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Palar S, Wantania FE, Honoris H. The Correlation of Interleukin-6, Malnutrition Inflammation Score and Asymmetric Dimethylarginine in Chronic Kidney Disease Patients Undergoing Routine Hemodialysis. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction: Chronic kidney disease (CKD) patients undergoing routine hemodialysis (HD) have a high prevalence of protein-energy malnutrition (PEM) and inflammation. The combination of inflammation and PEM is associated with cardiovascular disease and poor outcomes. Interleukin-6 (IL-6) is an inflammatory factor that runs parallel to endothelial damage and is closely related to the nutritional status of CKD HD patients. The tool to assess nutrition status is Malnutrition Inflammation Score (MIS) and to assess endothelial damage is Asymmetric Dimethylarginine (ADMA). It is currently unclear whether there is a correlation between inflammation, malnutrition, and endothelial dysfunction. Therefore the aim of this study is to determine the correlation between IL-6, MIS and ADMA in CKD HD patients.
Methods: A cross-sectional design with analytic observational study was conducted on end stage renal disease patient who undergo routine hemodialysis for at least 2 years with the duration of hemodialysis is 4-5 hours and at least twice per week. IL-6 was examined by kit (ELISA) and ADMA using LC-MS/MS at a certified laboratory in Manado city. History taking and physical examination were used to calculate MIS. Data analysis was done using SPSS version 22.
Results: There were 30 participants consisting of 22 men (72%) and 8 women (28%). The median age of the subjects was 56.50 years. There was a statistically significant positive correlation between IL-6 and ADMA (r = 0.440, p = 0.015), MIS and ADMA (r = 0.378, p = 0.039), and IL-6 and MIS (r = 0.682, p = 0.0001).
Conclusion: There was a significant correlation between IL-6, MIS and ADMA.
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Gok M, Kurtul A, Taylan G, Sayılar EI, Yalta K. Serum Prealbumin: a potential predictor of Right Ventricular Dysfunction in patients receiving programmed hemodialysis. Rev Assoc Med Bras (1992) 2022; 68:792-796. [PMID: 35766693 PMCID: PMC9575908 DOI: 10.1590/1806-9282.20211348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/05/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Prealbumin has been a reliable marker to predict protein energy malnutrition and hypercatabolic state. In this analysis, we particularly aimed to investigate the potential association between serum prealbumin levels and right ventricular dysfunction in patients receiving programmed hemodialysis. METHODS A total of 57 subjects were included in the analysis. The subjects were then categorized into two groups: right ventricular dysfunction (n=18) and non-right ventricular dysfunction (n=39) groups. In all patients, detailed transthoracic echocardiography (following hemodialysis) were performed along with the evaluation of complete blood count, routine biochemistry parameters, and, in particular, serum prealbumin levels. RESULTS Mortality rate at 3 years was found to be significantly higher in the right ventricular dysfunction group (p=0.042). Serum prealbumin levels were also significantly lower in the right ventricular dysfunction group compared with the non-right ventricular dysfunction group (23.83±8.50 mg/dL versus 31.38±6.81 mg/dL, p=0.001). In the receiver operating characteristics curve analysis, a prealbumin cutoff value of <28.5 mg/dL was found to predict right ventricular dysfunction, with a sensitivity of 67% and a specificity of 62% (area under the curve: 0.744). In the correlation analysis, a moderate yet significant positive correlation was demonstrated between serum prealbumin and tricuspid annular plane systolic excursion (r=0.365, p=0.005). CONCLUSION This study suggests that low serum prealbumin might serve as a potential predictor of right ventricular dysfunction (and its clinical consequences) in patients receiving programmed hemodialysis.
