scholarly journals Serum fetuin-A levels and its relationship with biochemical parameters in hemodialysis patients

2021 ◽  
Vol 11 (1) ◽  
pp. e6-e6
Author(s):  
Behzad Abbasi Jamaati ◽  
Raheb Ghorbani ◽  
Mehrdad Zahmatkesh ◽  
Mohammad Reza Tamadon
Keyword(s):  
Biochemical Markers ◽  
Heart Diseases ◽  
Statistical Significance ◽  
Serum Triglyceride ◽  
Cardiovascular Complications ◽  
Hemodialysis Patients ◽  
Fetuin A ◽  
Blood Hemoglobin ◽  
Significant Difference ◽  
Calcium Phosphorus

Introduction: Cardiovascular events are the most important complications of end-stage renal disease (ESRD). The role of fetuin-A and vascular calcification inhibitors in cardiovascular complications, dysregulated biochemical markers, and mortality is uncertain in patients under hemodialysis. Objectives: The aim of this study was to investigate the relationship of fetuin-A with cardiovascular complications and biochemical markers in hemodialysis patients. Patients and Methods: In this cross-sectional study, 65 patients undergoing hemodialysis were enrolled. Blood samples were taken at pre-dialysis to determine serum fetuin-A, calcium, phosphorus, intact parathyroid hormone (iPTH), C-reactive protein (CRP), albumin, triglyceride, total cholesterol, as well as blood hemoglobin, and hematocrit. The data was analyzed considering the statistical significance level of 0.05. Results: Out of 65 patients, seven patients died during the study, and 58 patients were finally evaluated. Mean (±SD) serum fetuin-A level was 1268.71 ± 1229.4 μg/mL. There was no significant difference in the mean fetuin-A level between genders (P=0.904). There were no significant correlations between the serum level of fetuin-A and age, duration of dialysis, heart diseases, serum levels of calcium, phosphorus, PTH, albumin, CRP, cholesterol and finally blood hemoglobin. However, significant relationships were found between fetuin-A level and serum triglyceride (TG) level (P=0.019) and body mass index (BMI) (P=0.024). Conclusion: Fetuin-A level was significantly associated with serum TG level and BMI. Regarding the links of obesity and hypertriglyceridemia with cardiovascular diseases (CVDs), controlling serum TG level and body weight can reduce the risk of vascular atherosclerosis in patients undergoing dialysis.

scholarly journals Relationship between plasma Atherogenic index and final pathology of Bosniak III-IV renal masses: a retrospective, single-center study

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Emre Karabay ◽  
Nejdet Karsiyakali ◽  
Serdar Duvar ◽  
Cagatay Tosun ◽  
Ahmet Ruknettin Aslan ◽  
...  
Keyword(s):  
Predictive Value ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Serum Triglyceride ◽  
Pathological Diagnosis ◽  
Atherogenic Index ◽  
Benign Tumors ◽  
Predictive Tool ◽  
Renal Masses ◽  
Significant Difference

Abstract Background There is an increased incidence of renal cell carcinoma (RCC) in patients with metabolic syndrome who usually have high levels of serum triglyceride (TG) and low high-density lipoprotein-cholesterol (HDL-C). Plasma atherogenic index (PAI) is the logarithmic ratio of serum TG level to HDL-C and related to cardiovascular diseases. In this study, we aimed to determine the accuracy of PAI in determining renal malignancy in localized renal masses preoperatively. Methods Totally 169 patients who were diagnosed with Bosniak III-IV lesions by imaging modalities and treated in our hospital with partial or radical nephrectomy were retrospectively analyzed using institutional renal cancer database between 2013 and 2018. Preoperative images were evaluated by two experienced radiologists. The patients were divided into two groups according to their postoperative pathological diagnosis as malignant or benign tumors. The PAI of each patient was calculated and the statistical significance of PAI in predicting malignancy for renal masses was analyzed using uni- and multivariable analyses. Results Of patients, 109 (64.5%) were males and 60 (35.5%) were females with a median age of 61 (33–84) years. Median tumor size was 6.5 (2–18) cm. Pathological diagnosis was malignant in 145 (85.8%) and benign in 24 (14.2%) patients. There was no statistically significant difference in serum TG levels between malignant and benign cases (p > 0.05). The HDL-C levels were significantly lower in malignant cases (p = 0.001). Median PAI value was 0.63 (0.34–1.58) and significantly higher in malignant cases (p = 0.003). The PAI cut-off value for malignancy was ≥0.34. The sensitivity was calculated as 88.2% and specificity as 45.8%, the positive predictive value as 90.8, negative predictive value as 39.3, and odds ratio as 6.37 (95% CI: 2.466–16.458). In multivariable analysis, gender, smoking status, and hypertension had no effect on malignancy, whereas PAI and HDL-C were independent risk factors (p = 0.003 and p = 0.003, respectively). The risk of malignancy was 5.019 times higher, when PAI was > 0.34 (95% CI: 1.744–14.445) in multivariable logistic regression analysis. Conclusions The PAI can be used as a predictive tool in suspicion of malignant renal masses. In case of a benign pathology, PAI levels may be encouraging for surgeons for nephron-sparing surgery.

