Monocyte Chemoattractant Protien-1 (MCP-1) and Atherosclerosis in End Stage Renal Disease Patients

Background: Emerging evidences suggest that inflammation is involved in the pathogenesis of cardiovascular diseases. Monocyte chemoattractant protein-1 (MCP-1) has a central role in atherogenesis. The study was performed as a cross-sectional study to determine the role of MCP-1 in hemodialysis (HD) induced inflammation, dyslipidemia and atherosclerosis among end stage renal disease (ESRD) patients.

Methods: Ninety HD patients were enrolled in the study. Pre-dialysis and post-dialysis MCP-1 gene expression, C-reactive protein (CRP), lipid profile and Carotid duplex for the assessment of the presence of plaque, stenosis and the carotid intima/media thickness (IMT) were done in addition to standard laboratory work up for ESRD patients. Twenty healthy individuals were considered as a control group.

Results: The patients` mean age was 46.35 years, 63.33% of them were males. The most common dyslipidemia type was low serum HDL (87.78%) followed by hypertriglyceridemia. Pre-dialysis and post-dialysis values of MCP-1 gene expression and CRP plasma levels were significantly up-regulated during the HD session (P<0.001). When were compared to controls; both pre-dialysis and post-dialysis MCP-1 gene expressions were significantly higher in patients` group (P=0.004, P=0.0001). 42.2% of patients had carotid plaques, 11.1% had carotid stenosis and 62.2% had thick IMT. LDL, triglycerides and cholesterol levels were significantly higher in the affected carotid patient subgroup than the normal carotid subgroups. MCP-1 gene expression both pre-dialysis and post-dialysis were significantly higher in patients who had carotid plaques when compared to patient subgroup without plaques while MCP-1 gene expression was not significantly changed by dialysis in patient subgroups that had either thick carotid IMT or carotid stenosis.

Conclusion: The most common dyslipidemia types among current studied Egyptian ESRD patients are low HDL and hypertriglyceridemia which are found to be related significantly to the development of atherosclerosis in ESRD. CRP was higher in post-dialysis patients than the normal controls, but it failed to show any significant association with the observed carotid lesions. MCP-1 was significantly up-regulated during hemodialysis and it was associated with the occurrence of carotid atherosclerotic plaques.