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Affiliation(s)
- Murat Gok
- Trakya Üniversitesi, Cardiology Department - Edirne, Turquia
| | - Alparslan Kurtul
- Hatay Mustafa Kemal Üniversitesi, Cardiology Department - Antakya, Turquia
| | - Gökay Taylan
- Trakya Üniversitesi, Cardiology Department - Edirne, Turquia
| | - Emel Işıktaş Sayılar
- Ufuk Üniversitesi, Dr. Rıdvan Ege Hastanesi, Nephrology Department - Çankaya/Ankara, Turquia
| | - Kenan Yalta
- Trakya Üniversitesi, Cardiology Department - Edirne, Turquia
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Ticala M, Rusu CC, Moldovan D, Potra AR, Tirinescu DC, Coman AL, Bondor CI, Budisan L, Kacsó IM. Hemodialysis Patients with Higher Serum Levels of Soluble Receptor for Advanced Glycation End Products Have an Increased Risk for Arteriovenous Fistula Failure. Blood Purif 2021; 51:764-771. [PMID: 34794141 DOI: 10.1159/000519879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/27/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Arteriovenous fistula (AVF) failure due to thrombosis is a major cause of morbidity in patients undergoing regular hemodialysis (HD). Advanced glycation end products (AGEs) and their receptor (RAGE) might contribute to inflammation, neointimal hyperplasia, and thrombosis. RAGE has a C-truncated secretory receptor form, called soluble RAGE (sRAGE). In this study, we aimed to evaluate the association of serum sRAGE with AVF failure due to thrombosis in HD patients. METHODS Eighty-eight prevalent HD patients with functional AVF were included in the study. The presence of stenosis, clinical and laboratory data, and serum sRAGE was evaluated at inclusion. sRAGE concentration was measured by a competitive enzyme-linked immunosorbent assay, and stenosis was detected by ultrasound. Patients were prospectively followed up for 36 months. During this period, AVF failure (defined as the absence of blast or palpable thrill and impossible cannulation with 2 needles because of complete thrombosis) was noted and thrombosis was certified by ultrasound examination. RESULTS During follow-up, 16 (18.18%) patients lost their vascular access due to thrombosis. In multivariate Cox regression analysis, sRAGE was a significant predictor of vascular access thrombosis (hazard ratio = 1.15, 95% confidence interval: 1.03-1.25, p = 0.012). Kaplan-Meier analysis showed a significantly lower AVF patency time in patients with sRAGE >16.78 ng/mL than those with sRAGE <16.78 ng/mL (p = 0.02). In the subgroup of patients with stenosis at baseline, sRAGE, serum albumin, obesity, and ischemic heart disease were associated with thrombosis. CONCLUSION In our study, baseline, systemic sRAGE is associated with the occurrence of thrombosis of AVF, and this marker has a significant impact on AVF survival.
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Affiliation(s)
- Maria Ticala
- Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - Crina Claudia Rusu
- Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - Diana Moldovan
- Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - Alina Ramona Potra
- Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - Dacian Călin Tirinescu
- Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - Anca Laura Coman
- Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - Cosmina Ioana Bondor
- Department of Informatics and Biostatistics, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
| | - Livia Budisan
- Research Center for Functional Genomic, Biomedicine and Translational Medicine, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj Napoca, Romania
| | - Ina Maria Kacsó
- Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania
