Aim: The current data have proven the pivotal role of inflammation in the development of atherosclerosis and cardiovascular diseases in patients with chronic kidney disease (CKD). Neutrophil to lymphocyte (N/L) ratio has increasingly been reported as a measure of systemic inflammation. This study assessed N/L ratio and investigated its associations with standard inflammatory biomarkers in different stages of CKD patients. Material and methods: This cross-sectional study included 30 predialysis, 40 hemodialysis, 35 peritoneal dialysis patients, and 30 healthy subjects. N/L ratio and important clinical and laboratory parameters were registered. Multivariate regression analyses were carried out to investigate the relations of N/L ratio. Results: N/L ratio was significantly higher in each patient group compared to the healthy subjects (for all, p < 0.001). It was positively correlated with interleukin-6 (IL-6) (r ¼ 0.393, p < 0.001) and high-sensitivity C-reactive protein (hs-CRP) (r ¼ 0.264, p ¼ 0.002) levels and negatively correlated with hemoglobin (r ¼ À0.271, p ¼ 0.001), serum albumin (r ¼ À0.400, p < 0.001), and high-density lipoprotein (HDL) cholesterol levels (r ¼ À0.302, p < 0.001). In CKD patients with hypertension (HT), higher N/L ratio was detected when compared to those without HT (p ¼ 0.006). Having CKD, the presence of HT, serum albumin, HDL-cholesterol, IL-6, and hs-CRP levels were found to be independent predictors of the ratio after adjusting for significant covariates (p < 0.001). Conclusion: An easy and inexpensive laboratory measure of N/L ratio might provide significant information regarding inflammation in CKD including predialysis and dialysis patients.
In contrast to what is seen for the general population, this study showed that there was a negative relationship between iron administration and serum iFGF23 level in a dialysis population. We can therefore conclude that if high levels of FGF23 are harmful, iron therapy may have a beneficial effect on bone metabolism by reducing FGF23 levels in a dialysis population.
H. pylori-induced gastritis appears to cause an increase in prohepcidin levels and a decrease in ferritin levels, supporting our hypothesis; but this relationship has not been proven.
YKL-40 has been introduced as a marker of inflammation in different clinical situations. The association between YKL-40 and inflammation in chronic renal failure patients has not been researched currently. The objectives of this study were to establish serum YKL-40 concentrations in dialysis patients with chronic renal failure compared to healthy subjects and to explore its relationships with a proinflammatory cytokine, interleukine-6 (IL-6) and an acute phase mediator, high sensitivity C-reactive protein (hs-CRP). The study population included hemodialysis patients (N = 43; mean age of 40.9 ± 14.5), peritoneal dialysis patients (N = 38; mean age of 45.8 ± 13.7) and healthy subjects (N = 37; mean age of 45.5 ± 10.6). Serum concentrations of YKL-40, IL-6, hs-CRP and routine laboratory measures were evaluated. Compared to the healthy subjects, hemodialysis and peritoneal dialysis patients had higher concentrations of YKL-40, IL-6, hs-CRP, as well as lower concentrations of hemoglobin, serum albumin and high density lipoprotein-cholesterol (P < 0.001). YKL-40 concentrations were positively correlated with serum creatinine (P < 0.001, r = 0.495), IL-6 (P < 0.001, r = 0.306), hs-CRP (P = 0.001, r = 0.306) levels and inversely correlated with hemoglobin (P = 0.002, r = -0.285), serum albumin (P < 0.001, r = -0.355) and high density lipoprotein-cholesterol (P = 0.001, r = -0.306). In multivariate regression analysis YKL-40 was associated with creatinine, serum albumin and hs-CRP concentrations after adjustments with covariates. Dialysis patients with chronic renal failure have elevated serum YKL-40 concentrations. Associations with standard inflammatory parameters suggest that YKL-40 might be a novel inflammatory marker in this population.
Hypertension possess a significant risk factor for a variety of diseases and affects millions of people all around the world. Recent studies suggest that NO plays a role in pathogenesis of hypertension while some investigators find a close relationship between acupuncture treatment
and NO levels. We therefore aimed to investigate the effect of acupuncture on the levels of blood pressure and nitric oxide (NO) in hypertensive patients. After obtaining institutional ethics committee approval and patients' informed consent, 32 essential hypertensive patients aged between
32-65 and taking antihypertensive drugs were included to the study. A total of 10 sessions of manual acupuncture were applied on body acupoints (EX-HN3 (Yintang), KI 3, LIV 3, SP 9, LI 4, HT 7, ST 36, SP 6) in 10 weeks. Systolic (SBP) and diastolic blood pressure (DBP) levels and blood NO
levels were measured for 3 times (i.e. before & after the first session, and after the 10 th session). Main outcome measures of our study were the changes in SBP and DBP as well as nitric oxide levels between 3 measurements were compared. Our study showed that SBP and DBP values decreased
both after the 1st and 10th sessions of acupuncture treatments (p<0.05). The NO concentration also increased both after the 1st (71.5%) and 10th sessions (184.6%) (p<0.05).
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