Significance of the factors of hypoxia and endothelial dysfunction in kidney injury in the presence of obesity

Abstract

AIM: To define the clinical significance of asymmetric dimethylarginine (ADMA) and that of methylenetetrahydrofolate reductase (MTHFR) gene polymorphism as factors of endothelial dysfunction (ED) in the development of early kidney injury in obese patients/MATERIAL AND METHODS: The investigation included 86 patients (64 men and 22 women aged 44±11 years) with abdominal obesity. Along with physical examination, the authors determined albuminuria, calculated glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula, estimated insulin resistance markers (fasting plasma insulin and C-peptide concentrations and homeostatic model assessment (HOMA) index), as well as serum ADMA levels by enzyme immunoassay in all the patients. C677T polymorphism in the MTHFR gene was studied by allele-specific polymerase chain reaction and restriction fragment length polymorphism analysis. Kidney injury (chronic kidney disease (CKD)) was diagnosed using the Kidney Disease Outcomes Quality Initiative (KDOQI) criteria. Early vascular remodeling was determined from the increased intima-media thickness (IMT) of the common carotid artery (CCA)/RESULTS: CKD was diagnosed in 27 (31%) patients. The latter, unlike the patients with CKD, were observed to have more pronounced obesity (body mass index (BMI) 36.8±8.0 and 32.0±4.7 kg/m2, respectively (p

Keywords

• obesity
• chronic kidney disease
• endothelial dysfunction
• mthfr
• asymmetric dimethylarginine
• insulin resistance
• atherosclerosis