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Cardoso A, Branco C, Sant’Ana M, Costa C, Silva B, Fonseca J, Outerelo C, Gameiro J. Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis. J Clin Med 2021; 10:4518. [PMID: 34640538 PMCID: PMC8509659 DOI: 10.3390/jcm10194518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The prevalence of chronic kidney disease (CKD) and heart failure (HF) has been rising over the past decade, with a prevalence close to 40%. Cardiovascular disease and malnutrition are common comorbidities and known risk factors for mortality in haemodialysis (HD) patients. We aimed to evaluate the one-year mortality rate after dialysis induction, and the impact of serum albumin levels on survival outcomes, in patients with CKD and HF. METHODS This was a retrospective analysis of patients with CKD and HF who underwent chronic HD between January 2016 and December 2019 in a tertiary-care Portuguese hospital. Variables were submitted to univariate and multivariate analysis to determine factors predictive of one-mortality after HD start. RESULTS In total, 204 patients were analysed (mean age 75.1 ± 10.3 years). Within the first year of HD start, 28.7% of patients died. These patients were significantly older [79.8 ± 7.2 versus 72.9 ± 10.9 years, p < 0.001; OR 1.08 (1.04-1.13), p < 0.001] and had a higher mean Charlson Index [9.0 ± 1.8 versus 8.3 ± 2.0, p = 0.015; OR 1.22 (1.04-1.44), p = 0.017], lower serum creatinine [5.1 ± 1.6 mg/dL versus 5.8 ± 2.0 mg/dL; p = 0.021; OR 0.80 (0.65-0.97), p = 0.022], lower albumin levels [3.1 ± 0.6 g/dL versus 3.4 ± 0.6 g/dL, p < 0.001; OR 0.38 (0.22-0.66), p = 0.001] and started haemodialysis with a central venous catheter more frequently [80.4% versus 66.2%, p = 0.050]. Multivariate analysis identified older age [aOR 1.07 (1.03-1.12), p = 0.002], lower serum creatinine [aOR 0.80 (0.64-0.99), p = 0.049] and lower serum albumin [aOR 0.41 (0.22-0.75), p = 0.004] as predictors of one-year mortality. CONCLUSION In our cohort, older age, lower serum creatinine and lower serum albumin were independent risk factors for one-year mortality, highlighting the prognostic importance of malnutrition in patients starting chronic HD.
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Affiliation(s)
- Ana Cardoso
- Centro Hospitalar Universitário Lisboa Norte, Department of Medicine, Division of Internal Medicine II, EPE, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal;
| | - Carolina Branco
- Centro Hospitalar Universitário Lisboa Norte, Department of Medicine, Division of Nephrology and Renal Transplantation, EPE, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal; (C.B.); (C.C.); (B.S.); (J.F.); (C.O.)
| | - Mariana Sant’Ana
- Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Lisboa, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal;
| | - Cláudia Costa
- Centro Hospitalar Universitário Lisboa Norte, Department of Medicine, Division of Nephrology and Renal Transplantation, EPE, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal; (C.B.); (C.C.); (B.S.); (J.F.); (C.O.)
| | - Bernardo Silva
- Centro Hospitalar Universitário Lisboa Norte, Department of Medicine, Division of Nephrology and Renal Transplantation, EPE, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal; (C.B.); (C.C.); (B.S.); (J.F.); (C.O.)
| | - José Fonseca
- Centro Hospitalar Universitário Lisboa Norte, Department of Medicine, Division of Nephrology and Renal Transplantation, EPE, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal; (C.B.); (C.C.); (B.S.); (J.F.); (C.O.)
- Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Lisboa, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal;
| | - Cristina Outerelo
- Centro Hospitalar Universitário Lisboa Norte, Department of Medicine, Division of Nephrology and Renal Transplantation, EPE, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal; (C.B.); (C.C.); (B.S.); (J.F.); (C.O.)
| | - Joana Gameiro
- Centro Hospitalar Universitário Lisboa Norte, Department of Medicine, Division of Nephrology and Renal Transplantation, EPE, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal; (C.B.); (C.C.); (B.S.); (J.F.); (C.O.)
