FP797ENDOCAN SERUM LEVELS IN HEMODIALYSIS PATIENTS BEFORE AND DURING THE PROCEDURE WITH TWO DIFFERENT DIALYSIS MEMBRANES

Abstract

Introduction and Aims: Chronic kidney disease (CKD) is well known of endothelial dysfunction (increased oxidative stress and inflammation followed by atherosclerosis) contributing to increased cardiovascular risk in this population of patients. Endocan is a novel, soluble, dermatan sulfate proteoglycan expressed by endothelial cells. It was proved to modulate the inflammatory processes and neoangiogenesis. Recently the overexpression of the molecule was shown in patients with sepsis, pneumonia, cancer, chronic kidney disease and in r enal transplant recipients. Endocan was also proposed to be a good diagnostic and prognostic marker in these diseases. We evaluated plasma Endocan levels during hemodialysis (HD) sessions with two different dialysis membranes. Methods: Nineteen clinically stable maintenance HD patients (9 men; aged 58.1 ± 18.8 yrs; dialyzed 3 x wk for at least 4 months) were enrolled. First HD sessions were performed as usual ‐ with no‐reuse low‐flux polysulfone membrane and an iv bolus of 40 (20‐60) mg of enoxaparine (ENX) given on HD initiation. Consecutive HD sessions were performed in the same patients with the use of a new anti‐thrombogenic heparin‐grafted HeprAN hydrogel membrane derived from polyacrylonitrile AN69 ST (Evodial, Gambro Diaverum) and no ENX administration. Blood samples were collected from the a‐v fistula circuit before the ENX‐anticoagulated or “Evodial” HD (T0) and, then, after 10 min (T10) and 120 min (T120) of HD procedures from the circuit. Serum Endocan levels were measured using a referential ELISA kit from Lunginnov. The control group consisted of 19 healthy volunteers. Results: The median Endocan concentration at the beginning of HD with ENX was 2,9 ng/ml and at the beginning of “Evodial” HD ‐ 3 ng/ml, and they did not differed (p>0,1). The median Endocan concentration in the control group was 1 ng/ml and it was almost 3 times lower than the protein concentration before both HD (p=0,001) There was significant change in plasma Endocan concentration during both standard and “Evodial” procedure ( p<0,05). We did not observed any difference in Endocan concentration after 10 minutes of the two procedures, but we showed that Endocan concentration is 2,25 times higher after 120 minutes of ENX‐anticoagulated HD than at the same time of “Evodial” HD. Conclusions: 1. Serum Endocan levels increased both: during standard procedure and HD with novel non‐thrombogenic membrane, however whether heparin adds to increased protein expression remains unclear. 2. Between HD sessions Endocan levels decreased, remaining still significantly higher in hemodialysis patients than in healthy control group. It is possible that hemodialysis bioincompatibility potentiates, already present in end stage kidney disease patients, endothelial dysfunction described based on Endocan serum levels.