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J Vis Exp. 2014 Jun 16;(88). doi: 10.3791/51478.

Assessment of vascular function in patients with chronic kidney disease.

Author information

1
Division of Renal Diseases and Hypertension, University of Colorado, Denver.
2
Department of Integrative Physiology, University of Colorado, Boulder.
3
Division of Renal Diseases and Hypertension, University of Colorado, Denver; Diana.Jalal@ucdenver.edu.

Abstract

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this is only partially explained by traditional CVD risk factors. Vascular dysfunction is an important non-traditional risk factor, characterized by vascular endothelial dysfunction (most commonly assessed as impaired endothelium-dependent dilation [EDD]) and stiffening of the large elastic arteries. While various techniques exist to assess EDD and large elastic artery stiffness, the most commonly used are brachial artery flow-mediated dilation (FMDBA) and aortic pulse-wave velocity (aPWV), respectively. Both of these noninvasive measures of vascular dysfunction are independent predictors of future cardiovascular events in patients with and without kidney disease. Patients with CKD demonstrate both impaired FMDBA, and increased aPWV. While the exact mechanisms by which vascular dysfunction develops in CKD are incompletely understood, increased oxidative stress and a subsequent reduction in nitric oxide (NO) bioavailability are important contributors. Cellular changes in oxidative stress can be assessed by collecting vascular endothelial cells from the antecubital vein and measuring protein expression of markers of oxidative stress using immunofluorescence. We provide here a discussion of these methods to measure FMDBA, aPWV, and vascular endothelial cell protein expression.

PMID:
24962357
PMCID:
PMC4193838
DOI:
10.3791/51478
[Indexed for MEDLINE]
Free PMC Article

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