Endothelial dysfunction as an early marker for cardiovascular disease in patients with chronic kidney disease on maintenance hemodialysis

Abstract

Background Cardiovascular disease is a major cause of mortality in dialysis patients. Magnesium (Mg) level has been found to correlate positively with endothelial function. Moreover, it is suggested that low Mg is associated with increased all-cause and cardiovascular mortality in hemodialysis (HD) patients. Objective Therefore, this study was conducted to define the relationship between Mg level and endothelial dysfunction as an early marker of cardiovascular disease in patients with end-stage renal disease (ESRD) on maintenance HD. Patients and methods In this cross-sectional study, 85 patients with ESRD on maintenance HD were included. Serum angiopoietin-2 (Ang-2) level, brachial flow-mediated dilation (BFMD), and carotid intima-media thickness (CIMT) were measured as indicators of endothelial dysfunction and atherosclerosis. Patients’ serum Mg levels were measured. All data are presented as mean and SD or percent frequency. Statistical tests, mainly t test, Mann–Whitney test, or χ 2 test, are used in comparison between groups for quantitative and qualitative data correspondingly. Results Our results indicate that Ang-2 and BFMD are associated and can predict atherosclerosis early in HD patients (P=0.036 and 0.006, respectively). When the patients were divided according to their serum Mg, there was no significant difference regarding Ang-2, BFMD, and CIMT between the two groups. Conclusion This study demonstrated that endothelial dysfunction markers such as Ang-2 and BFMD are associated and can predict atherosclerosis early in HD patients. On the contrary, Mg might not affect neither endothelial function (FMD and Ang-2) nor CIMT as a marker of atherosclerosis in ESRD on HD.