- Clínica Universitária de Nefrologia, Faculdade de Medicina da Universidade de Lisboa, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-035 Lisboa, Portugal;
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Su G, Iwagami M, Qin X, McDonald H, Liu X, Carrero JJ, Stålsby Lundborg C, Nitsch D. Kidney disease and mortality in patients with respiratory tract infections: a systematic review and meta-analysis. Clin Kidney J 2021; 14:602-611. [PMID: 33623685 PMCID: PMC7886553 DOI: 10.1093/ckj/sfz188] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Respiratory tract infections (RTIs) are a common reason for people to seek medical care. RTIs are associated with high short-term mortality. Inconsistent evidence exists in the association between the presence of kidney disease and the risk of death in patient with RTIs. METHODS We searched the PubMed, Cochrane Library and Embase databases from inception through April 2019 for cohort and case-control studies investigating the presence of kidney disease (defined as medical diagnosis of kidney disease, reduced estimated glomerular filtration rate or creatinine clearance, elevated serum creatinine and proteinuria) on mortality in adults with RTIs in different settings including community, inpatient and intensive care units. We assessed the quality of the included studies using Cochrane Collaboration's tool and conducted a meta-analysis on the relative risk (RR) of death. RESULTS Of 5362 records identified, 18 studies involving 16 676 participants met the inclusion criteria, with 15 studies investigating pneumonia and 3 studies exploring influenza. The risk of bias in the available evidence was moderate. Most [17/18 (94.5%)] of studies reported positive associations of underlying chronic kidney disease with mortality. The pooled adjusted risk for all-cause mortality in patients with RTIs almost doubled [RR 1.96 (95% confidence interval 1.48-2.59)] in patients with kidney disease. Associations were consistent across different timings of kidney disease assessment and provenances of RTIs (community-acquired or healthcare-associated). CONCLUSIONS The presence of kidney disease is associated with higher mortality among people with RTIs, especially in those with pneumonia. The presence of kidney disease might be taken into account when considering admission for patients who present with RTIs.
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Affiliation(s)
- Guobin Su
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou City, China
- Health Systems and Policy, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Masao Iwagami
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Department of Health Services Research, University of Tsukuba, Ibaraki, Japan
| | - Xindong Qin
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou City, China
| | - Helen McDonald
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Xusheng Liu
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou City, China
| | - Juan Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Stålsby Lundborg
- Health Systems and Policy, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Dorothea Nitsch
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Uncanin S, Serdarevic N, Klapuh N, Haskovic E. Peritoneal Transport Characteristics at the Beginning and in Long Term Peritoneal Dialysis: a Single Center Experience. Mater Sociomed 2020; 32:99-104. [PMID: 32843855 PMCID: PMC7428920 DOI: 10.5455/msm.2020.32.99-104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/30/2020] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Peritoneal dialysis (PD) is an established treatment for patients with end-srage kidney disease. The method was developed as an alternative to hemodialysis (HD) presenting a patient survival rate equivalent to HD and better preservation of residual renal function. Peritoneal dialysis (PD) patients have different peritoneal membrane permeability (transport) characteristics. High peritoneal membrane permeability is associated with increased mortality risk in the patient population. AIM The aim of this study was to analyze the importance of the peritoneal membrane transport status in patients treated with continuous ambulatory peritoneal dialysis (CAPD). METHODS The study included 60 adult continuous ambulatory peritoneal dialysis (CAPD) patients, 29 male and 31 female, mean age 56.63±15.06 years. All patients treated with conventional glucose- based PD fluids. For the short term (within 3 month after start of PD) and long term (more than 12 months) peritoneal dialysis analysis of peritoneal transport characteristics has been used peritoneal functional test (PFT). With the test, categorisation of patients was possible into high (H), high-average (HA), low average (LA), and low (L) transporters. RESULTS Dialysate-to plasma ratio (D/P) of creatinine showed significantly increased over time (0.654±0.141 vs... 0.705±0.13, p<0.001). In multivariate analysis age, gender, time on dialysis, comorbid diseases, diabetes mellitus (DM), serum albumin, were considered as independent factors influencing the PFT. The high transporter group had higher D/Pcreat (H 0.84±0.03 vs... LA 0.57±0.05, p<0.001), higher proportion of man (H 100% vs... LA 39.5%, p<0.05), higher proportion of patients with comorbid diseases (H 60% vs... LA 20.9%, p<0.05), lower serum albumin concentration (H 29±6.0 vs... LA 37±5.2, p<0.001), lower D4/D0 glucose ( H 0.23±0.07 vs... LA 0.42±0.14, p<0.001), and lower drained volume (H 600±173 vs... LA 1016±355, p<0.001). CONCLUSION The PFT was en easy, inexpensive, reliable test to assess peritoneal transport type and it also provided information about peritoneal clearance of solutes and ultrafiltration. Peritoneal transport type classification was recognized not only as aid for prescription, but also as a prognostic index.
