Effect of diabetes and oxidative stress on plasma CCL23 levels in patients with severe chronic kidney disease.
CCL23 is a new CC chemokine involved in leukocyte trafficking and inflammatory diseases. Inflammation, oxidative stress, and diabetes are common in patients with chronic kidney disease (CKD), particularly in those with cardiovascular disease (CVD). The aim of this study was to evaluate CCL23 concentrations in patients with CKD and to identify the factors affecting its plasma level. CCL23 levels, inflammatory markers (high-sensitivity C-reactive protein, interleukin 6, and tumor necrosis factor α) and oxidative stress markers (neopterin and Cu/Zn superoxide dismutase [Cu/Zn SOD]) were measured in the plasma of patients with mild-to-moderate CKD (group A) and severe CKD (group B) both with and without diabetes and in controls. CCL23 concentrations were higher in group B, particularly in patients with diabetes compared with controls (P <0.001) and group A (P <0.01). The inflammatory markers were increased in CKD patients but they were not correlated with CCL23 levels. In contrast, there were associations between CCL23 and oxidative stress markers and kidney function. The presence of diabetes, Cu/Zn SOD, and percentage of lymphocytes were found to be independent factors affecting CCL23 concentrations in the whole CKD group. In patients without diabetes, only Cu/Zn SOD was independently associated with CCL23. CCL23 levels were increased in patients with severe CKD and were strongly correlated with kidney function. The coexistence of diabetes and oxidative stress independently affected CCL23 levels, while the presence of CVD and inflammation had no impact on its concentrations.