Diagnostic and prognostic values of adhesion molecules VCAM-1, ICAM-1 and C-reactive protein in Egyptian patients with chronic kidney disease.

Soluble intracellular adhesion molecule-1 (ICAM-1) and soluble vascular adhesion molecule-1 (VCAM-1) are markers of endothelial dysfunction which is linked to the atherosclerotic process causing a series of complications in patients with chronic kidney disease. The aim of this study was to evaluate C-reactive protein and adhesion molecules VCAM-1, ICAM-1 in patients with predialysis, chronic renal failure (CRF), on maintenance hemodialysis (HD) and after kidney transplantation (KT). Ten patients with predialysis CRF, 20 on maintenance HD, 5 after KT and 10 subjects as a control group were included in this study. We evaluated serum levels of ICAM-1, VCAM-1 as acute phase proteins, C-reactive protein (CRP) as an inflammatory marker and body mass indices (BMI), serum albumin, cholesterol, triglyceride as nutritional indices. The mean values of serum levels of VCAM-1 and ICAM-1 were significantly higher in the three groups of patients than those of the controls (P < or = 0.05). There was statistically significant difference between the serum levels of VCAM-1 in the HD patients versus all other groups with the highest level in the HD patients. The circulating level of CRP, there was a progressive increase from controls to KT, CRF and to HD with the highest level in HD patients. There was a statistically significant difference between CRP serum levels in the HD patients versus all other groups with the highest level in the HD patients. Regression analysis showed significant positive correlation between CRP and ICAM-1 in KT patients (r = 0.9051; P = 0.0346), in CRF patients (r = 0.7621; P = 0.0170) and in HD patients (r = 0.4449, P = 0.0493). As regards the correlation between CRP and VCAM-1, there was positive correlation in KT patients (r = 0.9006; P = 0.0370), in CRF patients (r = 0.7088; p = 0.0326) and in HD patients (r = 0.4498; P = 0.0466). Age and BMI did not statistically differ in the study groups. In conclusion, serum levels of soluble adhesion molecules sVCAM-1, sICAM-1 correlate positively with the stage of renal disease. Also their serum levels were correlated positively with CRP as an inflammatory index in renal diseases. Further studies are needed to assess use of monoclonal antibodies against adhesion molecules and CRP as targets for therapeutic intervention in chronic kidney diseases.