scholarly journals Neutrophil Gelatinase–Associated Lipocalin in Peritoneal Effluent: Evaluation in Peritoneal Dialysis Patients in Basal Condition

2013 ◽  
Vol 33 (4) ◽  
pp. 379-381 ◽  
Author(s):  
Francesca Martino ◽  
Ilenia Filippi ◽  
Davide Giavarina ◽  
Gianpaolo Amici ◽  
Massimo de Cal ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Cross Sectional Study ◽  
Hydration Status ◽  
Linear Regression Models ◽  
Dialysis Adequacy ◽  
Cross Sectional ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Reactive Protein ◽  
Neutrophil Gelatinase

PurposeIn the present study, we assessed expression of neutrophil gelatinase-associated lipocalin (NGAL) in peritoneal effluent (pNGAL) from peritoneal dialysis (PD) patients, and we evaluated factors that might affect its level in basal conditions.MethodsOur cross-sectional study included all 69 patients on PD at our institution. We evaluated patient history, hydration status, residual renal function, indices of dialysis adequacy, peritoneal transport type, serum C-reactive protein, ferritin, serum NGAL (sNGAL) and pNGAL. Univariate and multivariate linear regression models were used to evaluate predictors of pNGAL.ResultsOf the study patients, 39 (56.5%) were men, and 54 (78.3%) were on continuous ambulatory PD. Median age in the group was 61 years [interquartile range (IQR): 46.5 - 71 years]. Median sNGAL was 487 ng/mL (IQR: 407 - 586 ng/mL), and median pNGAL was 35 ng/mL (IQR: 21 - 46 ng/mL). dNGAL correlated directly with weekly dialytic clearance of creatinine (ρ = 0.291, p = 0.02) and with sNGAL (ρ = 0.269, p = 0.031). The same variables were also independent predictors of pNGAL (β = 0.30 and 0.29 respectively, both p < 0.05) in multivariate analysis.ConclusionsIn our analysis, basal levels of pNGAL were influenced by sNGAL and by dialytic clearance of creatinine.

scholarly journals The Association Between Self-Management Ability and Malnutrition-Inflammation-Atherosclerosis Syndrome in Peritoneal Dialysis Patients: A Cross-Sectional Study

2020 ◽  
Author(s):  
Zehui Huang ◽  
Junyang Fang ◽  
Ahui Song ◽  
Yan Tong ◽  
Hai Deng ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cross Sectional Study ◽  
Self Management ◽  
Spearman Correlation ◽  
Effect Evaluation ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Management Ability ◽  
Evaluation And Monitoring ◽  
The Relationship

Abstract BackgroundThe relationship between malnutrition-inflammation-atherosclerosis syndrome (MIAS) and self-management ability has not been previously revealed even though both play an important role in the management of peritoneal dialysis (PD) patients.Materials and methodsIn total, 93 patients were enrolled in this study. A self-management questionnaire was used for the evaluation of self-management ability. The identification of MIAS was based on one or more of the following three conditions: C-reactive protein (CRP) ≥10 mg/L, malnutrition–inflammation score (MIS) > 7, and the presence of atherosclerosis related medical records. The possible association between different self-management abilities and MIAS was analyzed with a Spearman correlation analysis.ResultsThere were 40 (43.0%) patients in the atherosclerosis group, and 38 (40.9%), 38 (40.9%), 10 (10.8%), and 7 (7.5%) patients in the MIAS0, MIAS1, MIAS2, and MIAS3 groups, respectively. The group with a score above the mean score of the Dialysis Effect Evaluation and Monitoring dimension had a fewer number of hospitalizations, higher albumin levels, lower MIS scores, lower level of IL-6, and a lower number of MIAS factors. The Pearson and Spearman correlation analyses also revealed that this dimension was negatively correlated with the MIAS, MIS, IL-6, BNP, number of hospitalizations, and age and positively associated with albumin and prealbumin. ConclusionThe Dialysis Effect Evaluation and Monitoring dimension of the self-management scale for PD patients is closely linked to the MIAS, and the better the dialysis effect evaluation and monitoring capacity, the lower the chance of exposure to malnutrition and inflammation.Trial registrationChina Clinical Trials Register: SH9H-2020-T20-2, retrospectively registered 15 January 2020.