scholarly journals A comparative study on the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients; a double-blinded randomized clinical trial

2021 ◽  
Vol 11 (1) ◽  
pp. e12-e12
Author(s):  
Saeed Mardani ◽  
Faranak Sadat Filsouf
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Hemodialysis Patients ◽  
Significant Difference ◽  
Before And After ◽  
Calcium Phosphorus ◽  
Stage Renal Disease ◽  
Double Blinded ◽  
End Stage ◽  
Calcium And Phosphate Metabolism

Introduction:Chronic kidney disease (CKD) has lots of complication like calcium and phosphate metabolism disorders, hyperparathyroidism, vitamin D deficiency and metabolic acidosis. Objectives: The aim of this study was to determine and compare the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients due to end-stage renal disease (ESRD). Patients and Methods: This study was a double-blinded randomized clinical trial, which was conducted on 60 hemodialysis patients in 2017-2018. The patients were randomly assigned to two groups of 30 patients, which one group was treated with cinacalcet and the other group was treated with calcitriol. During this study, phosphorus, calcium and iPTH were measured. Results: The results showed that in the group treated with cinacalcet, the amount of calcium [t(22)=0.294, P>0.05] and the amount of phosphorus [t(22)=1.87, P>0.05] did not change significantly while iPTH values before and after the study had statistically significant difference [t(22)=4.37, P<0.05]. In group treated with calcitriol, the calcium, phosphorus and iPTH values did not change significantly (P>0.05). Calcium changes in the cinacalcet group compared to the calcitriol group [t (47) =-1.14, P>0.05] and also, the amount of phosphorus changes [t (47) =-1.022, P>0.05] was not statistically significant. The iPTH changes were not statistically significant between the two groups however iPTH in the calcitriol group was higher than the cinacalcet group [t (47) =-1.13, P>0.05]. Conclusion: In contrast to calcitriol, cinacalcet significantly reduced iPTH and did not significantly change calcium and phosphorus levels. Trial Registration: The trial was registered by Iranian Registry of Clinical Trials (IRCT) (identifier: IRCT20190702044076N1; https://en.irct.ir/trial/40547, Ethical code# IR.SKUMS.REC.1397.026).

scholarly journals Tinzaparin Provides Lower Lipid Profiles in Maintenance Hemodialysis Patients: A Cross-Sectional Observational Study

2014 ◽  
Vol 2014 ◽  
pp. 1-9
Author(s):  
Ming-Hsien Tsai ◽  
Yu-Wei Fang ◽  
Jyh-Gang Leu
Keyword(s):  
Multivariate Analysis ◽  
Total Cholesterol ◽  
Univariate Analysis ◽  
Serum Triglyceride ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Maintenance Hemodialysis ◽  
Diabetic Patients ◽  
Significant Difference ◽  
The Impact

As a low-molecular-weight heparin, tinzaparin has effectively been used as an anticoagulant during hemodialysis sessions. However, the impact of different heparin types on dyslipidemia is still controversial. In our study, 434 chronic hemodialysis patients were evaluated. The mean age was 65 ± 13. Forty-eight patients (11%) and 386 patients (89%) were in the tinzaparin and unfractionated heparin (UFH) groups, respectively. Triglyceride had significant difference between the two groups (P=0.001) but total cholesterol, HDL, or LDL did not. In the univariate analysis, the triglyceride level was significantly associated with tinzaparin use [β: −39.9, 95% confidence interval (CI): −76.7 to −3.0], and this association remained following the multivariate analysis (β: −40.8, 95% CI: −75.1 to −6.5). The difference in serum total cholesterol level between tinzaparin and UFH became significant (β: −13, 95% CI: −24.5 to −1.56) after adjustment in the multivariate analysis. Moreover, in a subgroup analysis, male diabetic patients showed lower serum triglyceride levels with the use of tinzaparin, while older, nondiabetic, male patients showed significant advantages in total cholesterol levels with the use of tinzaparin. Based on our findings, tinzaparin shows a significant association with a lower lipid profile in patients with chronic hemodialysis when compared to UFH.

