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Hu J, Tang L, Zhan X, Peng F, Wang X, Wen Y, Feng X, Wu X, Gao X, Zhou Q, Zheng W, Su N, Tang X. Serum uric acid to creatinine ratio as a risk factor for mortality among patients on continuous ambulatory peritoneal dialysis: a multi-center retrospective study. Ren Fail 2023; 45:2273979. [PMID: 37905944 PMCID: PMC10653642 DOI: 10.1080/0886022x.2023.2273979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Serum uric acid to serum creatinine ratio (SUA/Scr) has emerged as a new biomarker, which is significantly associated with several metabolic diseases. However, no study has investigated the association between SUA/Scr and mortality among patients on continuous ambulatory peritoneal dialysis (CAPD). METHODS In this multicenter retrospective cohort study, we enrolled CAPD patients in eight tertiary hospitals in China from 1 January 2005 to 31 May 2021. Cox proportional hazard models were used to determine the relationship between SUA/Scr and mortality. RESULTS A total of 2480 patients were included; the mean age was 48.9 ± 13.9 years and 56.2% were males. During 12648.0 person-years of follow-up, 527 (21.3%) patients died, of which 267 (50.7%) deaths were caused by cardiovascular disease. After multivariable adjustment for covariates, per unit increase in SUA/Scr was associated with a 62.9% (HR, 1.629 (95% confidence interval (CI) 1.420-1.867)) and 73.0% (HR, 1.730 (95% CI 1.467-2.041)) higher risk of all-cause and cardiovascular mortality. Results were similar when categorized individuals by SUA/Scr quartiles. Compared with the lowest quartile of SUA/Scr, the highest and the second highest quartile of SUA/Scr had a 2.361-fold (95% CI 1.810-3.080) and 1.325-fold (95% CI 1.003-1.749) higher risk of all-cause mortality, as well as a 3.701-fold (95% CI 2.496-5.489) and 2.074-fold (95% CI 1.387-3.100) higher risk of cardiovascular mortality. Multivariable-adjusted spline regression models showed nonlinear association of SUA/Scr with mortality in CAPD patients. CONCLUSIONS Higher levels of SUA/Scr were associated with higher risk of all-cause and cardiovascular mortality in CAPD patients.
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Affiliation(s)
- Jieping Hu
- Department of Nephrology, Dongguan Tungwah Hospital, Dongguan, China
- Department of Nephrology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
| | - Liwen Tang
- Department of Nephrology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
| | - Xiaojiang Zhan
- Department of Nephrology, The First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Fenfen Peng
- Department of Nephrology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoyang Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yueqiang Wen
- Department of Nephrology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xiaoran Feng
- Department of Nephrology, Jiujiang No. 1 People’s Hospital, Jiujiang, China
| | - Xianfeng Wu
- Department of Nephrology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xingcui Gao
- Department of Cardiology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
| | - Qian Zhou
- Department of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei Zheng
- Department of Nephrology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
| | - Ning Su
- Department of Hematology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xingming Tang
- Department of Nephrology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
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Chen Y, Dai S, Ge X, Shang D, Xie Q, Hao C, Zhu T. Plasma fibrinogen: a driver of left ventricular remodeling in patients undergoing peritoneal dialysis and its related risk factors. Ren Fail 2023; 45:2255679. [PMID: 38346031 PMCID: PMC10512895 DOI: 10.1080/0886022x.2023.2255679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/31/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND AND AIM Plasma fibrinogen has been proven to be significantly associated with cardiovascular mortality in patients undergoing peritoneal dialysis (PD). The study aimed to investigate the role of fibrinogen in left ventricular (LV) remodeling and functions in patients on PD, and explore risk factors related to high fibrinogen level. METHODS From February 2008 to July 2018, adult patients on regular PD for at least 1 month were recruited and followed up for two years. Correlation analysis was performed to explore the fibrinogen level and echocardiography measurements. Pathogenic factors correlated to the left ventricular hypertrophy (LVH) progression were explored by logistic regression models and the role of fibrinogen in it was verified by receiver operating characteristic (ROC) curves. Linear regression models were conducted to identify factors associated with fibrinogen level. RESULTS A total of 278 patients undergoing PD (168 males, 60.4%) were recruited. Patients were trisected according to fibrinogen levels at baseline. Mean wall thickness (MWT), relative wall thickness (RWT), and left ventricular mass index (LVMI) were positively associated with fibrinogen level while E/A ratio was negatively associated with it. Multivariate logistic regression and ROC curve showed that fibrinogen was an independent risk factor for LVH progression. Multivariate linear regression analysis identified age, total cholesterol (CHO), fasting blood glucose (FBG), and high-sensitivity C-reactive protein (hsCRP) were significantly related to plasma fibrinogen level. CONCLUSIONS An elevated fibrinogen level was independently associated with LVH progression in patients undergoing PD. Older age, higher level of FBG, CHO, and hsCRP were risk factors for elevated plasma fibrinogen level.
