Background : Patients with end-stage renal disease (ESRD) show markedly increased mortality due to atherosclerosis. Because importance of endothelial progenitor cells (EPCs) contribution in vascular function and cumulative cardiovascular risk have been demonstrated, EPC dysfunction may be important in pathophysiology of ESRD.
Material and Results : EPC were isolated from ESRD patients on maintenance hemodialysis patients (n=44) and age-matched control subjects (n=30). EPC of ESRD patients showed colony formation decreased by 75.3% and proliferation of characteristic spindle-shaped EPC decreased by 44.6% when compared to control subjects (p<0.001). These findings were corroborated by 48.8% decrease of EPC incorporation into HUVEC (p<0.001), and 69.5% decrease of migration in response to VEGF (p=0.040). Moreover, Dialysis clearance measured by Kt/V was strongly correlated with EPC incorporation (r=0.427, p=0.004).
Conclusions : This is the first clinical demonstration showing that EPC biology, which is critical for new vessel growth, is altered in ESRD. Our data suggest that dysfunction of circulating EPC may have a role in progression of cardiovascular disease in ESRD patients.