The relationship between SCUBE1 level electrocardiography echocardiography findings, epicardial fat tissue, and carotid intima media thickness in patients receiving renal replacement therapy

Purpose: The most important cause of morbidity and mortality is cardiovascular diseases in chronic kidney disease (CKD). In patients with advanced stage renal insufficiency arterial stiffness and vascular calcification are strong predictors of cardiovascular risk. Patients receiving renal replacement therapy are also prone to thrombotic events. SCUBE1 is found in platelet alpha granules and is presented to the cell surface by platelet activation. SCUBE1 levels have been shown to increase during platelet activation and acute ischemic events. The aim of this study was to evaluate the relationship between SCUBE1 level and electrocardiographic and echocardiographic findings, epicardial fat tissue thickness and carotid intima media thickness in patients undergoing renal replacement therapy. Materials and Methods: Twenty-one renal transplant recipients, 20 patients undergoing peritoneal dialysis, 20 hemodialysis patients, 20 predialysis patients with GFR<30 ml/min and 16 healthy volunteers were included in the study. Acute infections, cardiovascular events, malignant disease, uncontrolled hypertension/diabetes mellitus were excluded. Routine biochemical parameters, SCUBE1 level were measured. Echocardiographic and echocardiographic examinations were performed. Carotid intima media thickness was measured with Doppler USG. SPSS 20 for Windows package program was used for statistical evaluations. Results: There were 49 male and 32 female in patient groups. In the control group, there were 9 male and 7 female. The mean age was 47.90 for the patient groups and 44.87 for the control group. There was no difference for SCUBE1 levels between the patient groups and the control group. SCUBE1 levels were found to be correlated with CRP in renal transplant group, Mg in peritoneal dialysis, ESH in predialysis, PTH, PLT, CaXP, and Ca levels in hemodialysis group. SCUBE1 levels did not accompany ECG or ECO pathologies. CRP elevation in predialysis patients was associated with valve pathology. In the hemodialysis patient group, SCUBE1 level after dialysis was significantly higher than before dialysis (p = 0.007). No statistically significant difference was found between epicardial fat tissue thickness, electrocardiography, echocardiographic findings and SCUBE1 levels in patient groups and control group. A positive correlation was found between carotis intima media thickness and SCUBE1 level in peritoneal dialysis and hemodialysis group (p <0.05). Conclusion: SCUBE1 levels were correlated with CRP in renal transplant patients and platelet count and erythrocyte sedimentation rate in peritoneal dialysis. Hemodialysis may also contribute to cardiovascular events because of increased SCUBE1 level after hemodialysis. However, SCUBE1 levels did not accompany patholgical finding of ECG or ECO in our patients. Interestingly, elevated CRP was associated with valve pathology in predialysis patients. Since there is no correlation between epicardial fat tissue and SCUBE levels, and SCUBE1 is significantly higher in healthy controls with normal echocardiographic finding and in predialysis patients without SVDD, it can not comment any cardiovascular events with a single SCUBE1 measurement. Except hemodialysis patients in women with CKD even though nonsignificantly, higher SCUBE1 levels may be important. Due to correlations between SCUBE1 levels and carotid intima media thickness and secondary hyperparathyroidism markers SCUBE1 levels may be associated with atherosclerosis and bone mineral disease in dialysis patients. Key words: Chronic renal failure, SCUBE1