Abstracts
Background: Ischemic heart disease (IHD) is the main cause of death in patients with chronic kidney disease (CKD)with coronary atherosclerosis , which could be predicted by inflammatory biomarkers , as high sensitive C-reactive protein (hs-CRP), IHD is linked to other independent risk factors as asymmetric dimethylarginine (ADMA) and lectin-like oxidized LDL receptor-1(LOX-1),which have proven roles in atherogenesis .objective to evaluate the clinical significance of ADMA and LOX-1 in addition to hs-CRP as biomarkers of IHD in ESRD patients with regular hemodialysis. Subjects and method: Patients groups included 27 patients under hemodialysis with known IHD (Subgroup Ia), 13 patients under hemodialysis without IHD (Subgroup Ib), 19 patients with CKD under conservative treatment (Subgroup Ic). And A control group of 29 healthy volunteers (group II) serum hs-CRP, ADMA, and LOX-1 were assayed. Results: the value of hs-CRP, ADMA and LOX-1 showed statistically significant increase in subgroup Ia versus subgroup Ib, also between subgroup Ib and subgroup Ic. Furthermore there is a highly statistical significant difference between different subgroups and control group. Correlation studies in subgroup Ia between hs-CRP, ADMA and LOX-1 revealed a statistically significant positive correlation. Conclusion: the combined use of hs-CRP and ADMA or LOX-1 showed to be valid for differentiating ESRD with IHD from ESRD without IHD. Serum levels of ADMA and LOX-1 could be relevant and convenient biomarkers for IHD in patients with CKD and its use beside hs-CRP adds more strength and specification to its known predictive value.