The levels of inflammatory biomarkers in hemodialysis and peritoneal dialysis patients

Yıldırım, Mehmet; Açıkgöz, Seyyid Bilal; Genç, Ahmed Bilal; Yaylacı, Selçuk; Dheir, Hamad; Sipahi, Sava S

doi:10.1590/1806-9282.20210056

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…In summary, the complex pathophysiologic mechanisms suggested that Klotho downregulation is not merely an early biomarker for kidney damage, but also one of the principal complications of CKD and may play a pathogenic role in CKD progression [ 24 ]. Additionally, due to the complexity of the mechanism, whether serum Klotho reflects kidney function remains controversial in some studies [ 49 , 50 ], which requires high-quality research evidence.…”

Section: Discussionmentioning

confidence: 99%

Association between Serum Soluble α-Klotho and Urinary Albumin Excretion in Middle-Aged and Older US Adults: NHANES 2007–2016

Chang

Zheng

et al. 2023

JCM

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(1) Background: Preclinical and clinical studies on the anti-aging effect of α-Klotho are emerging. Urinary albumin excretion (UAE) is a well-known biomarker of kidney injury and generalized damage in the cardiovascular system. However, the potential relationship between α-Klotho and UAE is limited and controversial. This study aimed to quantify this relationship in the general middle-aged and elderly population from the National Health and Nutrition Survey (NHANES) 2007–2016. (2) Methods: Serum α-Klotho was measured by enzyme-linked immunosorbent assay. UAE was assessed by the albumin-to-creatinine ratio (ACR). After adjusting for several confounding variables, the relationship between α-Klotho and ACR was analyzed by weighted multivariable logistic regression, subgroup analysis, and interaction tests. A generalized additive model (GAM) with smooth functions using the two-piecewise linear regression model was used to examine the potential nonlinear relationship between α-Klotho and ACR. (3) Results: Among 13,584 participants aged 40–79 years, we observed an independent and significant negative correlation between α-Klotho and ACR (β = −12.22; 95% CI, −23.91, −0.53, p = 0.0448) by multivariable logistic regression analysis, especially in those with age ≥ 60 years, pulse pressure (PP) ≥ 60 mmHg, hypertension or diabetes. We further discovered the nonlinear relationship between α-Klotho and ACR by GAM, revealing the first negative and then positive correlations with an inflection point of 9.91 pg/mL between α-Klotho and ACR. (4) Conclusions: A dose-response relationship between α-Klotho and ACR was demonstrated, and the negative correlation therein indicated that α-Klotho has potential as a serum marker and prophylactic or therapeutic agent despite its metabolic and effective mechanisms needing to be further explored.

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Section: Discussionmentioning

confidence: 99%

Association between Serum Soluble α-Klotho and Urinary Albumin Excretion in Middle-Aged and Older US Adults: NHANES 2007–2016

Chang

Zheng

et al. 2023

JCM

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“…The authors saw no correlation between Klotho levels and eGFR or parameters associated with calcium-phosphate metabolism. Yildirim et al [ 26 ] have demonstrated that HD and PD patients have higher serum α-Klotho than healthy people. In a recent study by Gamrot et al [ 27 ], mean serum α-Klotho was higher in children with CKD on dialysis than in conservatively treated children.…”

Section: Discussionmentioning

confidence: 99%

“…Its soluble form results from direct secretion by the cell of truncated form or from cleavage of the extracellular domain of the full-length protein [ 5 ]. The different tissue locations of α-Klotho and the different mechanisms of soluble Klotho production bring into question the relationship between protein expression in the kidney and its amount in the blood in CKD patients [ 11 , 25 , 26 , 27 ]. The lack of relationship between serum α-Klotho and fatal or non-fatal cardiovascular events could be explained by several factors.…”

Section: Discussionmentioning

confidence: 99%

Serum Levels of α-Klotho, Inflammation-Related Cytokines, and Mortality in Hemodialysis Patients

Lisowska

Storoniak

Soroczyńska-Cybula

et al. 2022

JCM

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It has been hypothesized that α-Klotho deficiency might contribute to chronic inflammation in patients with end-stage renal disease (ESRD), especially those on hemodialysis (HD). Serum Klotho levels by some authors are considered a potential predictor of cerebrovascular events. Therefore, we analyzed serum levels of α-Klotho with ELISA and inflammation-related cytokines in HD patients. Sixty-seven HD patients and 19 healthy people were recruited between November 2017 and June 2021. A Cytometric Bead Array (CBA) was used to determine the level of different cytokines: IL-12p70, TNF, IL-10, IL-6, IL-1β, and IL-8. A human Klotho ELISA kit was used to determine the level of α-Klotho in the plasma samples of HD patients. There was no difference in serum levels of α-Klotho between HD patients and healthy people. Patients had increased serum IL-6 and IL-8. Significant positive correlations existed between the concentration of α-Klotho and the serum concentrations of IL-12p70, IL-10, and IL-1β. However, in a multivariable linear regression analysis, only patients’ age was associated independently with α-Klotho level. Serum α-Klotho was not associated with higher mortality risk in HD patients. While these results draw attention to potential relationships between α-Klotho proteins and inflammatory markers in HD patients, our cross-sectional study could not confirm the pathogenic link between α-Klotho, inflammation, and cardiovascular mortality.

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“…Often, HD and CAPD result in alterations in several inflammatory markers. Fibroblast growth factor 23 (FGF23), indoxyl sulfate, sclerostin, alpha klotho, Procollagen 1 N terminal Propetide and beta-CrossLaps are upregulated during dialysis [ 84 ]. Indoxyl sulfate is positively correlated with mortality.…”

Section: Dialysis and Inflammationmentioning

confidence: 99%

The Role of Inflammation in CKD

Kadatane

Satariano

Massey

et al. 2023

Cells

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Chronic kidney disease (CKD) affects many adults worldwide. Persistent low-grade inflammation is a substantial factor in its development and progression and has correlated with increased mortality and cardiovascular problems. This low-grade inflammation is a product of dysregulation of the normal balance between pro- and anti-inflammatory markers. Various factors such as increased innate immune system activation, reactive oxygen species production, periodontal disease, dysregulation of anti-inflammatory systems and intestinal dysbiosis result in the dysregulation of this balance. Furthermore, this low-grade inflammation has down-effects such as hypertension, renal fibrosis and acceleration of renal function decline. Moreover, low-grade inflammation over time has been linked to malignancy in CKD. As CKD progresses, many patients require dialysis, which has a negative bidirectional relationship with persistent inflammation. Treatment options for inflammation in CKD are vast, including cytokine inhibitors, statins and diets. However, more research is needed to create a standardized management plan. In this review, we will examine the normal physiology of the kidney and its relationship with the immune system. We will then delve into the pathology behind persistent inflammation, the various causes of inflammation, the downstream effects of inflammation, dialysis and potential treatments for inflammation in CKD.

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The levels of inflammatory biomarkers in hemodialysis and peritoneal dialysis patients

Cited by 4 publications

References 27 publications

Association between Serum Soluble α-Klotho and Urinary Albumin Excretion in Middle-Aged and Older US Adults: NHANES 2007–2016

Association between Serum Soluble α-Klotho and Urinary Albumin Excretion in Middle-Aged and Older US Adults: NHANES 2007–2016

Serum Levels of α-Klotho, Inflammation-Related Cytokines, and Mortality in Hemodialysis Patients

The Role of Inflammation in CKD

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