The Relationship Between Carotid Intima Thickness And α-SMA Expression In Each Phase Of The Kidney Tissues For Patients With Chronic Kidney Disease (CKD)

Objectives: The incidence of Chronic Kidney Disease (CKD)has beenrising year by year, especially in the developed countries. CKD has seriouslyaffected the quality of patient’s survival. And eventually CKD developmentinto the end-stage renal disease (End stage takes diseases, ESRD), which needmaintenance treatment, treatment of complications and expensive medicalcosts, end-stage renal disease also has a huge influence to patient’s quality oflife.CKD are high risk factors of cardiovascular events, and cardiovascularevents is the main cause of death in CKD. Studies show that cardiovascularcomplications accounted for50%of end-stage renal disease cause of death.Carotid intimal thickening is a window of cardiovascular disease, monitoringof carotid intima thickness can predict the occurrence of cardiovascular events.The expression of ɑ-SMA is rich in the small arteries in the kidney tissues, butthe expression in middle artery will be significantly reduced in patients withsevere calcification. This experiment mainly study the different inɑ-SMAexpression in different periods in patients with CKD, and the relationshipbetween carotid intima thickness and the expression of ɑ-SMA in renalarteriole and the relationship between degree of the expression of ɑ-SMA inrenal interstitial and the damage degree in renal interstitial, reveal therelationship between the expression of renal tissue ɑ-SMA and kidney lesionseverity and through detection kidney ɑ-SMA positive levels by renal biopsyto predict cardiovascular events.Methods:Select60patients with renal biopsy clear kidney pathologicalchanges in the second hospital of hebei medical university in March2012toSeptember2012.According to the eGFR divided into3groups,26patients inCKD1period,21patients in CKD2period,13patients in CKD3,3patients in CKD4period,after renal biopsy kidney tissues with FAA fixed liquid, afterembedding with2um thickness serial section, PSA staining andimmunohistochemical staining, Continuous observation in50at highmagnification, observe weather the renal tubular epithelial cells is expansion,atrophy, degeneration, and inflammatory cell infiltration in renal interstitial,divided into4degrees through renal interstitial lesion. immunohistochemicalstaining under the same conditions and the same time. Then examine eachspecimen dyeing results, immunohistochemical results according to the renaltubules cytoplasm and small artery walls appear tan granule or block depositfor positive results, and observed at high magnification, the selection of fivepositive result area of image analysis, it is concluded that positive area andcumulative optical density, and calculated the average optical density, withquantitative the ɑ-SMA positive expression degree with the average opticaldensity.Results:1The average optical of ɑ-SMA in small arteries in the kidney: the CKD1group is0.2816±0.0161; CKD2group is0.2681±0.0990; CKD3group is0.2172±0.0512, CKD4group is0.1916±0.0301. There are statisticallysignificant between every two groups (P <0.05). The average positive areapercentage of small arteries ɑ-SMA: CKD1is22.2301±6.3452%;CKD2is19.1032±9.3423%;CKD3is13.5078±1.2504%,CKD4is10.4049±11.6902%. There are statistically significant between every two groups (P <0.05).2The average optical density of ɑ-SMA in renal interstitial: CKD1group is0.0231±0.3252; CKD2group is0.1631±0.4962; CKD3group is0.2117±0.5162, CKD4group is0.3016±0.3016. There are statisticallysignificant between every two groups (P <0.05).3Carotid intima thickness: CKD1group is0.5021±0.0401mm; CKD2group is0.5137±0.1042mm; CKD3group is0.8147±0.1016mm; CKD4group is1.1047±0.1106mm. There are statistically significant among CKD1group and CKD3group，CKD4group (P <0.05). There are statistically significant among CKD2group and CKD3group，CKD4group (P <0.05).4The average positive area percentage of small arteries ɑ-SMA in thekidney are negatively related with Scr, blood pressure, potassium and carotidintima thickness, and are positively related with CO2combining power,TG,TC(P <0.05); The average positive area percentage of renal interstitiumare positively related with Scr, blood pressure, potassium and carotid intimathickness, and are negatively related with CO2combining power, TG,TC(P <0.05).Conclusion:1The kidney tissues of ɑ-SMA expression changes may participate in thedevelopment of chronic kidney disease.2Joint detection of the small arteries in the kidney and renal interstitialɑ-SMA expression level and the relationship between carotid intima thicknessfor the possibility of cardiovascular accident for patients with CKD to providea certain basis.