FP254CYLINDRICAL VESICLES AS DIAGNOSTIC CELLULAR INDICES IN CARDIORENAL SYNDROME TYPES III AND IV: BIOPSY OF PERIPHERAL BLOOD SMEARS WITH THE ATOMIC FORCE AND SCANNING ELECTRON MICROSCOPES

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Introduction and Aims: Cardio-Renal Syndrome (CRS) is classified in 5 Types, depending on the primary impaired organ, Heart (Types I and II) or Kidney (Types III and IV), and the chronic (Types II and IV) or acute (Types I and III) nature. Type V refers to a systemic disease. The biochemical indices (e.g. B-type natriuretic peptide (BNP), neutrophil gelatinase associated lipocalin (NGAL) etc) that document the Type of CRS have not been completely clarified until now. Here we performed biopsy of peripheral blood smears of patients with CRS to investigate the possible existence of cellular indices of diagnostic value. Methods: Smears of peripheral blood were imaged with the Atomic Force Microscope (AFM) and Scanning Electron Microscope (SEM), allowing to obtain quantitative information at the nanometer level (1 nm=10-9 m). Intact RBCs (iRBCs) (N>1000) and intact platelets (Plts) (N>1000) of patients with CRS (N=5; 2 patients: Types I/II, 2 patients: Types III/IV and 1 patient: Type V) were imaged with AFM and SEM, in comparison with iRBCs and iPlts of healthy donors (N=5). Biochemical and hematological indices were recorded with the standard clinical methods.

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