Serum albumin, inflammation, and nutrition in end-stage renal disease: C-reactive protein is needed for optimal assessment

2018 ◽  
Vol 31 (5) ◽  
pp. 435-439 ◽  
Author(s):  
Hideyuki Mukai ◽  
Hilda Villafuerte ◽  
Abdul Rashid Qureshi ◽  
Bengt Lindholm ◽  
Peter Stenvinkel
Author(s):  
Caroline Schöffer ◽  
Leandro Machado Oliveira ◽  
Samantha Simoni Santi ◽  
Raquel Pippi Antoniazzi ◽  
Fabricio Batistin Zanatta

Open Medicine ◽  
2013 ◽  
Vol 8 (3) ◽  
pp. 346-353 ◽  
Author(s):  
Aleksandra Ignjatović ◽  
Tatjana Cvetković ◽  
Radmila Pavlović ◽  
Vidojko Đorđević ◽  
Zoran Milošević ◽  
...  

AbstractThere is a higher mortality between patients with end-stage renal disease than patients in the general population. These circumstances have led to a search for risk factors as predictors of mortality in dialysis patients. Amongst those, inhibitors of the nitric-oxide (NO) synthesis deserve special attention, since patients with end-stage renal disease are also characterized by accelerated atherosclerosis. Asymmetric-dimethylarginine (ADMA) and symmetric-dimethylarginine (SDMA), as well as C-reactive protein (CRP), have also been recognized as predictors of mortality in patients on dialysis. The aim of our study was to compare the prediction power of ADMA, SDMA and CRP for all-cause mortality in patients with end stage renal disease during the fourteen month follow-up. In total 162 patients on hemodialysis were included. ADMA and SDMA were measured by the high-performance liquid chromatography (HPLC); CRP was measured using immunonephelometric assays. During the 14-month period 28 patients (34.1%) died from all-cause mortality. Using univariate analysis, hazard ratios (HR) of the potential independent predictors of mortality in hemodialysis patients were ADMA (HR 1.39 (1.01–1.91) p=0.043) and CRP (HR 1.024 (1.009–1.1.040) p=0.001). Further, multivariate analysis (MVA), however, showed that ADMA is the only predictor of all-cause mortality (HR 1.76 (1.002–3.11) P=0.049), while SDMA failed to predict death in this population. Therefore, our data shows that ADMA is an independent and better marker of all-cause mortality compared with CRP.


2021 ◽  
Author(s):  
Vijairam Selvaraj ◽  
Muhammad Baig ◽  
Kwame Dapaah-Afriyie ◽  
Arkadiy Finn ◽  
Atin Jindal ◽  
...  

ABSTRACTBACKGROUNDSince the beginning of the COVID-19 pandemic, there has been widespread use of remdesivir in adults and children. There is little known information about its outcomes in patients with severe renal dysfunction or end-stage renal disease who are on hemodialysis.METHODSA retrospective, multicenter study was conducted on patients with end-stage renal disease on hemodialysis that were discharged after treatment for COVID-19 between April 1st and December 31st, 2020. Primary endpoints were the length of stay, mortality, maximum oxygen requirements along with the escalation of care needing mechanical ventilation. Secondary endpoints included change in C reactive protein, d dimer levels, and disposition.RESULTSA total of 52 charts were reviewed, of which 28 met the inclusion criteria. 14 patients received remdesivir, and 14 patients did not receive remdesivir. The majority of patients were caucasian, female, with diabetes mellitus and hypertension. The mean age was 65.33 +14.14 years. All the patients in the remdesivir group received dexamethasone as compared to only 30% of patients in the non-remdesivir group. There was no significant difference in C reactive protein, d dimer levels, and disposition between the two groups. Approximately 35% of the patients died, 18% required intensive ventilation, and the mean length of stay was 12.21 days.DISCUSSIONThe study demonstrated no clinically significant difference in length of stay, maximum oxygen requirements, or mortality in COVID-19 patients with end-stage renal disease in the remdesivir group as compared to the non-remdesivir group. Further studies are needed to study the effects of remdesivir on the renal function and disease course in patients with chronic kidney disease stage 4 or 5 that are not on dialysis.


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