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Affiliation(s)
- Snezana Uncanin
- Clinic of Nephrology, Clinics Center, Sarajevo, Bosnia and Herzegovina
- Faculty of Health Studies, University of Sarajevo, Bosnia and Herzegovina
| | - Nafija Serdarevic
- Faculty of Health Studies, University of Sarajevo, Bosnia and Herzegovina
- Institute for Clinical Biochemistry and Immunology University of Sarajevo, Clinics Center, Sarajevo, Bosnia and Herzegovina
| | - Nermina Klapuh
- Faculty of Health Studies, University of Sarajevo, Bosnia and Herzegovina
- Institute for Clinical Biochemistry and Immunology University of Sarajevo, Clinics Center, Sarajevo, Bosnia and Herzegovina
| | - Edhem Haskovic
- Department of Biology, Faculty of Science, University of Sarajevo, Bosnia and Herzegovina
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SARI A, ULU MS, KAZAN S, TUNCA O, KAZAN ED. Comparison Of Monocyte / HDL Ratio In Routine Hemodialysis And Peritoneal Dialysis Patients. DICLE MEDICAL JOURNAL 2020. [DOI: 10.5798/dicletip.706097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lu J, Sun M, Wu X, Yuan X, Liu Z, Qu X, Ji X, Merriman TR, Li C. Urate-lowering therapy alleviates atherosclerosis inflammatory response factors and neointimal lesions in a mouse model of induced carotid atherosclerosis. FEBS J 2019; 286:1346-1359. [PMID: 30690853 PMCID: PMC6849826 DOI: 10.1111/febs.14768] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/10/2018] [Accepted: 01/23/2019] [Indexed: 12/18/2022]
Abstract
Hyperuricemia (HU) is a cause of gout. Clinical studies show a link between HU and cardiovascular disease. However, the role of soluble serum urate (SU) on atherosclerosis development remains elusive. We aimed to use a new HU mouse model [Uricase/Uox knockout (KO)] to further investigate the relationship between HU and atherosclerosis. A mouse model by perivascular collar placement of induced carotid atherosclerosis was established in male Uox-KO mice. The Uox-KO mice had elevated SU levels and enhanced levels of atherosclerosis inflammatory response proteins. In contrast, Uox-KO mice with carotid atherosclerosis showed severe neointimal changes in histology staining consistent with increases in intimal area and increases in proliferating cell nuclear antigen (PCNA)- and F4/80-positive cells. Allopurinol reduced neointimal areas induced by the perivascular collar in hyperuricemic mice, accompanied by decreased expression of PCNA- and F4/80-positive cells. Urate-lowering treatment alleviated atherosclerosis inflammatory response factors and reactive oxygen species (ROS) intensities in both collar placement Uox-KO mice and urate-stimulated human umbilical vein endothelial cells (HUVECs). In vitro results using HUVECs showed ROS was induced by urate and ROS induction was abrogated using antioxidants. These data demonstrate that urate per se does not trigger atherosclerosis intima lesions in male mice. Urate worsens carotid neointimal lesions induced by the perivascular collar and urate-lowering therapy partially abrogates the effects. The current study warrants clinical studies on the possible benefits of urate-lowering therapy in atherosclerosis patients with HU.