Assessment of Magnesium level Among Hemodialysis Patients and Its Relation to Vascular Stiffness

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Zaki ◽  
Abdel Rahman Khedr ◽  
Ashraf Hassan ◽  
Nouran Abdel Fattah
Keyword(s):  
Vascular Calcification ◽  
Cardiovascular Complications ◽  
Hemodialysis Patients ◽  
Pulse Velocity ◽  
Magnesium Level ◽  
Vascular Stiffness ◽  
Valve Calcification ◽  
Media Thickness ◽  
Group I ◽  
Significant Difference

Abstract Background The pathogenesis of vascular calcification in Chronic kidney disease (CKD) patients is multifactorial and complicated. It has been proposed that Magnesium (Mg) may be implicated in the process of vascular calcification on various levels. Aim This study aims to assess the level of magnesium in hemodialysis patients and its relation to the vascular stiffness. Patients and methods 100 prevalent hemodialysis patients were included in the study and they were clinically stable with absence of cardiovascular complications, all patients underwent the following laboratory investigation including complete blood picture, median of magnesium level over 3 months, electrolytes, ipth, lipid profile and radiological investigations including transthoracic echocardiography and carotid duplex. Results The studied population was divided into two groups, group I included 68 patients with normal mg level and group II included 32 patients with low mg level. There was statistically significant difference between the two groups as regard hemoglobin level (pvalue=0.033), otherwise there was no statistically significant difference as regard other laboratory and radiological investigations. Then they were divided into another two groups according to the presence of mitral valve calcification (MVC), group III involved 85 patients without MVC and group IV involved 15 patients with MVC. There was statistically significant difference between 2 groups as regard aortic wave pulse velocity (aPWV) with (pvalue=0.002), presence of plaques with (pvalue &lt;0.001) and intimal media thickness with (pvalue&lt;0.001). Another group was divided according to presence of aortic valve calcification (AVC) into two groups, first group V included 39 patients without AVC and second group VI included 61 patients with AVC. There was statistically significant difference between two groups as regard age with (pvalue&lt;0.001), ipth with (pvalue=0.033), presence of plaques with (pvalue=0.048) and intimal media thickness with (pvalue&lt;0.001). Conclusion There was high prevalence of vascular calcification among hemodialysis patients which may be related to age and hyperparathyroidism but without statistically significant correlation to Mg level.

Serum fetuin-A levels and association with hematological parameters in chronic kidney disease and hemodialysis patients

2019 ◽  
Vol 44 (4) ◽  
pp. 517-523
Author(s):  
Aybala Erek Toprak ◽  
Fetullah Gerin ◽  
Hayriye Erman ◽  
İlyas Duran ◽  
Eray Atalay ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Complete Blood Count ◽  
Hematological Parameters ◽  
Acute Phase Reactant ◽  
Hemodialysis Patients ◽  
Serum Glucose ◽  
Control Group ◽  
Fetuin A ◽  
Calcium Phosphorus

Abstract Aim The objective of the current study is to examine the association between serum fetuin-A concentrations and some other inflammation markers neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV) and C reactive protein (CRP) in patients with chronic kidney disease (CKD) and hemodialysis. Methods The study subjects are composed of healthy volunteers (n = 47) and two patient groups; CKD patients (n = 26) and hemodialysis patients (n = 33). We measured serum glucose, urea, creatinine, total protein, albumin, sodium, potassium, calcium, phosphorus, iron, alkaline phosphatase, parathyroid hormone, ferritin and CRP levels by auto-analyzer and fetuin-A levels by ELISA method. Also, complete blood count parameters were analyzed and NLR was calculated. Results There were significant differences in serum fetuin-A concentrations, NLR and MPV values among three groups (p < 0.001, p < 0.001, p < 0.001). The correlation analyses revealed that fetuin-A negatively correlated with urea, creatinine, ferritin, and CRP concentrations (r: 0.349, 0.367, 0.399, 0.550, respectively, p < 0.05). Conclusion Fetuin-A is lower in CKD and hemodialysis patients than the control group; supporting as a negative acute phase reactant. Determination of serum fetuin-A, NLR and MPV might be useful to assess inflammation in CKD and hemodialysis patients.

scholarly journals Reversibility of heart block after congenital heart surgeries in pediatrics, is it predictable?

