05). vWF has a positive correlation with EMPs(r=0.41,P<0.05).Conclusion1 Patients with chronic kidney disease have platelet activation and endothelial dysfunction. The platelet activation and endothelial dysfunction are participate in the pathophysiological process of the occurrence and development of chronic kidney disease.2 Hypertension is one of the important reasons for platelet activation and endothelial dysfunction in patients with chronic kidney disease.3 As a new marker, PMPs and EMPs can be used as a reflection of platelet activation and endothelial function.