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Affiliation(s)
- Jie Lu
- Institute of Metabolic Diseases, Qingdao University, China.,Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, China.,Department of Endocrinology and Metabolic Diseases, The Affiliated Hospital of Qingdao University, China
| | - Mingshu Sun
- Institute of Metabolic Diseases, Qingdao University, China.,Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, China.,Department of Rheumatology and Clinical Immunology, The Affiliated Hospital of Qingdao University, China
| | - Xinjiang Wu
- Institute of Metabolic Diseases, Qingdao University, China
| | - Xuan Yuan
- Institute of Metabolic Diseases, Qingdao University, China
| | - Zhen Liu
- Institute of Metabolic Diseases, Qingdao University, China.,Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, China
| | - Xiaojie Qu
- Institute of Metabolic Diseases, Qingdao University, China.,Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, China.,Department of Endocrinology and Metabolic Diseases, The Affiliated Hospital of Qingdao University, China
| | - Xiaopeng Ji
- Institute of Metabolic Diseases, Qingdao University, China.,Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, China
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Changgui Li
- Institute of Metabolic Diseases, Qingdao University, China.,Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, The Affiliated Hospital of Qingdao University, China.,Department of Endocrinology and Metabolic Diseases, The Affiliated Hospital of Qingdao University, China
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9
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Su G, Xu Y, Xu X, Xu H, Lu L, Marrone G, Lindholm B, Wen Z, Liu X, Johnson DW, Carrero JJ, Stålsby Lundborg C. Association between reduced renal function and cardiovascular mortality in patients hospitalized with infection: A multi-center cohort study. Eur J Intern Med 2018; 57:32-38. [PMID: 29958748 DOI: 10.1016/j.ejim.2018.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/11/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Infection is one of the main reasons for hospitalization worldwide, and is associated with an increased risk of cardiovascular mortality. It is unclear whether this association is modified by the presence of reduced renal function. The aim of this study was to analyze the relationship between estimated glomerular filtration rate (eGFR) and cardiovascular mortality in patients hospitalized with infection. METHODS This cohort study included all adult, incident patients who were hospitalized at one of four hospitals in China between 2012 and 2015, had a discharge diagnosis of infection, and had a serum creatinine measurement at admission. Patients receiving renal replacement therapy were excluded. Hospital data were linked to death registry data. All-cause and cardiovascular mortality were evaluated according to admission eGFR [≥60 (reference), 30-59 and < 30 mL/min/1.73m2] using multivariable Cox regression and competing risk analyses. RESULTS During a median follow-up period of 2.39 years, 40,524 patients were hospitalized with infection (mean age 61 years, 54.3% female 18.4% diabetic). Of these, 4781 died. Lower admission eGFR was associated with progressively increased risks of cardiovascular mortality (≥60 mL/min/1.73m2 reference; 30-59 mL/min/1.73m2 subdistribution hazard ratio [SHR] 2.15, 95% CI 1.85-2.50, P< .01; <30 mL/min/1.73m2 SHR 3.19, 95% CI 2.68-3.80, P < .01). The proportion of deaths due to cardiovascular disease increased as the eGFR decreased, predominantly due to ischemic heart disease. CONCLUSIONS Patients hospitalized with infections and reduced renal function have significantly increased risks of cardiovascular mortality. Heart status should be carefully monitored following infections, especially for those with reduced renal function.
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Affiliation(s)
- Guobin Su
- Global Health - Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou city, Guangdong Province, China
| | - Yanjun Xu
- Institute of chronic non-communicable disease, Center for Disease Control and Prevention of Guangdong Province, China
| | - Xiaojun Xu
- Institute of chronic non-communicable disease, Center for Disease Control and Prevention of Guangdong Province, China
| | - Hong Xu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Liming Lu
- Key Unit of Methodology in Clinical Research (KUMCR), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou city, Guangdong Province, China
| | - Gaetano Marrone
- Global Health - Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Lindholm
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Zehuai Wen
- Key Unit of Methodology in Clinical Research (KUMCR), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou city, Guangdong Province, China
| | - Xusheng Liu
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou city, Guangdong Province, China.