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
W Hassan ◽  
W Ali ◽  
MS Sayed ◽  
ATM Aliaa Mahfouz ◽  
HH Hatem Hosny ◽  
...  
Keyword(s):  
Heart Block ◽  
Congenital Heart ◽  
Late Onset ◽  
Heart Diseases ◽  
Statistical Significance ◽  
P Value ◽  
Mortality And Morbidity ◽  
Funding Sources ◽  
Significant Difference ◽  
Pr Interval

Abstract Funding Acknowledgements Type of funding sources: None. Background   AV block is a serious complication of congenital heart diseases(CHD) repair surgeries.it is associated with an increased mortality and morbidity. Purpose :  Identifying the incidence of Complete Heart Block (CHB) after heart surgeries for CHD, analyzing the patients` specifications and procedural data to evaluate the potential correlations that contribute the HB postoperatively. Patients and methods :  We enrolled all patients who underwent CHD surgeries from September 2014 till February 2020 and identified the patients who developed postoperative CHB, those patients  were divided into two groups, (a group who developed transient  CHB  and those who developed permanent CHB which required implantation  of permanent pacemaker (PPM). We defined the transient HB as the recovery from  an advanced second or third degree HB after the surgery within 10days .   And the presence of advanced second or third degree HB persisting for more than 10 days after cardiac surgery is considered a permanent HB and indicated  for PPM implantation according to current guidelines . Results :   Our cohort includes 2377 CHD surgeries, 46 % female patients, median weight was 12.06 kg at the time of the operation, median height was 85 cm.  Mean age at the time of the operation was 2.7 years in the cohort with transient HB while it was 2.6 years  in the cohort who received PPM. Incidence of HB following those surgeries was 3 %(72) patients, 1.8 %of the patients (43)  had transient HB  and 1.2% of the patients (21 ) received a PPM.  Recovery from HB was within 7days in 35 patients (82%),Two out of the 43 patients who had transient HB ended up with late onset CHB requiring pacing representing 4.6 % of that cohort, one after one month of recovery and the other one after 11 years from the surgery despite they restored their sinus rhythm within 6 days and 10 days respectively.  We found the highest incidence of postoperative HB associated with VSDs surgeries either isolated or with other complex CHD diseases followed by TOF with no significant difference between transient and permanent groups according to the type of surgery.  The duration of preoperative PR interval suggested the incidence of permanent  CHB postoperatively with a P value of 0.005 We found that gender, age, weight and height didn`t affect the outcome, preoperative heart rate and preoperative medications didn`t alter the prognosis, the duration of CBP time and the clamping time were of no statistical significance between the 2 groups with P value of ( 0.38 and 0.33 ).  Conclusion :  Incidence of CHB post CHD surgeries in our center is 3 %, only 1.2 % required PPM.  Various clinical data , ECG criteria , procedural time and duration of the HB except for the preoperative PR interval  failed to prove a significant correlation with the incidence of CHB necessitating further investigation to identify the specific risk factors for such complication. Abstract Figure. Incidence of CHB with various surgeries

scholarly journals Non-traditional Risk Factors of Cardiovascular Disease and Coenzyme Q10 Therapy in Hemodialysis Patients

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Elham Shahraki ◽  
Batool Shahraki ◽  
AliReza Dashipour
Keyword(s):  
Serum Albumin ◽  
Coenzyme Q10 ◽  
Antioxidant Properties ◽  
Serum Levels ◽  
Cardiovascular Complications ◽  
Hemodialysis Patients ◽  
Diabetic Patients ◽  
Beneficial Effects ◽  
Significant Difference ◽  
Coq10 Supplementation

Background: Inflammatory markers increase in end-stage renal disease (ESRD), especially in diabetic patients, and are positively correlated with cardiovascular mortality. Coenzyme Q10 (CoQ10), an agent with antioxidant properties, may be effective in reducing cardiovascular complications in hemodialysis patients. This study aimed to investigate the effects of CoQ10 supplementation on plasma C-reactive protein (CRP), homocysteine, and albumin in hemodialysis patients. Methods: Forty diabetic ESRD patients on hemodialysis for at least six months were evaluated in a double-blinded randomized clinical trial. The patients were randomly assigned to one of the two groups to receive either CoQ10 100 mg daily or placebo. In all patients, the serum levels of homocysteine, albumin, and CRP were measured before and after six months. Results: The mean age of the patients was 60.3 ± 9.1 years, and 57.5% of the participants were female. There was no statistical difference between the two groups at baseline. Furthermore, no significant difference was observed in serum albumin (P = 0.843), CRP (P = 0.214), and homocysteine (P = 0.21) at the end of the intervention between the groups. Conclusions: This study showed that in patients with ESRD, using CoQ10 supplementation has minimal beneficial effects on serum albumin, CRP, and homocysteine levels.