scholarly journals The role of education in the association between self-rated health and levels of C-reactive protein: a cross-sectional study in rural areas of China

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e027659 ◽  
Author(s):  
Raoping Tu ◽  
Kuan-Yu Pan ◽  
Guoxi Cai ◽  
Taro Yamamoto ◽  
Hui-Xin Wang
Keyword(s):  
Rural Areas ◽  
Protein A ◽  
Cross Sectional Study ◽  
Linear Regression Models ◽  
Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Self Rated Health

ObjectivesThis study aims to examine the association between self-rated health (SRH) and levels of C-reactive protein (CRP) among adults aged 45 to 101 years old in rural areas of China, and to explore the role of education in the association.DesignCross-sectional study.SettingThe study population was derived from two databases in China: Nanping project (NP) and the China Health and Retirement Longitudinal Study (CHARLS).ParticipantsThere were 646 participants from a rural area of Nanping (NP) and 8555 rural participants from a national representative sample of China (CHARLS).MethodsCRP was measured using a high sensitivity sandwich enzyme immunoassay in the NP and immunoturbidimetric assay in the CHARLS. SRH was assessed by SRH questionnaires and categorised into good and poor. Education was measured by the maximum years of schooling and dichotomised into illiterate and literate. Multivariate linear regression models were used to study the associations.ResultsCompared to people with good SRH, those with poor SRH had higher levels of CRP in NP (β=0.16, 95% CI −0.02 to 0.34) and in CHARLS (β=0.07, 95% CI 0.02 to 0.11) after adjusting for potential confounders. Similar findings were observed in the pooled population (β=0.08, 95% CI 0.03 to 0.12), especially in men (β=0.13, 95% CI 0.06 to 0.20) and in literate people (β=0.12, 95% CI 0.06 to 0.18).ConclusionPoor SRH may be a predicator of elevated levels of CRP among middle-aged and older people in rural areas, especially in men and literate people.

Clinical Utility of Potassium-Sparing Diuretics to Maintain Normal Serum Potassium in Peritoneal Dialysis Patients

2017 ◽  
Vol 37 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Tibor Fülöp ◽  
Lajos Zsom ◽  
Betzaida Rodríguez ◽  
Sabahat Afshan ◽  
Jamie V. Davidson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Potassium ◽  
Residual Renal Function ◽  
Normal Serum ◽  
Dialysis Adequacy ◽  
Cross Sectional ◽  
Laboratory Variables ◽  
Stage Renal Disease ◽  
End Stage ◽  
Vexing Problem

BackgroundHypokalemia is a vexing problem in end-stage renal disease patients on peritoneal dialysis (PD), and oral potassium supplements (OPS) have limited palatability. Potassium-sparing diuretics (KSD) (spironolactone, amiloride) may be effective in these patients.MethodsWe performed a cross-sectional review of 75 current or past (vintage > 6 months) PD patients with regard to serum potassium (K+), OPS, and KSD utilization. We reviewed charts for multiple clinical and laboratory variables, including dialysis adequacy, residual renal function, nutritional status and co-existing medical therapy.ResultsThe cohort was middle-aged with a mean age of 49.2 years (standard deviation [SD] = 14.7) and overweight with a body mass index of 29.5 (6.7) kg/m2. Of all the participants, 57.3% were female, 73.3% African-American, and 48% diabetic with an overall PD vintage of 28.2 (24.3) months at the time of enrollment. Weekly Kt/V was 2.12 (0.43), creatinine clearance was 73.5 (33.6) L/week/1.73 m2with total daily exchange volume of 10.8 (2.7) L. Residual urine output (RUO) measured at 440 (494) mL (anuric 30.6%). Three-month averaged serum K+measured at 4 (0.5) mmol/L with 36% of the participants receiving K+supplements (median: 20 [0;20] mmol/day) and 41.3% KSD (spironolactone dose: 25 – 200 mg/day; amiloride dose: 5 – 10 mg/day). Serum K+correlated positively with weekly Kt/V (r = 0.239; p = 0.039), PD vintage (r = 0.272; p = 0.018) but not with PD modality, daily exchange volume, RUO, or KSD use. However, KSD use was associated with decreased use of OPS (r = -0.646; p < 0.0001).ConclusionsPotassium-sparing diuretics were effective in this cohort of PD patients and decreased the need for OPS utilization.

