Endothelial Microparticles: A Novel Marker of Vascular Dysfunction

The primary hypothesis of this proposal is that chronic kidney disease (CKD) and treatment
with calcineurin inhibitors (CNIs) are each associated with the release of endothelial
microparticles into the plasma. These injury-associated microparticles have a different
molecular/protein composition than those released from endothelial cells in healthy
patients, and their abundance correlates with vascular injury. To test this hypothesis the
investigators propose a 3 arm case-controlled study including normal controls, individuals
with stage III and IV CKD not receiving CNI therapy, and individuals with stage III and IV
CKD post kidney transplantation receiving a CNI. The goal of this study is to measure the
amount of microparticles in patients with kidney disease who have had a kidney transplant.
Another goal of this study is to see if the measurements of microparticles are related to
poor function of the vessels (endothelial dysfunction).

Inclusion Criteria:

For Healthy controls:

- BMI less than 40 kg/m^2

- Able to give informed consent

For Stage III or IV CKD patients:

- BMI less than 40 kg/m^2

- Able to give informed consent

- An estimated Glomerular-Filtration Rate (GFR) of 20-60 mL/min/1.73m^2

For Post-kidney transplant and stage III or IV CKD patients:

- BMI less than 40 kg/m^2

- Able to give informed consent

- An estimated Glomerular-Filtration Rate (GFR) of 20-60 mL/min/1.73m^2

Exclusion Criteria:

For Healthy controls:

-Women pregnant or breastfeeding

For Stage III or IV CKD patients:

- Women pregnant or breastfeeding

- Adults with a life expectancy of less than one year

- A history of significant liver disease or congestive heart failure

- Hospitalization within the last three months

- Active infection on antibiotic therapy

- Uncontrolled hypertension (>140/90)

- Immunosuppressive therapy within the last year

For Post-transplant stage III or IV CKD patients:

- Women pregnant or breastfeeding

- Adults with a life expectancy of less than one year

- A history of significant liver disease or congestive heart failure

- Hospitalization within the last three months

- Active infection on antibiotic therapy

- Uncontrolled hypertension (>140/90)