Reduced Microvascular Density in Omental Biopsies of Children with Chronic Kidney Disease

• DOI: 10.1371/journal.pone.0166050
• Publication Date: 2016-11-15T19:05:23Z
• Authors: Dorothea Burkhardt; Maria Bartosova; Betti Schaefer; Niels Grabe; Bernd Lahrmann; Hamoud Nasser; Christian Freise; Axel Schneider; Anja Lingnau; Petra Degenhardt; Bruno Ranchin; Peter Sallay; Rimante Cerkauskiene; Michal Malina; Gema Ariceta; Claus Peter Schmitt; Uwe Querfeld
• Keywords: Male; Adolescent; Science; Biopsy; 610; Apoptosis; 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit; Angiopoietin-2; 03 medical and health sciences; 0302 clinical medicine; Angiopoietin-1; Autophagy; Humans; Renal Insufficiency, Chronic; Child; Microcirculation; Q; R; Infant, Newborn; Infant; 3. Good health; Gene Expression Regulation; Cardiovascular Diseases; Child, Preschool; Microvessels; Medicine; Female; Peritoneal Dialysis; Biomarkers; Research Article

Endothelial dysfunction is an early manifestation of cardiovascular disease (CVD) and consistently observed in patients with chronic kidney (CKD). We hypothesized that CKD associated systemic damage to the microcirculation, preceding macrovascular pathology. To assess degree "uremic microangiopathy", we have measured microvascular density biopsies omentum children CKD.Omental tissue was collected from 32 healthy (0-18 years) undergoing elective abdominal surgery 23 age-matched cases stage 5 at time catheter insertion for initiation peritoneal dialysis. Biopsies were analyzed by independent observers using either a manual or automated imaging system assessment density. Quantitative immunohistochemistry performed markers autophagy apoptosis, abundance angiogenesis-regulating proteins VEGF-A, VEGF-R2, Angpt1 Angpt2.Microvascular significantly reduced uremic compared controls, both digital microscope (median surface area 0.61% vs. 0.95%, p<0.0021 quantification (total 0.89% 1.17% p = 0.01). Density age, height, weight body controls. In multivariate analysis, age serum creatinine level only independent, significant predictors (r2 0.73). There no immunohistochemical evidence apoptosis autophagy. staining showed similar expression levels angiogenesis regulators VEGF-receptor 2 (p 0.11), but Angpt2 lower 0.01).Microvascular profoundly omental diminished signaling. Microvascular rarefaction could be CKD-induced disease.