Dialysis Adequacy of Asian Patients Receiving Small Volume Continuous Ambulatory Peritoneal Dialysis

1997 ◽  
Vol 20 (8) ◽  
pp. 428-435 ◽  
Author(s):  
C.C. Szeto ◽  
K.N. Lai ◽  
A.W.Y. Yu ◽  
C.B. Leung ◽  
K.K.L. Ho ◽  
...  
Keyword(s):  
Small Volume ◽  
Asian Population ◽  
Residual Renal Function ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Dialysis Adequacy ◽  
Cross Sectional ◽  
Asian Patients ◽  
Catabolic Rate ◽  
Peritoneal Permeability

The usage of three × 2 liter daily exchanges is adopted as the standard CAPD regime in Hong Kong over the last 10 years due to budgetary constraint. This dialysis prescription is considered suboptimal in Western standard. However, the necessity of maintaining Kt/V > 1.7 for CAPD dialysis adequacy is not unanimously agreed. We performed a cross-sectional study of 117 patients on CAPD. Seventy-eight percent of our patients had 3 × 2 liter daily exchange while the rest had 4 daily exchanges. Fifteen percent of patients were diabetic. Patients with Kt/V < 1.7 were similar to those with Kt/V > 1.7 in age, duration of CAPD, BUN, plasma creatinine, albumin, peritonitis rate, and incidence of hypertension. Patients with Kt/V ≥ 1.7 had higher hemoglobin, higher nPCR, more residual renal function; and more of them received 4 daily exchanges. Their peritoneal permeability did not differ. Their employment and rehabilitation status was also similar. Our 5-year survival was 79% despite a lower Kt/V. Notably, the protein catabolic rate of our patients was higher than that in Western patients. This is likely due to dietary difference. Our study suggests small-volume dialysis may be acceptable in Asian population with smaller body size given the financial constraint.

scholarly journals Urinay neutrophil gelatinase-associated lipocalin as a biomarker in different renal problems

2020 ◽  
Vol 50 (6) ◽  
pp. 1566-1572
Author(s):  
Didem TURGUT ◽  
Serhan Vahit PİŞKİNPAŞA ◽  
Ezgi COŞKUN YENİGÜN ◽  
Nihal AYDEMİR ◽  
Fatih DEDE
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Healthy Subjects ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Background/aim: Neutrophil gelatinase-associated lipocalin (NGAL) is used previously to estimate the etiology, severity, and clinical outcomes of acute kidney injury (AKI). However, the role of urinary NGAL (uNGAL) in the postrenal setting is not clear. In our study, we aimed to discover the cut-off value of uNGAL that can be used in the differential diagnosis of underlying AKI etiologies.Materials and methods: In this prospective cross-sectional study, we examined 82 subjects in four groups: patients that had (1) postrenal AKI; (2) AKI other than postrenal etiologies; (3) stable chronic kidney disease; and (4) healthy subjects. A renal function assessment was carried out by measuring serum creatinine (sCr) and uNGAL at the time of diagnosis [0th min (T0)]. We followed the study group for three months. Results: At the time of diagnosis, sCr (T0) was highest in the postrenal AKI and AKI groups in contrast to stable chronic kidney disease patients and healthy subjects (P < 0.001), as expected. T0 median uNGAL was highest in the postrenal group (P < 0.001). Area under curve (AUC) of uNGAL to estimate postrenal AKI presence was 0.957 (95% CI, 0.897–1.000; P < 0.001). The cut-off point of uNGAL was 42.625 ng/mL for this estimation. Conclusion: Patients with AKI must be classified according to the underlying etiologies as soon as possible. uNGAL may be useful to estimate the etiologies, and whether the problem is acute or chronic in the course. In postrenal kidney problems, to plan the urgency of the urologic procedures, it is crucial.

