CXCL12 in Patients with Chronic Kidney Disease and Healthy Controls: Relationships to Ambulatory 24-Hour Blood Pressure and Echocardiographic Measures

Cardiorenal Med. 2018;8(3):249-258. doi: 10.1159/000490396. Epub 2018 Jul 18.

Abstract

Background/aims: Chronic kidney disease is a pro-inflammatory condition where the interplay between different regulatory pathways and immune cells mediates an unfavorable remodeling of the vascular wall and myocardial hypertrophy. These mechanisms include the action of CXCL12. The aim of this study is to evaluate the association between serum CXCL12 with left ventricular hypertrophy (LVH) and blood pressure control in chronic kidney disease (CKD) patients.

Methods: This single-center observational study involved 90 stable CKD stage 1-5 patients (including 33 renal transplant recipients) and 25 healthy age- and sex-matched control subjects. CXCL12 was quantified by ELISA. 24-h ambulatory blood pressure monitoring was performed in 90 patients and 25 healthy controls. Left ventricular mass index (LVMI) was calculated based on the transthoracic echocardiography measurements in 27 patients out of the CKD population and in the whole control group.

Results: CXCL12 correlated significantly with LVMI by multivariate regression analysis (coefficient B = 0.33, p = 0.02) together with age (B = 0.30, p = 0.03) and gender (B = 0.41, p = 0.003). A positive correlation was observed between CXCL12 and average 24-h systolic blood pressure (SBP) (rho = 0.35, p = 0.001), daytime SBP (rho = 0.35, p = 0.001), and nocturnal SBP (rho = 0.30, p = 0.002). Nocturnal hypertension was frequent (46% of CKD patients).

Conclusions: The results of our study point towards a link between CXCL12 and LVH as well as blood pressure control among patients with CKD, supporting the thesis that CXCL12 may be regarded as a new potential uremic toxin.

Keywords: Left ventricular hypertrophy; Nocturnal hypertension; Renin-angiotensin-aldosterone; SDF-1alpha.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Apoptosis
  • Biomarkers / blood
  • Blood Pressure Monitoring, Ambulatory
  • Chemokine CXCL12 / blood*
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Humans
  • Hypertension / blood
  • Hypertension / complications*
  • Hypertension / drug therapy
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / complications*
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Inflammation / physiopathology
  • Male
  • Middle Aged
  • Myocytes, Cardiac / metabolism
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / diagnostic imaging
  • Renal Insufficiency, Chronic / physiopathology
  • Vascular Remodeling

Substances

  • Antihypertensive Agents
  • Biomarkers
  • CXCL12 protein, human
  • Chemokine CXCL12