Korean J Nephrol.  2004 May;23(3):466-475.

Infection, Inflammation, and Cell Adhesion Molecules are Associated the Progression of Carotid Atherosclerosis in Continous Ambulatory Peritoneal Dialysis Patients

• Kim HJ
• Kim DK
• Choi HY
• Kim HJ
• Yoo TH
• Ryu DR
• Kim BS
• Kang SW
• Choi KH
• Lee HY
• Han DS

Abstract

BACKGROUND
In ESRD patients, the annual mortality rate due to cardiovascular disease (CVD) is 10 to 20 fold higher than that of the general population. Much recent interest have been focused on the association between chronic inflammation and the increased mortality rate due to CVD in ESRD patients. This study was performed to investigate whether the C.pneumoniae infection and inflammation play important roles in the change of the carotid intima- media thickness (IMT) in ESRD patients. METHODS: 52 patients undergoing CAPD were enrolled in the study. We measured IMT by using B-mode ultrasonography. IL-6, antibody titers to C. pneumoniae, cell-adhesion molecules were assessed by ELISA. RESULTS: Significant increase in carotid IMT (0.71+/-0.02 to 0.77+/-0.12 mm, p<0.05), cIM area (19.62+/-4.21 to 21.82+/-4.80 mm2, p<0.05), prevalence of plaque (36.5% to 57.7%, p<0.05) were observed in 52 patients. The patients were divided into two groups according to the change in IMT. Progressor for 32 patients who had more than 0.1 mm increase in IMT and nonprogressor for 20 who had lesser than 0.1 mm increase or no changes in IMT. Log IL-6, IgA antibody titers to C. pneumoniae, ICAM-1 level were significantly higher in progressors compared to nonprogressors (4.20+/-5.14 vs. 1.44+/-0.58 pg/mL, 1.14+/-0.60 vs. 0.77+/-0.32, 297.42+/-88.22 vs. 233.93+/-88.89 ng/mL, p<0.05). Logistic regression analysis showed that elevated log IL-6 and IgA antibody titers to C. pneumoniae were independent factors adversely affecting change of IMT. Stepwise multiple regression analysis showed that log IL-6, ICAM-1, and IgA antibody titers to C. pneumoniae were independent factors affecting carotid IMT. CONCLUSION: Our data suggest that inflammation and seropositivity of IgA to C. pneumoniae can be associated with the progression of atherosclerosis in CAPD patients.

Keyword

Interleukin-6; Chlamydia pneumoniae; Cell adhesion molecules; Carotid atherosclerosis; Continuous ambulatory peritoneal dialysis

MeSH Terms

Atherosclerosis
Cardiovascular Diseases
Carotid Artery Diseases*
Cell Adhesion Molecules*
Cell Adhesion*
Chlamydophila pneumoniae
Enzyme-Linked Immunosorbent Assay
Humans
Immunoglobulin A
Inflammation*
Intercellular Adhesion Molecule-1
Interleukin-6
Kidney Failure, Chronic
Logistic Models
Mortality
Peritoneal Dialysis*
Peritoneal Dialysis, Continuous Ambulatory
Pneumonia
Prevalence
Ultrasonography
Cell Adhesion Molecules
Immunoglobulin A
Intercellular Adhesion Molecule-1
Interleukin-6