scholarly journals Low Serum Concentration of Obestatin as a Predictor of Mortality in Maintenance Hemodialysis Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Ilia Beberashvili ◽  
Inna Sinuani ◽  
Ada Azar ◽  
Hadas Kadoshi ◽  
Gregory Shapiro ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Experimental Studies ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Hazard Ratios ◽  
Gut Hormone ◽  
All Cause Mortality ◽  
Low Serum

Obestatin, a proposed anorexigenic gut hormone, has been shown to have a number of beneficial cardiotropic effects in experimental studies. We hypothesized that obestatin alteration in hemodialysis patients may link to clinical outcomes. This cross-sectional study with prospective followup for almost 4 years was performed on 94 prevalent hemodialysis patients. Obestatin, leptin, proinflammatory cytokines (tumor necrosis factor-α[TNF-α], interleukin-6, and various nutritional markers were measured. Patients with low obestatin levels, defined as a level less than median, had a worse all-cause mortality and cardiovascular mortality. The crude all-cause (HR 2.23, 95% CI 1.17 to 4.24) and cardiovascular mortality hazard ratios (HR 4.03, 95% CI 1.27 to 12.76) in these patients continued to be significant after adjustment for various confounders for all-cause mortality. Across the four obestatin-TNF-αcategories, the group with low obestatin and high TNF-α(above median level) exhibited a worse outcome in both all-cause mortality and cardiovascular mortality. Clinical characteristics of patients in low obestatin high TNF-αgroup did not differ from other obestatin-TNF-αcategorized groups. In summary, low serum obestatin concentration is an independent predictor of mortality in prevalent hemodialysis patients. Novel interactions were observed between obestatin and TNF-α, which were associated with mortality risk, especially those due to cardiovascular causes.

A 3-day diary of dietary protein and calorie intake by serum phosphate concentration and binder use in hemodialysis patients

2017 ◽  
Vol 41 (2) ◽  
pp. 94-99
Author(s):  
Meiry J.S. Araújo ◽  
Luciana F. Silva ◽  
Maria T.S. Martins ◽  
Cacia M. Matos ◽  
Marcelo B. Lopes ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Serum Phosphate ◽  
Phosphate Binders ◽  
Calorie Intake ◽  
Maintenance Hemodialysis ◽  
Dietary Intakes ◽  
Cross Sectional ◽  
Low Serum

Introduction: The use of phosphate binders to control hyperphosphatemia may allow diets less restricted in protein and calories for maintenance hemodialysis (MHD) patients. The study compared intakes of protein, calorie and phosphate among MHD patients with different serum phosphate concentrations, taking into account binder use. The hypothesis was that low serum phosphate would be associated with low intakes of protein and calories only in patients not on binders. Methods: A cross-sectional study of 443 patients enrolled in the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO) in Salvador, Brazil, with stratified sampling on serum phosphate: ≤3.0 (n = 41), 3.5-5.5 (n = 328) and ≥7.0 mg/dL (n = 74). A 3-day diet diary was used to determine dietary intakes. Results: Approximately 49.0% confirmed binder use. Covariate-adjusted linear regression showed that associations between dietary intakes and serum phosphate were modified by the binder use. In patients not on binders, protein intake was >20% lower for serum phosphate ≤3.0 mg/dL compared to higher concentrations. Also in those not on binders, calorie intake was >30% lower for serum phosphate ≤3.0 mg/dL compared to ≥7.0 mg/dL. Differences in dietary intakes by serum phosphate were virtually absent in patients on binders. Conclusions: The results are consistent with the hypothesis that low serum phosphate is associated with low protein and calorie intake only among MHD patients not on binders. This study supports recommendations to prevent hyperphosphatemia in MHD patients by adequate combination of binder use and selection of foods restricted in phosphors but not severely restricted in protein and calories.