Sevelamer Hydrochloride in Peritoneal Dialysis Patients: Results of a Multicenter Cross-Sectional Study

2007 ◽  
Vol 27 (6) ◽  
pp. 697-701 ◽  
Author(s):  
Rosa Ramos ◽  
Francesc Moreso ◽  
Mercè Borras ◽  
Esther Ponz ◽  
Joan M. Buades ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Serum Phosphate ◽  
Sectional Study ◽  
C Reactive Protein ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Reactive Protein

Background Sevelamer hydrochloride is a phosphate binder widely employed in hemodialysis patients. Until now, information about its efficacy and safety in peritoneal dialysis patients has been scarce. Patients and Methods In September 2005 a cross-sectional study of demographic, biochemical, and therapeutic data of patients from 10 peritoneal dialysis units in Catalonia and the Balearic Islands, Spain, was conducted. Results We analyzed data from 228 patients. At the time of the study, 128 patients (56%) were receiving sevelamer. Patients receiving sevelamer were younger ( p < 0.01), showed a longer period of time on dialysis ( p < 0.01), and had a lower Charlson Comorbidity Index ( p < 0.01). Serum calcium and intact parathyroid hormone levels were not different between the two groups, while phosphate levels <5.5 mg/dL were observed more frequently in patients not receiving sevelamer (79% vs 61%, p < 0.01). Serum total cholesterol (167 ± 41 vs 189 ± 42 mg/dL, p < 0.01) and low density lipoprotein (LDL) cholesterol (90 ± 34 vs 109 ± 34 mg/dL, p < 0.01), but not high density lipoprotein cholesterol or triglycerides, were lower in sevelamer-treated patients. Moreover, sevelamer-treated patients displayed a higher serum albumin (38 ± 5 vs 36 ± 4 g/L, p < 0.01) and a lower C-reactive protein (4.9 ± 12.8 vs 8.8 ± 15.7 mg/L, p < 0.01). Blood bicarbonate levels <22 mmol/L were observed more frequently in patients receiving sevelamer (22% vs 5%, p < 0.01). Logistic regression analysis adjusting by confounding variables confirmed that sevelamer therapy was associated with serum total cholesterol <200 mg/dL [relative risk (RR): 2.77, 95% confidence interval (CI): 1.44 – 5.26, p = 0.002] and blood bicarbonate <22 mmol/L (RR: 8.5, 95% CI: 2.6 – 27.0, p < 0.001), but not with serum phosphate >5.5 mg/dL, calcium–phosphate product >55 mg2/dL2, serum albumin <35 g/L, or C-reactive protein >5 mg/L. Conclusions This uncontrolled cross-sectional study in peritoneal dialysis patients showed that sevelamer hydro-chloride treatment allows an adequate serum phosphate level in about 60% of patients and significantly reduces total and LDL-cholesterol levels. Since this treatment is associated with metabolic acidosis in 22% of patients, we recommend close monitoring of bicarbonate levels in this group of patients until the clinical significance of this result is clarified.

scholarly journals Hydration Status of Patients Dialyzed with Biocompatible Peritoneal Dialysis Fluids

2016 ◽  
Vol 36 (3) ◽  
pp. 257-261 ◽  
Author(s):  
Monika Lichodziejewska-Niemierko ◽  
Michał Chmielewski ◽  
Maria Dudziak ◽  
Alicja Ryta ◽  
Bolesław Rutkowski
Keyword(s):  
Peritoneal Dialysis ◽  
Degradation Products ◽  
Urine Volume ◽  
Residual Renal Function ◽  
Hydration Status ◽  
Bioimpedance Spectroscopy ◽  
Dialysis Fluid ◽  
Dialysis Adequacy ◽  
Stage Renal Disease ◽  
Dialysis Fluids

