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Chinese Journal of Blood Purification ›› 2006, Vol. 5 ›› Issue (6) : 316-319.

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Abstract

Objective To observe the plasma levels of endothelin (ET)、soluble thrombomodulin (sTM) and vascular endothelial growth factor (VEGF) in patients with diabetic nephropathy and to explore the interrelationship among ET、sTM and VEGF and identify their significance during the pathogenesis of diabetic nephropathy. Methods Sixty-one patients with type 2 diabetes were classified into four groups (normoalbuminuria,microalbuminuria,overt proteinuria and end-stage renal failure) according to urinary alburmin excretion (UAE) and the status of renal function. Plasma endothelin was measured by Radioimmunoassay (RIA); The concentrations of plasmas TM and VEGF were measured by enzyme-linked immunosolvent assay (EUSA) methods.Theresults were compared with those of 21 healthy subjects. Results ①There was no significant difference in plasma ET、sTM and VEGF between the controls and the patients with normoalbuminuric group (P ＞0.05); ②The serun levels of ET and sTM in patients with microalbuminuric group were significantly higher than controls(P＜0.01)，while the levels of VEGF were similar in controls and in patients with microalbuminuria (P＞0.05); ③ Plasma ET level in patients with overt proteinuria was significantly higher than that in controls(P＜0.01); Plasma sTM and VEGF levels in overt nephropathy group were higher than those in normoalbuminuria and those in microalbminuria group; ④Plasma ET、sTM and VEGF from patients with end-stage renal failure were greater than those in controls and in normoalbuminuric group; ⑤ There were significant correlation among ET、 sTM and VEGF (r =0.5126, 0.6526, and 0.6398, respectively, P ＜ 0.01), and the markers were correlated with UAE (r=0.5126, 0.6525, 0.6442 and respectively, P ＜0.01), and creatinine clearance (r=-0.5380、 -0.5347、-0.6486，P ＜0.01). Conclusion ① Plasma ET、sTM、and VEGF increased with progressive renal dysfunction; ② There were significant correlation among plasma ET、sTM、and VEGF. Furthermore，the three indexes were positively correlated with the level of UAER. These suggest that endothelial injury may be involved in the pathogenesis of DN. ③ Our results suggest that the measurement of plasma ET、sTM and VEGF may be important in evaluating the diagnosis and analysis of type 2 DN.