Chronic kidney disease (CKD) is associated with a high incidence of cardiovascular disease (CVD) due to the accumulation of uremic toxins, altered redox state, and chronic systemic inflammation. This study aimed to analyze the relationship between the redox status of patients with CKD and the phenotype of microvesicles (MVs) subtypes, and cardiovascular events. The oxidative stress level of each participant was determined using an individualized OXY-SCORE. The relationship between pro-oxidant and antioxidant parameters and the expression of membrane markers in endothelial-derived microvesicles (EMVs) and platelet-derived microvesicles (PMVs) was established. Patients with advanced CKD (ACKD) and hemodialysis (HD) had a higher OXY-SCORE than healthy subjects (HS), whereas peritoneal dialysis (PD) patients had similar scores to HS. PD patients showed elevated PMVs and CD41 expression, whereas HD patients had higher EMVs and CD31 expression. Patients with ACKD had higher tissue factor (TF) expression in the PMVs and EMVs. TF expression was correlated with xanthine oxidase (XO) activity and was negatively correlated with antioxidant parameters. Patients with cardiovascular events show elevated TF. In conclusion, microvesicles and oxidative stress may serve as markers of cardiovascular risk in CKD, with TF expression in PMVs and EMVs being potential predictive and prognostic biomarkers of CVD.

Chronic kidney disease is closely associated with an increased risk of cardiovascular disease. Although kidney transplantation represents the treatment of choice for patients with end-stage chronic kidney disease, it is also linked to significant cardiovascular risk. This study aimed to evaluate the relationship between cardiovascular pathology and oxidative status in kidney transplant recipients, while also assessing the influence of disease etiology and humoral immune response on oxidative imbalance. A cross-sectional analysis was conducted in individuals with advanced chronic kidney disease (n = 36) and kidney transplant recipients (n = 40). A total of 18 healthy subjects were included. The enzymatic activities of xanthine oxidase, superoxide dismutase, and glutathione peroxidase, and levels of lipid peroxidation products, oxidized glutathione, and reduced glutathione were measured using spectrophotometry in plasma and mononuclear and polymorphonuclear leukocytes isolated using Ficoll density gradients. Individual oxidative status was evaluated using OXYSCORE. Kidney transplantation was associated with a higher incidence of cardiovascular disease (p < 0.01) and increased levels of both prooxidant (p < 0.01) and antioxidant parameters (p < 0.01). Elevated OXYSCORE values were observed particularly in patients with nephroangiosclerosis, diabetic kidney disease, polycystic kidney disease (p < 0.05), and cardiovascular comorbidities (p < 0.001). Additionally, the presence of anti-graft antibodies correlated with higher oxidative scores. These findings suggest that OXYSCORE may serve as a potential indicator of cardiovascular damage in kidney transplant recipients.

Chronic kidney disease is closely associated with an increased risk of cardiovas-cular disease. Although kidney transplantation represents the treatment of choice for patients with end-stage chronic kidney disease, it is also linked to significant cardio-vascular risk. This study aimed to evaluate the relationship between cardiovascular pathology and oxidative status in kidney transplant recipients, while also assessing the influence of disease etiology and humoral immune response on oxidative imbalance. A cross-sectional analysis was conducted in thirty-six individuals with advanced chronic kidney disease and forty kidney transplant recipients. The enzymatic activities of xan-thine oxidase, superoxide dismutase, and glutathione peroxidase, levels of lipid perox-idation products, oxidized glutathione, and reduced glutathione, were measured by spectrophotometry in plasma and mononuclear and polymorphonuclear leukocytes isolated using Ficoll density gradients. Individual oxidative status was evaluated using an OXYSCORE. Kidney transplantation was associated with a higher incidence of car-diovascular disease and increased levels of both pro-oxidant and antioxidant bi-omarkers. Elevated OXYSCORE values were observed particularly in patients with nephroangiosclerosis, diabetic kidney disease, polycystic kidney disease, and cardio-vascular comorbidities. Additionally, the presence of anti-graft antibodies correlated with higher oxidative scores. These findings suggest that redox status may serve as a potential biomarker for cardiovascular risk in kidney transplant recipients.

Background: Frailty is a highly prevalent syndrome in patients with advanced age and chronic diseases, and it is associated with atherothrombotic pathologies, suggesting a procoagulant state in these patients. Circulating microvesicles (cMVs), are small phospholipid-rich vesicles, which have been shown to participate in atherothrombotic onset and progression. We aim to analyze frailty in patients with advanced chronic kidney disease (CKD), and to determine the role of microvesicles in this population. Materials and methods: We conducted a prospective cohort study with 85 patients with advanced CKD. Our main objective was to evaluate frailty and its novel association with circulating microvesicles in advanced CKD. To define frailty, Fried’s five criteria were used and we obtained blood for cMVs analysis by flow cytometry. Results: The prevalence of frailty in patients with advanced CKD was 27% (CI 95% 17-37%). We found that risk factors for frailty were age (OR 1.06; CI 95% to 1.11; p=0.027), type 2 diabetes mellitus (OR 5.77; CI 95% to 18.9; p=0.004) and hemoglobin (g/dL) (OR 0.63; CI 95% to 0.94; p=0.023). Total cMVs, platelet derived cMVs and endothelial derived cMVs were significantly higher in frail patients. In the predictive multivariable binary logistic regression model over frailty, three predictors explain 41% of the variability of frailty (Nagelkerke square R = 0.41; p <0.001) with the following contribution: T2DM (19%), total cMVs (14%) and hemoglobin (8%). Discussion: Frailty is highly prevalent in patients with advanced CKD. Although we still do not know in depth the mechanisms involved in frailty, to our knowledge this is the first study that links cMVs and frailty in patients with advanced CKD. In our opinion it could be explored as a good biomarker or therapeutic target in advanced CKD.