Possible Role of G-csf on Neutrophil Activation, Endothelial Dysfunction and Haemostatic Changes, in Chronic Renal FailurePatients

Cardiovascular disease remains the main cause of morbidity and mortality in maintenance haemodialysis patients. This study was designed to evaluate granulocyte colony stimulating factor (G-CSF) level in chronic renal failure patients, and to clarify its impact on neutrophil activation, endothelial dysfunction and haemostatic activation in these patients. Thirty patients on regular haemodialysis treatment were included in the study, as well as ten healthy controls. G-CSF was assayed by ELISA technique. 11b 18 Neutrophil activation was examined by surface expression of Mac1 (CD /CD ) using flowcytometry. Endothelial dysfunction marker (von Willebrand factor {vWF}) and the haemostatic activation marker (D-dimer) were measured by ELISA technique. Our results revealed a significant rise in G-CSF level, up regulation of neutrophil activation marker (Mac1) and endothelial dysfunction marker (vWF) in these patients. Also there is a significant haemostatic activation evidenced by high level of D-dimer. G-CSF 11b 18 showed a significant direct correlation with Mac1 (CD /CD ), vWF and D-dimer which incriminate GCSF in the hypercoagulable state encountered in these patients. In conclusion, High level of G-CSF in CRF patients may play a role in cardiovascular disease events in these patents.