Background Biocompatible fluids for peritoneal dialysis (PD) have been introduced to improve dialysis and patient outcome in end-stage renal disease. However, their impact on hydration status (HS), residual renal function (RRF), and dialysis adequacy has been a matter of debate. The aim of the study was to evaluate the influence of a biocompatible dialysis fluid on the HS of prevalent PD patients. Methods The study population consisted of 18 prevalent PD subjects, treated with standard dialysis fluids. At baseline, 9 patients were switched to a biocompatible solution, low in glucose degradation products (GDPs) (Balance; Fresenius Medical Care, Bad Homburg, Germany). Hydration status was assessed through clinical evaluation, laboratory parameters, echocardiography, and bioimpedance spectroscopy over a 24-month observation period. Results During the study period, urine volume decreased similarly in both groups. At the end of the evaluation, there were also no differences in clinical (body weight, edema, blood pressure), laboratory (N-terminal pro-brain natriuretic peptide, NTproBNP), or echocardiography determinants of HS. However, dialysis ultra-filtration decreased in the low-GDP group and, at the end of the study, equaled 929 ± 404 mL, compared with 1,317 ± 363 mL in the standard-fluid subjects ( p = 0.06). Hydration status assessed by bioimpedance spectroscopy was +3.64 ± 2.08 L in the low-GDP patients and +1.47 ± 1.61 L in the controls ( p = 0.03). Conclusions The use of a low-GDP biocompatible dialysis fluid was associated with a tendency to overhydration, probably due to diminished ultrafiltration in prevalent PD patients.

Procalcitonin Levels in Peritoneal Dialysis Patients

2005 ◽  
Vol 25 (5) ◽  
pp. 470-472 ◽  
Author(s):  
Sylvie Opatrná ◽  
Jan Klaboch ◽  
Karel Opatrný ◽  
Luboŝ Holubec ◽  
Martina Tomŝu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Healthy Volunteers ◽  
Systemic Infection ◽  
Systemic Circulation ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Detection Range ◽  
Reactive Protein ◽  
Serum Crp

Objective To examine whether the levels of procalcitonin (PCT), a new marker of infection and/or inflammation, differ between peritoneal dialysis (PD) patients and healthy volunteers, and whether PCT is detectable in uninfected drained dialysate. Design Observational cross-sectional study. Setting PD unit, department of medicine, in a university hospital. Patients A total of 28 PD patients, free of systemic infection, and 28 age- and sex-matched healthy volunteers. Methods PCT was determined by immunoluminometry; detection range 0.01 – 500 ng/mL, reference range <0.5 ng/mL. Results Plasma levels of PCT were significantly higher (Wilcoxon's paired test, p < 0.001) in PD patients (median 0.33 ng/mL) compared with healthy volunteers (0.18 ng/mL). Spearman's test demonstrated a significant positive correlation between PCT and serum C-reactive protein (CRP) ( r = 0.59, p < 0.01); correlations between PCT and transferrin, total weekly creatinine clearance (ClCr), and the renal components of ClCr and Kt/V urea were negative. PCT levels in dialysate (PCTd) were 0.07 ng/mL and correlated positively with plasma PCT, serum CRP, and dialysate fibrinogen levels. The dialysate-to-plasma ratio (D/P) of PCT was 0.2. Neither PCTd nor D/P PCT correlated with D/P creatinine at 4-hours of dwell. Conclusion Compared with healthy volunteers, PD patients without overt signs of infection showed increased plasma PCT levels. Given the study design, it is impossible to determine to what extent the increase in plasma PCT is due to reduced elimination and to what extent it reflects the microinflammation of uremia. Based on the D/P PCT gradient, we assume that PCT transport is more likely to occur from the systemic circulation to the peritoneal cavity than vice versa.

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