Evaluation of serum YKL-40 and cardiovascular risk in chronic kidney disease

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Abstract

Background
Chronic kidney disease (CKD) is a worldwide health problem. Patients with end-stage renal disease have high prevalence of atherosclerosis and consequently development of cardiovascular disease resulting in elevated mortality rates. YKL-40 has been shown to play a role in the pathogenesis of endothelial dysfunction, atherosclerosis, and abnormal angiogenesis. It is closely related to the early and late phases in the development of atherosclerosis.
Aim
To study serum YKL-40 levels in patients with CKD and to assess its correlation with high-sensitive C-reactive protein (Hs-CRP) and carotid intima-media thickness (CIMT) as a predictor for early atherosclerosis.
Patients and methods
A cross-sectional study included 40 CKD patients. Group I was classified into: Ia which 20 patients on regular hemodialysis and Ib which included 20 predialysis patients’ CKD (stages 4–5), compared with 40 healthy controls of the same age and sex (group II). Routine laboratory investigations were done and serum Hs-CRP and YKL-40 level were measured in both groups and healthy controls. CIMT was measured by B-mode ultrasound.
Results
There were a highly significant increase of serum YKL-40 and Hs-CRP levels and intima-media thickness of carotid artery in group I when compared with the control group and a highly significant increase in group Ia in comparison to group Ib. There were highly significance positive correlations between YKL-40 level and Hs-CRP, CIMT in groups Ia and Ib.
Conclusion
The study concluded that the serum level of YKL-40 is significantly elevated in patients with chronic renal failure both hemodialysis and predialysis and there was significant positive correlation between YKL-40 and CIMT as well as Hs-CRP in all patients with chronic renal failure. We suggest that YKL-40 had a role as an inflammatory marker and for early detection of atherosclerosis.

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