Monocyte chemoattractant protein-1 in patients with dyslipidemia and chronic kidney disease stage 5 on hemodiafiltration, relationship with risk factors and cardiovascular complications

Objective: To study the interrelationships of MCP-1 levels in the blood of patients with dyslipidemia and stage 5 chronic kidney disease on hemodiafiltration (HDF) with metabolic and hemodynamic parameters, as well as the risk of cardiovascular complications. Materials and methods: a single-stage, cohort study with a retrospective analysis of cardiovascular complications. The study included 103 patients with an average age of 61.9 ± 12.9 years. Cardiovascular complications were recorded, which at the time of the examination had already developed during the period of dialysis treatment. Lipidogram parameters, including lipoprotein(a) and oxidized lipoproteins, were determined in all patients. Metabolic parameters, signs of vascular calcification, vascular stiffness, and nutritional status were also determined. Results: the average value of MCP-1 in the studied cohort of patients was 54.3 ± 13.6 pg/ml and ranged from 31 to 79 pg/ml. In patients with HDF, an increase in the concentration of MCP-1 occurred unidirectionally with an increase in the levels of LP(a) and LDL, which play an important role in the process of atherogenesis. There was also a unidirectional increase in MCP-1 levels in the blood as the severity of uremic calcification of the valves and aortic wall, hyperuricemia, and signs of vascular inflammation (CRP) increased. An increase in MCP-1 levels was accompanied by a high probability of detecting vascular calcification and calcification of the heart valves, peripheral atherosclerosis, coronary lesions, cerebral stroke (MI) and a combined MI + MI + CHF point. Conclusion: MCP-1 has a negative effect on the risk of cardiovascular events, both as an independent effect and as a combined effect with parameters of lipid metabolism and hemodynamic factors. The latter was the motivation for the development of the original LDL-C + LP(a) scale + MCP-1, which allows you to assess the risk of developing cardiovascular complications.

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