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia; Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia
| | - Juan-Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Stålsby Lundborg
- Global Health - Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Pássaro PG, D’Ávila R. Nursing educational intervention for the identification of Adverse Events in hemodialysis. Rev Bras Enferm 2018; 71:1507-1513. [DOI: 10.1590/0034-7167-2017-0843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/18/2017] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To develop an educational program aimed at the qualification of the nursing technicians that makes possible the understanding of Adverse Events (AE), aiming to adapt the data records; to elaborate tools for the records of the AE in hemodialysis patients; and to assess the knowledge before and after the educational program. Method: An educational intervention was conducted through a classroom and online course on how to recognize and record AE in hemodialysis. The effectiveness of the program was assessed through the gain of knowledge measured through online record of the AE in fictitious problem cases before and after the course. Result: Sixteen nursing technicians participated in the study. In the initial test, the mean score was 3.7 ± 0.3 points and in the final assessment was 4.2 ± 0.3 points (p=0.0002). Conclusion: It was possible to verify that the educational intervention contributed to increase the knowledge of the participants and that the training of these can be achieved with classroom and online learning courses.
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Wu H, Lee L, Wang W. Associations among Serum Beta 2 Microglobulin, Malnutrition, Inflammation, and Advanced Cardiovascular Event in Patients with Chronic Kidney Disease. J Clin Lab Anal 2017; 31:e22056. [PMID: 27645611 PMCID: PMC6817072 DOI: 10.1002/jcla.22056] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 07/28/2016] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES This study examines the associations among serum β2 microglobulin (B2M), malnutrition, inflammation, and atherosclerosis (MIA) in those with chronic kidney disease (CKD). METHODS CKD patients who were followed in Taoyuan General Hospital from 2009 to 2015 were enrolled. Demographic and biochemical data, including B2M and C-reactive protein (CRP) were reviewed. The participants were stratified according to B2M tertiles. Adjusted hazard ratios (AHRs) and cumulative survival curves for death and MIA syndrome were evaluated by Cox hazard model and Kaplan-Meier method. We also calculated the area under the curve for the receiver operating characteristic curve (AUROC). RESULTS From a total of 312 CKD patients, mean follow-up time was 39.7 months. Compared to those with lowest tertile of B2M, the highest tertile group had lower serum albumin, hemoglobin, and estimated glomerular filtration rate. After multivariate adjustment, the associations among tertiles of B2M, death or dialysis, cardiovascular events (CVEs), and MIA syndrome remained significant. The AHRs for the highest tertile group in death or dialysis, CVEs, and MIA syndrome were 25.91 and 65.84 and 152.50(all Ps <0.05).The AUROC for B2M in death or dialysis, CVEs, and MIA syndrome were greater than that for creatinine. The best cut-off value of B2M for predicting death or dialysis, CVEs, and MIA syndrome were 5.39 mg/dL(sensitivity: 67.1%, specificity 62.5%), 4.21 mg/dL(sensitivity: 85.1%, specificity 52.1%), and 5.40 mg/dL(sensitivity: 79.7%, specificity 64.1%). CONCLUSIONS In those with CKD, serum B2M was more sensitive than creatinine in predicting CVEs and MIA syndrome.
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Affiliation(s)
- Hung‐Chieh Wu
- Division of NephrologyDepartment of Internal MedicineTaoyuan General HospitalMinistry of Health and WelfareTaoyuanTaiwan
| | - Lin‐Chien Lee
- Department of Physical Medicine and RehabilitationCheng Hsin General HospitalTaipeiTaiwan
| | - Wei‐Jie Wang
- Department of Biomedical EngineeringChung Yuan Christian UniversityTaoyuanTaiwan
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Huang J, Yi B, Li AM, Zhang H. Effects of vitamin E-coated dialysis membranes on anemia, nutrition and dyslipidemia status in hemodialysis patients: a meta-analysis. Ren Fail 2015; 37:398-407. [DOI: 10.3109/0886022x.2014.1001281] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zyga S, Christopoulou G, Malliarou M. MALNUTRITION-INFLAMMATION-ATHEROSCLEROSIS SYNDROME IN PATIENTS WITH END-STAGE RENAL DISEASE. J Ren Care 2011; 37:12-5. [PMID: 21288312 DOI: 10.1111/j.1755-6686.2011.00201.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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