LAUSR

The stratification of early cardiovascular (CV) risk is a major unmet need in chronic kidney disease (CKD). Since angiogenic T-cells are emerging mediators of vascular homeostasis and have been linked to CV disease (CVD), this study evaluated the frequency of circulating angiogenic T-cells in CKD patients undergoing peritoneal dialysis (CKD-5D) and their potential as predictive biomarkers of CVD. In 30 peritoneal dialysis patients and 16 matched healthy controls (HC), we quantified: Vascular calcification (by Kauppila Index); left carotid intima media thickness (lc-IMT by ultrasound), carotid adventitial vasa vasorum density (an early marker of atherosclerosis stage, by Superb Microvascular Ultrasound Image), pulse wave velocity (a marker of vascular stiffness and dysfunction, using the Complior Analyzer), angiogenic T cell frequency in blood (by Flow cytometry) and the traditional 10-year CVD risk (using the SCORE chart). As expected, CKD-5D patients exhibited higher Kauppila index (p<0.001), lcIMT (p=0.010) and adventitial vasa vasorum density (p=0.008) than HC. Angiogenic-T cell frequency was decreased in CKD compared to HC (1.68(1.05) vs. 3.33(1.44)%, p<0.001). In CKD-5D patients, angiogenic-T cell frequency was not associated with blood pressure, cholesterol levels or time on dialysis (all p>0.05) and did not correlate with Kauppila (r=-0.350, p=0.080) or lcIMT (r=-0.154, p=0.600), but strongly associated negatively with both pulse wave velocity (r=-0.734, p<0.001) and with adventitial vasa vasorum (newly formed vasa vasorum) number: r=-0.640, p=0.006; or density: r=-0.813, p<0.001). Angiogenic-T cell levels paralleled pulse wave velocity (B[95% CI]: -0.083[-0.155, -0.010], p=0.028; R2=0.531) and adventitial vasa vasorum -15.049[-26.705, -3.392], p=0.015; R2=0.598) and improved the prediction model over that of the SCORE chart (R2=0.360 and R2=0.336, respectively). Angiogenic-T cell frequency was decreased in CKD-5D patients and could be considered as biomarkers of vascular dysfunction and early atherosclerosis stage.