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Affiliation(s)
- Yun Chen
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuqi Dai
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaolin Ge
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Da Shang
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qionghong Xie
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuanming Hao
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Tongying Zhu
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
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Prognostic value of the albumin-to-fibrinogen ratio (AFR) in IgA nephropathy patients. Int Immunopharmacol 2022; 113:109324. [DOI: 10.1016/j.intimp.2022.109324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
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Effects of High Flux Hemodialysis Combined with L-Carnitine on Microinflammation and Arteriovenous Fistula in Maintenance Hemodialysis Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6964127. [PMID: 35836826 PMCID: PMC9276479 DOI: 10.1155/2022/6964127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 11/23/2022]
Abstract
Objective To explore the effects of high-flux hemodialysis combined with L-carnitine on microinflammation and arteriovenous fistulas in maintenance hemodialysis patients. Methods A total of 65 patients admitted to our hospital from May 2017 to May 2019 were selected and divided into a control group of 30 cases and an experimental group of 35 cases according to the selected treatment plan. Combined with L-carnitine, the cardiac function of the two groups of patients before and after the treatment was evaluated, the microinflammatory indexes of the two groups were compared, and the clinical efficacy of the combined treatment on MHD patients was analyzed. Results The two groups were not significantly different in general information such as age, gender, course of disease, and past medical history (P > 0.05). The experimental group generated a notably higher total effective rate of treatment in relation to the control group (P < 0.05). After treatment, lower heart function levels of LVST and LEVDD were observed in the experimental group as compared to the control group, but LVEF was higher than that in the control group (P < 0.05). The GQOLI-74 score of the experimental group was better than that of the control group (P < 0.05). The incidence of venous fistula complications in the experimental group was significantly lower than that in the control group (P < 0.05). The microinflammatory index hs-CRP in the experimental group was lower (P < 0.05) and the microinflammatory index TNF-α was significantly lower (P < 0.05). The HAD score after treatment of the experimental group was better than that of the control group (P < 0.05). Conclusion High-flux hemodialysis combined with L-carnitine therapy has achieved satisfactory results in patients with MHD in terms of alleviating the level of inflammatory factors, improving heart function, enhancing patients' living standards, reducing complications of intravenous fistula, and boosting the prognosis. It is worthy of promotion.
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Xia W, Li C, Yao X, Chen Y, Zhang Y, Hu H. Prognostic value of fibrinogen to albumin ratios among critically ill patients with acute kidney injury. Intern Emerg Med 2022; 17:1023-1031. [PMID: 34850361 PMCID: PMC9135817 DOI: 10.1007/s11739-021-02898-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/17/2021] [Indexed: 12/14/2022]
Abstract
Fibrinogen to albumin ratios (FAR) have shown to be a promising prognostic factor for improving the predictive accuracy in various diseases. This study explores FAR's prognostic significance in critically ill patients with acute kidney injury (AKI). All clinical data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III version 1.4. All patients were divided into four groups based on FAR quartiles. The primary endpoint was in-hospital mortality. A generalized additive model was applied to explore a nonlinear association between FAR and in-hospital mortality. The Cox proportional hazards models were used to determine the association between FAR and in-hospital mortality. A total of 5001 eligible subjects were enrolled. Multivariate analysis demonstrated that higher FAR was an independent predictor of in-hospital mortality after adjusting for potential confounders (HR, 95% CI 1.23, 1.03-1.48, P = 0.025). A nonlinear relationship between FAR and in-hospital mortality was observed. FAR may serve as a potential prognostic biomarker in critically patients with AKI and higher FAR was associated with increased risk of in-hospital mortality among these patients.
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Affiliation(s)
- Wenkai Xia
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 3 Yinrui Road, Jiangsu, 214400, Jiangyin, China
- Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Chenyu Li
- Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Xiajuan Yao
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 3 Yinrui Road, Jiangsu, 214400, Jiangyin, China
| | - Yan Chen
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 3 Yinrui Road, Jiangsu, 214400, Jiangyin, China
| | - Yaoquan Zhang
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 3 Yinrui Road, Jiangsu, 214400, Jiangyin, China
| | - Hong Hu
- Department of Nephrology, The Affiliated Jiangyin Hospital of Southeast University Medical College, 3 Yinrui Road, Jiangsu, 214400, Jiangyin, China.
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Chen W, Shan B, Zhou S, Yang H, Ye S. Fibrinogen/albumin ratio as a promising predictor of platinum response and survival in ovarian clear cell carcinoma. BMC Cancer 2022; 22:92. [PMID: 35062908 PMCID: PMC8780809 DOI: 10.1186/s12885-022-09204-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
Background This study aims to evaluate the role of the fibrinogen/albumin ratio (FAR) in predicting platinum resistance and survival outcomes of patients with ovarian clear cell carcinoma (OCCC). Methods Coagulation function and D-dimer, serum albumin, CA125 and HE4 levels were measured before surgery in OCCC patients undergoing initial surgery in our institution. FAR was calculated as fibrinogen/albumin level. The correlation between these indicators and clinicopathological features, platinum response, and survival outcomes was further analyzed. The Kaplan-Meier method and multivariable Cox regression model were used to assess the effects of FAR on progression-free survival (PFS) and overall survival (OS). Results Advanced stage patients accounted for 42.1% of the 114 participants. Optimal cytoreductive surgery was achieved in 105 patients, and the complete resection rate was 78.1%. FAR was associated with tumor stage, residual tumor and platinum response. A receiver operating characteristic curve for predicting platinum response showed that the optimal cutoff point of the FAR was 12%. The sensitivity was 73.3% and the specificity was 68.2%. In multivariate analysis, FAR ≥12% (HR = 4.963, P = 0.002) was an independent risk factor for platinum resistance. In addition, FAR and D-dimer proved to be independent negative factors for outcomes including both PFS and OS. The median follow-up time was 52 months. A high FAR (≥ 12%) showed a stronger correlation with poor OS and PFS in the subgroup analysis of advanced and completely resected patients. Conclusions The FAR might be a potential preoperative biochemical marker for predicting treatment response and oncological outcomes in OCCC patients.
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