Serum Obestatin: A Biomarker of Cardiovascular and All-Cause Mortality in Hemodialysis Patients

2018 ◽  
Vol 47 (4) ◽  
pp. 254-265 ◽  
Author(s):  
Ilia Beberashvili ◽  
Anna Katkov ◽  
Inna Sinuani ◽  
Ada Azar ◽  
Gregory Shapiro ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Experimental Studies ◽  
Cardiovascular Death ◽  
Maintenance Hemodialysis ◽  
Necrosis Factor Alpha ◽  
Markers Of Inflammation ◽  
Gut Hormone ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Acyl Ghrelin

Background: Recent experimental studies have suggested that obestatin, a proposed anorexigenic gut hormone and a physiological opponent of acyl-ghrelin, has protective cardiovascular effects. We tested the hypothesis that obestatin is independent of inflammatory mediators and/or acyl-ghrelin in predicting outcomes of the maintenance hemodialysis (MHD) population. Methods: It was a 6-year cohort study on 261 MHD patients. Obestatin, acyl-ghrelin, adipokines (leptin and adiponectin), markers of inflammation and nutrition, prospective all-cause and cardiovascular mortality were studied. Results: During the follow-up, 160 patients died in total, with 74 deaths due to cardiovascular causes. For each ng/mL increase in baseline obestatin level in fully adjusted models (including malnutrition-inflammation score, Interleukin-6 [IL-6], adipokines and acyl-ghrelin), the hazard for death from all causes was 0.90 (95% CI 0.81–0.99) and for cardiovascular death 0.85 (95% CI 0.73–0.99). However, these associations were more robust in the subgroup of patients aged above 71 years: 0.85 (95% CI 0.73–0.98) for all-cause death and 0.66 (95% CI 0.52–0.85) for cardiovascular death. An interaction between high IL-6 (above median) and low obestatin (below median) levels for increased risk of all-cause mortality (synergy index [SI] 5.14, p = 0.001) and cardiovascular mortality (SI 4.81, p = 0.02) emerged in the development of multivariable adjusted models. Interactions were also observed between obestatin, Tumor necrosis factor-alpha, adipokines and acyl-ghrelin, which were associated with mortality risk. Conclusion: Serum obestatin behaves as a biomarker for cardiovascular and all-cause mortality in MHD patients. The prognostic ability of obestatin in this regard is independent of inflammation, nutritional status, acyl-ghrelin’s and adipokines’ activity and is modified by age being very prominent in patients older than 71 years.

scholarly journals High Erythropoiesis Resistance Index Is a Significant Predictor of Cardiovascular and All-Cause Mortality in Chinese Maintenance Hemodialysis Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Xiangxue Lu ◽  
Jialing Zhang ◽  
Shixiang Wang ◽  
Qian Yu ◽  
Han Li
Keyword(s):  
Cardiovascular Mortality ◽  
Resistance Index ◽  
High Sensitivity ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
All Cause Mortality ◽  
Correlated Factors ◽  
Maintenance Hemodialysis Patients

Background. Renal anemia is a common complication of hemodialysis patients. Erythropoietin (EPO) hyporesponsiveness has been recognized as an important factor to poor efficacy of recombinant human erythropoietin in the treatment of renal anemia. More importantly, increased erythropoiesis resistance index (ERI) may be associated with inflammation and increased mortality. Objective. The objective of this research was to investigate correlated factors of EPO responsiveness and to clarify the relationships between EPO hyporesponsiveness and cardiovascular mortality and all-cause mortality among maintenance hemodialysis patients. Methods. This prospective cohort study enrolled 276 maintenance hemodialysis patients for a 55-month follow-up to investigate the factors related to ERI and its relationship to all-cause mortality and cardiovascular mortality. Results. ERI was positively correlated with predialysis serum high-sensitivity C-reactive protein ( r = 0.234 , p < 0.001 ), alkaline phosphatase ( r = 0.134 , p = 0.028 ), and ferritin ( r = 0.155 , p = 0.010 ) and negatively correlated with albumin ( r = − 0.206 , p < 0.001 ) and creatinine ( r = − 0.232 , p < 0.001 ). As multiple linear regression showed, predialysis serum albumin, high-sensitivity C-reactive protein, ferritin, and creatinine were independent correlated factors of ERI ( p < 0.05 ). Kaplan–Meier curves showed that the cumulative incidences of both cardiovascular mortality and all-cause mortality were significantly higher in patients with ERI > 11.04   IU / kg / w / g / dL (both p < 0.01 ). The high ERI group was significantly associated with higher risk for all-cause mortality (OR 1.781, 95% CI 1.091 to 2.910, p = 0.021 ) and cardiovascular mortality (OR 1.972, 95% CI 1.139 to 3.417, p = 0.015 ) after adjusting for confounders. Conclusions. Predialysis serum albumin, high-sensitivity C-reactive protein, ferritin, and creatinine were independent correlated factors of EPO responsiveness among maintenance hemodialysis patients. Patients with higher ERI values had a higher all-cause mortality rate and cardiovascular mortality rate.

Arteriosclerosis in Dialysis Patients

1996 ◽  
Vol 19 (11) ◽  
pp. 638-644 ◽  
Author(s):  
J. Bommer ◽  
E. Strohbeck ◽  
J. Goerich ◽  
M. Bahner ◽  
I. Zuna
Keyword(s):  
Calcium Phosphate ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Maintenance Hemodialysis ◽  
Time Interval ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Vldl Cholesterol

Arteriosclerosis is a constant problem in long-term hemodialysis patients. Computer tomography of the abdominal aorta allows a well-defined and reproducible evaluation of aortosclerosis. In the cross-sectional study, aortosclerosis was significantly accelerated in 84 chronic hemodialysis patients and was comparable to the results found in 20-year older control patients without renal disease. The increase of aortosclerosis correlated significantly with age of the patient, smoking, and duration of dialysis therapy. Furthermore, increased VLDL cholesterol and decreased HDL cholesterol seem to enhance aortosclerosis in our dialysis patients. In the longitudinal study (two CT scans with a time interval of 87 ± 62.7 months) in 36 dialysis patients, progressed aortosclerosis correlated significantly with the long duration of hypertriglyceridemia, VLDL cholesterol, uric acid, and calcium phosphate products. Progression of aortosclerosis was reduced in parathyroidectomized patients. The study suggests that premature aortosclerosis is found in dialysis patients. In addition to the common risk factor of aortosclerosis, disturbed calcium phosphate and parathyroid hormone metabolism seem to enhance aortosclerosis in patients under maintenance hemodialysis.

Blood Pressure of Maintenance Hemodialysis Patients in the Dalmatian Region of Croatia: Differences between Hospital and Out-of-Hospital Dialysis Centers

2017 ◽  
Vol 44 (2) ◽  
pp. 110-121
Author(s):  
Marijana Gulin ◽  
Dragan Klarić ◽  
Mario Ilić ◽  
Josipa Radić ◽  
Vedran Kovačić ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Beta Blockers ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Interdialytic Weight Gain ◽  
Maintenance Hemodialysis Patients

Aims: This study was aimed at comparing the incidence of arterial hypertension and blood pressure (BP) variance in hospital and out-of-hospital hemodialysis (HD) patients during HD sessions. Methods: A cross-sectional study was conducted for 1 week at all the HD centers in Dalmatia, Croatia. The pre-, intra-, and post-dialysis BP values were collected for 3 consecutive HD sessions per patient. Results: Of the 399 subjects, 73.9% were hypertensives, who showed higher interdialytic weight gain compared to the normotensives (2.58 vs. 2.40). Hospital and out-of-hospital HD patients received identical antihypertensive therapies, except that beta blockers were more frequently administered to out-of-hospital HD patients. Higher pre-, intra-, and post-dialysis BP values were recorded in patients at out-of-hospital HD centers. Conclusion: The differences in BP variability and antihypertensive therapies administered to hospital HD patients as compared to out-of-hospital HD patients may reflect differing approaches by the nephrologists at these centers.

scholarly journals ERECTILE DYSFUNCTION

2016 ◽  
Vol 23 (03) ◽  
pp. 268-273
Author(s):  
Ansari Muhammad Rafique ◽  
Pooran Mal ◽  
Jairamani Bhagwan Das ◽  
Shafique-Ur-Rehman Memon ◽  
Syed M Tahir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Male Patients

Objectives: Erectile dysfunction (ED) is a very common and distressing healthproblem in chronic maintenance hemodialysis patients. There is no such data available fromSind province of Pakistan on this issue; we want to highlight the factors and prevalence oferectile dysfunction among hemodialysis patients in this part of our country. Study Design:This hospital based observational, cross-sectional study Setting: It was conducted at 04hemodialysis centers of Hyderabad city Perod: In 2014 Methods: The Study was conductedby using International Index of Erectile Dysfunction (IIEF-5) for determination of prevalence& severity of ED among these patients. Comparative analysis for frequency of ED was alsodone between urban & rural patients. Adapted Urdu version of IIEF-5 was used for those whocannot understand English pro forma. Results: There were total 62 male patients; all of themwere on maintenance hemodialysis for more than 6 months. Their ages were between 20 to59 years with mean 36±11. In this series of patients 80% (n=50) were < 50 years of age whilethe diabetic patients were 58% (n=36). The overall prevalence of ED observed in patients was88.7% (n=55) in our study. Severe ED was seen in 30 (48.4%) patients. The prevalence &severity of ED was significantly higher in diabetes mellitus and over 50 years of age. There washigher incidence of ED 94% observed in patients who are living in rural areas as compared tourban areas patients 82%. Conclusions: It has been concluded in this study that majority ofmale hemodialysis patients were suffering from ED problem. Diabetes mellitus and & > 50 yearsof age has the highest prevalence of ED. Erectile dysfunction is very common and distressinghealth related issue among hemodialysis patients and this should be addressed with routine

scholarly journals Association of Anabolic Effect of Calcitriol with Osteoclast-Derived Wnt 10b Secretion

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1164 ◽  
Author(s):  
Chien-Lin Lu ◽  
Jia-Fwu Shyu ◽  
Chia-Chao Wu ◽  
Chi-Feng Hung ◽  
Min-Tser Liao ◽  
...  
Keyword(s):  
Bone Development ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Tartrate Resistant Acid Phosphatase ◽  
Dependent Manner ◽  
Mesenchymal Progenitor Cells ◽  
Micro Computed Tomography ◽  
Cross Sectional ◽  
Maintenance Hemodialysis Patients

Canonical Wnt (Wingless/Integrated) signaling is crucial in bone development and the Wnt ligand can promote osteoblast differentiation from mesenchymal progenitor cells. Calcitriol, an active vitamin D3, is used clinically for treatment of secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD) patients. The bone effects of calcitriol in SHPT remains uncertain. We hypothesized that calcitriol improves bone mass by suppressing osteoclast activity, and simultaneously promoting Wnt ligand secretion. We designed a cross-sectional study in maintenance hemodialysis patients to explore the effects of calcitriol on different bone turnover markers and specifically emphasized the Wnt 10b levels. Then, we explored the source of Wnt 10b secretion by using osteoclasts and osteoblasts treated with calcitriol in cell culture studies. Finally, we explored the effects of calcitriol on bone microarchitectures in CKD mice, using the 5/6 nephrectomy CKD animal model with analysis using micro-computed tomography. Calcitriol promoted the growth of both trabecular and cortical bones in the CKD mice. Wnt 10b and Procollagen 1 N-terminal Propeptide (P1NP) significantly increased, but Tartrate-resistant acid phosphatase 5b (Trap 5b) significantly decreased in the calcitriol-treated maintenance hemodialysis patients. Calcitriol enhanced Wnt 10b secretion from osteoclasts in a dose-dependent manner. Treatment of SHPT with calcitriol improved the bone anabolism by inhibiting osteoclasts and promoting osteoblasts that might be achieved by increasing the Wnt 10b level.

Underreporting of Energy Intake in Maintenance Hemodialysis Patients: A Cross-sectional Study

2012 ◽  
Vol 22 (6) ◽  
pp. 578-583 ◽  
Author(s):  
Denise Mafra ◽  
Cristiane Moraes ◽  
Viviane O. Leal ◽  
Najla E. Farage ◽  
Milena B. Stockler-Pinto ◽  
...  
Keyword(s):  
Energy Intake ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Maintenance Hemodialysis Patients
Sign in / Sign up

Export Citation Format

Share Document