scholarly journals Effect of N-Acetylcysteine on Inflammatory and Biochemical Markers of Hemodialysis Patients: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Rozina Abasi Larki ◽  
Alireza Panahi ◽  
Leila Manzouri ◽  
Moslem Sedaghattalab
Keyword(s):  
Interleukin 6 ◽  
Biochemical Markers ◽  
Controlled Trial ◽  
Intervention Group ◽  
Hemodialysis Patients ◽  
C Reactive Protein ◽  
Double Blind ◽  
Reactive Protein ◽  
Significant Difference ◽  
And Control

Abstract- The oxidative stress results in atherosclerosis and cardiovascular diseases in patients receiving hemodialysis. N-acetylcysteine is a well-known antioxidant agent. There are little studies about the effect of N-acetylcysteine on patients receiving hemodialysis, and, if any, their results are inconsistent. This study, as a double-blind, randomized clinical trial, was conducted on 44 hemodialysis patients in Shahid Beheshti Hospital, Yasuj, Iran in 2015. Patients were randomly allocated into two groups, in the intervention group, N-acetylcysteine 600 mg every 12 hours for eight weeks was administered and the second group received placebo during this period every 12 hours. Blood samples were taken to measure C-reactive protein, interleukin-6 and other biochemical markers such as ferritin, albumin, and creatinine at baseline and at the end of treatment. 40 patients completed the study (21 on N-acetylcysteine, 19 on placebo), with a mean age of 60.72±17.60. There was not any significant difference between intervention and control groups in interleukin-6 (8.85±6.9 vs. 10.32±8.68, 95% CI, -3.52 to 6.46; P=0.55) and C - reactive protein (0.85±0.29 vs. 0.9±0.31, 95% CI, -.14 to .24; P=0.60). In addition, there was no significant relationship between the two groups in other biochemical markers. In this study, administering N-acetylcysteine was safe and caused a reduction in some inflammatory markers, but these changes were not significant in comparison with placebo.

Effect of Vitamin C Supplementation on Oxidative Stress and Lipid Profiles in Hemodialysis Patients

2009 ◽  
Vol 79 (56) ◽  
pp. 281-287 ◽  
Author(s):  
Hadi Abdollahzad ◽  
Shahriar Eghtesadi ◽  
Issa Nourmohammadi ◽  
Mohammadhasan Khadem-Ansari ◽  
Hossein Nejad-Gashti ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Lipid Peroxidation ◽  
Vitamin C ◽  
Serum Vitamin ◽  
Density Lipoprotein ◽  
Serum Triglyceride ◽  
Hemodialysis Patients ◽  
Lipid Profiles ◽  
Significant Difference ◽  
Vitamin C Supplementation

Background and aims: The increase in oxidative stress is the main factor in acceleration of atherosclerosis, leading to death in hemodialysis patients. Vitamin C is one of the most important antioxidants that inhibits lipid peroxidation and improves endothelial function. This study aims to assess the effects of vitamin C supplementation on lipid profiles as well as markers of lipid peroxidation among hemodialysis patients. Materials and methods: In this double-blind, randomized, controlled clinical trial, a total of 42 patients were randomly assigned to vitamin C (n=21) or placebo groups (n=21). Patients in the vitamin C group consumed 250 mg vitamin C and those in the placebo group were given placebo every other day for 12 weeks. Fasting blood samples were collected at baseline and at the end of the study to measure serum concentrations of lipid profiles, as well as malondialdehyde (MDA) and vitamin C. Results: After supplementation with vitamin C, serum vitamin C levels increased significantly in the vitamin C group as compared to baseline (p=0.033). There was also a significant difference in serum vitamin C levels between vitamin C and placebo groups (p=0.001). Serum MDA concentrations were marginally decreased in the vitamin C group after taking supplements (p=0.057). A significant difference was also seen in mean MDA changes between vitamin C and placebo groups (p=0.002). There was a significant difference in serum levels of total cholesterol (p=0.005), low-density lipoprotein (LDL-C) (p=0.012), and LDL-C/high-density lipoprotein (HDL-C) ratio (p=0.018) between the two groups; however, serum triglyceride and HDL-C levels were not significantly different between groups. Conclusion: Every other day supplementation with 250 mg vitamin C for 12 weeks increases serum vitamin C, decreases MDA levels, and improves lipid profiles in hemodialysis patients.

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