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The primary research objective of the project is to determine the role of eGC in microvascular reactivity in CKD (cross-sectional study 1).
The main objective of the project is to increase the excellence and interdisciplinarity of scientific work at MEFOS by connecting researchers from different scientific fields, improving conditions and resources for scientific work, and increasing international cooperation, in line with strategic objective 1: raising scientific excellence. The results of the project could provide pathophysiological insight into the development and maintenance of endothelial dysfunction in CKD, as well as identify new biomarkers for CKD.
The primary objective of this project is to determine the role of endothelial glycocalyx (eGC) in impaired microvascular endothelium-dependent reactivity in patients with chronic kidney disease compared to healthy and hypertensive patients without complications (cross-sectional study 1).
Specific objective 1.1: Measure the reactivity of the peripheral microcirculation (using a laser Doppler blood flow meter) and the thickness of eGC (using Glycocheck) in the specified groups.
Specific objective 1.2: Quantify soluble markers of eGC, oxidative stress, and inflammation from serum samples and peripheral blood mononuclear cells (PBMC), as well as antioxidant capacity in the specified groups.
Specific objective 1.3: Determine the relationship between the results of functional tests, eGC, and markers from specific objective 1.2.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Chronic Kidney Disease (CKD) group | Patients with CKD of hypertensive etiology, stages 1-2 and 3-5 (eGFR CKD-EPI GFR ≥ 90 ml/min/1.73 m², i.e. < 60 mL/min/1.73 m2), non-diabetics, non-smokers | ||
| Hypertension (HT) group | Patients who have hypertension (according to ESH2023 Guidelines doi: 10.1097/HJH.0000000000003480) without kidney damage (eGFR CKD-EPI >90 mL/min/1.73 m2) non-diabetics, non-smokers | ||
| Normotensive (NT) group | Healthy volunteer subjects as controls |
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| Measure | Description | Time Frame |
|---|---|---|
| Microvascular reactivity | Skin microvascular reactivity in patients with chronic kidney disease compared to hypertensive patients and healthy subjects - assessed by Laser Doppler flowmetry (post-occlusive reactive hyperemia, acetylcholine and sodium nitroprusside) | Baseline, at one time point (first visit to the laboratory) |
| Endothelial glycocalyx | Measurement of the thickness of eGC in the specified groups - measured by Glycocheck | Baseline, at one time point (first visit to the laboratory) |
| Measure | Description | Time Frame |
|---|---|---|
| Endothelial glycocalyx soluble markers | Quantification of soluble markers of eGC from serum or plasma samples in the specified groups - measured by ELISA assays (syndecan-1, syndecan-4, glypican-1, MMP-9) | Baseline, at one time point (first visit to the laboratory) |
| Concentration of MPO, 8-iso prostaglandin F2a, OxLDL, AOPP and intracellular oxidative stress production |
| Measure | Description | Time Frame |
|---|---|---|
| Blood pressure | Automatic oscillometric measurement of systolic and diastolic blood measurement (mmHg) | Baseline, at one time point (first visit to the laboratory) |
| Heart rate | Automatic oscillometric measurement of heart rate (bpm) |
Inclusion Criteria:
Exclusion Criteria:
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Patients with CKD of hypertensive etiology, patients with hypertension and healthy volunteer subjects as controls.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ines Drenjančević, MD, PhD | Contact | +385912241406 | ines.drenjancevic@mefos.hr |
| Name | Affiliation | Role |
|---|---|---|
| Ines Drenjančević, MD, PhD | Faculty of Medicine Josip Juraj Strossmayer University of Osijek | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Osijek University Hospital | Recruiting | Osijek | 31000 | Croatia |
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| ID | Term |
|---|---|
| D007249 | Inflammation |
| D051436 | Renal Insufficiency, Chronic |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
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serum, plasma, peripheral blood mononuclear cells (PBMC)
Quantification of oxidative stress biomarkers from serum samples and peripheral blood mononuclear cells (PBMC) in the specified groups - measured by ELISA assays (MPO, 8-iso prostaglandin F2a, OxLDL, AOPP) and flow cytometry (intracellulare oxidative stress production; DCF-DA and DHE) |
| Baseline, at one time point (first visit to the laboratory) |
| Macrophage frequency | Quantification of inflammation from peripheral blood mononuclear cells (PBMC) in the specified groups - flow cytometry (macrophage frequency) | Baseline, at one time point (first visit to the laboratory) |
| Antioxidant enzyme (SOD, CAT, GPx) concentration and activity | Quantification of antioxidative enzyme concentration and activation from serum samples in the specified groups - measured by ELISA assays and UV-Vis spectrophotometry (SOD, GPx, CAT) | Baseline, at one time point (first visit to the laboratory) |
| Baseline, at one time point (first visit to the laboratory) |
| Body Mass Index | Weight and height will be combined to report BMI (kg/m2) | Baseline, at one time point (first visit to the laboratory) |
| Body composition | Body composition and body fluid status measurement by a four-terminal portable impedance analyzer. Based on the value of skin resistance (Ohm) empirically derived formulas (the original manufacturer's software) will be used to calculate the estimated Fat Free Mass (FFM kg) and Fat (Fat Mass kg). | Baseline, at one time point (first visit to the laboratory) |
| Body fluid status: Estimation of Total Body Water (TBW L), Extracellular Water (ECW L), Intracellular Water (ICW L), Plasma Fluid (PF L) and Interstitial Fluid (IF L) | Body fluid status measurement by four-terminal portable impedance analyzer. A single impedance measurement is used to derive Total Body Water (TBW), Extracellular Water (ECW), Intracellular Water (ICW), Plasma Fluid (PF), and Interstitial Fluid (IF) using the manufacturer's software. | Baseline, at one time point (first visit to the laboratory) |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |