Qual o impacto do diabetes na função endotelial de pacientes renais crônicos? Um estudo caso-controle

• Ano de defesa: 2018
• Autor(a) principal: Coutinho, Mariana Nogueira [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Chronic kidney disease; Diabetes; Endothelial function; Doença renal crônica; Função endotelial; Epc; Sdf-1" Fmd
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6635210; https://repositorio.unifesp.br/handle/11600/53170

Background: Patients with chronic kidney disease (CKD) and type 2 diabete mellito (DM) have increased risk of endothelial dysfunction, cardiovascular disease and mortality. Several studies have separately analyzed endothelial function in these populations. However, data of patients with both CKD and DM are scarce. The aim of this study was to evaluate whether the presence of DM has any additional effect on the endothelial dysfunction of CKD patients. Methods: We measured endothelial progenitor cells (EPC), stromal derived factor 1 alpha (SDF1 ), serum and urinary nitric oxide (NO), flow mediated dilation (FMD) and pulse wave velocity (PWV) in 37 CKD patients with DM (CKDDM group) and in 37 without DM (CKD group). Results: CKDDM group had a higher prevalence of obesity (p<0.01), previous myocardial infarction (p=0.02), myocardial revascularization (p=0.04) and a trend for more peripheral artery disease (p=0.07). Additionally, CKDDM group had higher EPC (p=0.001) and PWV (p<0.001) values. On the other hand, although no difference in SDF1 , serum or urinary NO and FMD were observed between the groups, we found high values of SDF1  and low values of FMD in both groups. Conclusion: Endothelial dysfunction is frequent in CKD patients, and an additive effect of diabetes cannot be implicated, suggesting the predominant role of uremia in this condition.