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Scientists Identify Mechanisms in Kidney Disease That Trigger Heart Attacks and Strokes

Damage to the inner lining of blood vessels appears to be the culprit (Aug. 20)

While a small number of patients with kidney disease will develop kidney failure, a far greater number will develop circulatory diseases, such as heart attacks and strokes. Researchers at the University of Bristol, U.K., announced on August 20 that they have identified mechanisms that may contribute to an increased risk of cardiovascular disease in kidney disease patients.

The study, published in the Journal of the American Society of Nephrology, investigated the cellular changes that occur in kidney disease, which increase the risk of circulatory disease by about the same amount as smoking. Until now, the factors that link kidney and widespread circulatory diseases were not well understood, given that it is difficult to study the inner lining of blood vessels in human subjects.

However, using animal models with a form of chronic kidney disease that mimics the disease seen in humans, the researchers found that the inner lining of blood vessels throughout the body is damaged. This damage, which results in leaky blood vessels, is typical of the changes seen in patients with kidney disease.

The inner lining of blood vessels comprises a thick layer of sugars and proteins that form a continuous coat inside the vessels, protecting the blood-vessel walls. When this inner coat becomes damaged, the blood vessels become leaky and inflamed. Previous studies have shown that damage to this inner layer speeds up the process of atherosclerosis.

If the finding of damage to the blood-vessel lining in animals with kidney disease are also true in humans, then injury to this inner layer may help explain the high rates of circulatory disease in patients with chronic kidney disease. Interestingly, the researchers also found that substances that stick to the inner layer improve the function of the damaged blood vessels by making the vessels less leaky.

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation (BHF), which co-funded the study, said: “This study shows that damage to the glycocalyx — the sugar coating that lines our blood vessels — causes blood vessels in patients with chronic kidney disease to become more leaky. The discovery could help lead towards new ways of preventing kidney disease in the future.

“But this breakthrough also brings us closer to understanding how other circulatory diseases develop, including coronary heart disease — the cause of heart attacks. We need to put this vessel sugar coat under the microscope, because it could be important in many different ways.”

For more information, visit the University of Bristol Web site.

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