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World J Nephrol. Aug 6, 2013; 2(3): 77-83
Published online Aug 6, 2013. doi: 10.5527/wjn.v2.i3.77
Evaluation of microvascular reactivity with laser Doppler flowmetry in chronic kidney disease
Levente Babos, Zoltán Járai, János Nemcsik
Levente Babos, János Nemcsik, Department of Family Medicine, Semmelweis University, 1125 Budapest, Hungary
Zoltán Járai, Department of Cardiology, St. Imre Teaching Hospital, 1115 Budapest, Hungary
Author contributions: Babos L solely contributed to this paper; Járai Z and Nemcsik J revised it critically for important intellectual content.
Correspondence to: János Nemcsik MD, PhD, Department of Family Medicine, Semmelweis University, Kútvölgyi str. 4, 1125 Budapest, Hungary.
Telephone: +36-14-694667 Fax: +36-13-358530
Received: June 13, 2013
Revised: July 31, 2013
Accepted: August 2, 2013
Published online: August 6, 2013

Cardiovascular diseases are the major causes of mortality in patients with chronic kidney disease (CKD). The complex process of accelerated athero- and arteriosclerosis in CKD is associated with this phenomenon, where endothelial dysfunction (ED) is one of the initial steps. Hence, the early diagnosis of ED can potentially lead to early interventions which could result in a better outcome for these patients. Several methodologies have been developed for the diagnosis of ED. Laser Doppler flowmetry (LDF) enables us to study the microcirculation continuously in a non-invasive manner. In our review we would like to focus on different tests developed for LDF, like postocclusive reactive hyperaemia, local heating, iontophoresis, microdialysis or analysis of flowmotion. We would also like to summarize the available data in CKD with these methodologies to enlighten their perspectives in the clinical use on this patient population.

Keywords: Chronic kidney disease, Laser Doppler flowmetry, Endothelial dysfunction, Iontophoresis, Postocclusive reactive hyperaemia, Local heating, Microdialysis, Flowmotion

Core tip: Atherosclerotic diseases are the leading causes of death in chronic kidney disease (CKD) patients. Endothelial dysfunction is an important initial step of atherosclerotic processes, so with the early diagnosis and treatment of endothelial dysfunction many cardiovascular events can potentially be prevented. Laser Doppler flowmetry (LDF) gives the opportunity of the non-invasive study of microcirculation and endothelial function. This review summarizes the results of different LDF techniques and their usefulness in the diagnosis of endothelial dysfunction in CKD patients.