Hemodiyaliz Hastalarında Volüm Durumu ve Tuz Alımının Serum Vasküler Endotelyal Büyüme Faktörü-C (Vegf-C) Düzeyleri Üzerine Etkisi

Abstract

Recent studies have shown that sodium can accumulate in the skin interstitium without osmotic effect. GAGs, macrophages and related factors such as tonEBP, VEGF-C, and eNOS take part in accumulation and mobilization of sodium in tissues. Disturbance of any of these factors leads to sodium accumulation in the skin, and salt-sensitive hypertension. Although there are some preliminary data on non-dialytic chronic kidney disease patients, there are no data on the relation between salt intake, volume alterations, and non-osmotic sodium mechanisms in hemodialysis patients. In this study, we investigated the effect of volume variables, salt intake, and hemodialysis on serum VEGF-C levels. Twenty patients (11/9; M/F) were included in the study. The alterations in volume, salt intake and VEGF-C levels during an interdialytic period were recorded. In order to show the influence of the dialysis, VEGF-C levels before and after dialysis session were compared. On the other hand, we tried to identify determinants of serum VEGF-C levels. No difference was observed between predialysis and postdialysis VEGF-C levels. Serum VEGF-C levels were not related to salt intake and interdialytic weight gain. However, in patients with higher interdialytic weight gain (>3% of dry weight); serum VEGF-C and total VEGF-C levels were numerically higher than the patients with lower interdialytic weight gain (<3% of lower weight gain). The difference between these two groups was close to statistical significance. Furthermore, at least a mid-level correlation was determined between serum VEGF-C levels and interdialytic weight gain (R=0.45). Dialysis did not change serum VEGF-C levels. Our study is the first to investigate whether salt intake, volume alterations and serum VEGF-C are related in dialysis patients. Although VEGF-C levels were not related to salt intake and volume change; there was a mid-level correlation between interdialytic weight gain and VEGF-C levels. This correlation may reflect clinically long-term volume and salt overload. However, in order to determine the relation more clearly, and to find out the factors influencing serum VEGF-C levels in dialysis population, further studies will be needed.