Background and AimMetabolic disorders are prevalent in patients with chronic kidney disease (CKD) and may lead to protein energy wasting (PEW). Adipokines improve connections between PEW and energy metabolism. We aimed to determine the relationship between adipokine levels and resting energy expenditure (REE) in patients with CKD.MethodsA total of 208 patients in non-dialyzed CKD stages 3–5 were enrolled in this cross-sectional study. Serum adipokines (leptin, adiponectin, and interleukin 6 (IL-6) were measured using enzyme-linked immunosorbent assay. Patient's REE was measured using indirect calorimetry. Fat mass (FM) and lean tissue mass (LTM) were measured using multiple-frequency bioimpedance analysis. Spearman correlation analyses and multivariate linear regression models were used to assess the association between serum adipokines and REE.ResultsThe mean age was 52.7 ± 14.6 years, and 26.9, 26.4, and 46.7% of our participants had CKD stages 3, 4, and 5, respectively. The median values of serum adiponectin, leptin, and IL-6 were 470.4 (range, 291.1–802.2), 238.1 (range, 187.9–418.4), and 4.0 (range, 2.4–9.5) pg/mL, respectively. The male participants had significantly lower FM% (P = 0.001) and lower leptin levels (P < 0.001) than the female participants. After adjusting for age, diabetes, high-sensitivity C-reactive protein, intact parathyroid hormone, LTM, and FM, multiple linear regression analysis revealed that serum leptin levels were significantly positively associated with REE in men rather than in women (P < 0.05). Serum adiponectin levels were inversely associated with REE in men, but this association disappeared while FM was additionally adjusted. Adiponectin levels in women were not correlated with REE (P > 0.05). IL-6 was not significantly associated with REE in either men or women.ConclusionsA sex-specific relationship between serum adipokines (leptin and adiponectin) and REE was observed in patients with CKD stages 3–5, which was partly confounded by FM.
Introduction Increased intraperitoneal pressure (IPP) is associated with abdominal wall complications and technical failure in peritoneal dialysis. Since the standard measurement of IPP is limited due to its cumbersome procedures, we aimed to develop and validate equations for evaluating IPP (eIPP). Methods A cross-sectional study. Totally 200 prevalent PD patients were divided into development and validation datasets after random sampling matched by body mass index. The IPPs were measured using the Durand method, with whole-body and abdominal anthropometry indices collected. Equations with 2.0 L and 1.5 L fill volume were generated by stepwise linear regression modeling respectively. The bias, accuracy and precision of eIPP with 2 L and 1.5 L fill volume were compared with actual IPP by Durand method respectively. The eIPP for 2 L fill volume was also compared with other existing equations. Results Two new equations both incorporating waist and height from decubitus plane to midaxillary line were generated. The value of eIPP exhibited small biases in relation to golden standard, with median differences of -0.24 cmH2O and -0.10 cmH2O for 2 L and 1.5 L respectively. The precisions evaluated by the SD of the absolute value of the differences were 2.59 cmH2O and 2.50 cmH2O respectively. The accuracies evaluated by the value of 1-P20 for eIPP were 26% for 2.0 L and 27% for 1.5 L. Better bias, precision and accuracy were observed for the eIPP equation compared with other existing equations for 2.0 L fill volume. Conclusions We provided two new equations, first developed from abdominal anthropometry indices, to accurately estimate the IPP in the PD population.
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