Time‐dependent lipid profile inversely associates with mortality in hemodialysis patients – independent of inflammation/malnutrition

Ebert, Thomas; Qureshi, Abdul Rashid; Lamina, Claudia; Fotheringham, James; Froissart, Marc; Eckardt, Kai Uwe; Wheeler, David C.; Floege, Jürgen; Kronenberg, Florian; Stenvinkel, Peter

doi:10.1111/joim.13291

Cited by 12 publications

(10 citation statements)

References 44 publications

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“…Elbert et al proved that a total cholesterol, HDL, non-HDL, and LDL level was associated with higher allcause, cardiovascular and non-cardiovascular mortality. In this study there was no correlation between mortality and an inflammation/malnutrition status for all lipid fractions (Ebert et al, 2021). Moreover, because of an enormous relationship between lipid serum profile and CVD risk, there is a need to find new diagnostic pathways which will improve the assessment of prognosis in dialysis patients.…”

Section: Lipid Abnormalities In Haemodialyzed Patientsmentioning

confidence: 56%

Lipid disorders – the comparison between general population and haemodialyzed patients. Will the Oral Fat Tolerance Test improve the diagnostic?

2022

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The cardiovascular events are frequent complications in chronic kidney disease (CKD). In the general population the risk factors of CV disease are well established and divided into two groups: non-modifiable, and modifiable. The best-known modifiable risk factors leading to the atherosclerotic plaque formation are lipid disorders. In comparison, an association between serum lipid profile in haemodialyzed patients and cardiovascular mortality is more complex and still unclear. Furthermore, it is important to note that recent studies suggest an inverse relationship between lipid disorders and CV mortality in a haemodialyzed population called ‘reverse epidemiology’. The disparity between the general and haemodialyzed populations may be supported by the fact that the haemodialysis process itself contributes to the development of dyslipidaemia. Moreover, the chronic kidney disease is associated with metabolic abnormalities which can increase the risk of CVD occurrence. It is estimated that one-third of the patients on haemodialysis have lipid profile abnormalities, the most common one is hypertriglyceridemia. The assessment of the lipid profile has so far been performed in a fasting and non-fasting (postprandial) state, but both of these methods have some limitations. This review evaluates the current knowledge about lipid profile abnormalities in haemodialyzed patients and discusses a potential role of the Oral Fat Tolerance Test (OFTT) as a new tool in clinical practice that may improve the diagnosis of postprandial hypertriglyceridemia.

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Section: Lipid Abnormalities In Haemodialyzed Patientsmentioning

confidence: 56%

Lipid disorders – the comparison between general population and haemodialyzed patients. Will the Oral Fat Tolerance Test improve the diagnostic?

2022

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“…For example, the uremic toxin symmetric dimethylarginine was shown to accumulate in HDL cholesterol, modulating its function by inhibiting anti-inflammatory properties, and was associated with reduced reverse cholesterol efflux and increased mortality [18]. In accordance, our group recently demonstrated that lipid parameters are counterintuitively inversely associated with mortality in incident hemodialysis patients [19] suggesting a uremia-induced dysregulation of lipid profile.…”

Section: Introductionmentioning

confidence: 78%

“…Furthermore, statin treatment does not affect uremic toxins' independent significant associations with lipid profile (i.e., IAA, TMAO, and PAG) in our tri-national cohort. Moreover, the ARO hemodialysis study has recently demonstrated an inverse relationship between lipid profile and mortality independent of the aforementioned covariates [19].…”

Section: Discussionmentioning

confidence: 99%

Lipid Profile Is Negatively Associated with Uremic Toxins in Patients with Kidney Failure—A Tri-National Cohort

Hobson

Loor

Kublickiene

et al. 2022

Toxins

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Patients with kidney failure (KF) have a high incidence of cardiovascular (CV) disease, partly driven by insufficient clearance of uremic toxins. Recent investigations have questioned the accepted effects of adverse lipid profile and CV risk in uremic patients. Therefore, we related a panel of uremic toxins previously associated with CV morbidity/mortality to a full lipid profile in a large, tri-national, cross-sectional cohort. Total, high-density lipoprotein (HDL), non-HDL, low-density lipoprotein (LDL), and remnant cholesterol, as well as triglyceride, levels were associated with five uremic toxins in a cohort of 611 adult KF patients with adjustment for clinically relevant covariates and other patient-level variables. Univariate analyses revealed negative correlations of total, non-HDL, and LDL cholesterol with all investigated uremic toxins. Multivariate linear regression analyses confirmed independent, negative associations of phenylacetylglutamine with total, non-HDL, and LDL cholesterol, while indole-3 acetic acid associated with non-HDL and LDL cholesterol. Furthermore, trimethylamine-N-Oxide was independently and negatively associated with non-HDL cholesterol. Sensitivity analyses largely confirmed findings in the entire cohort. In conclusion, significant inverse associations between lipid profile and distinct uremic toxins in KF highlight the complexity of the uremic milieu, suggesting that not all uremic toxin interactions with conventional CV risk markers may be pathogenic.

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“…Most lung transplant recipients have ESLD, and their complex conditions may lead to malnutrition (17). Malnutrition can increase the risk of respiratory infections, affect the immune system, and even worsen the function of respiratory muscles (18), which can affect the incidence of postoperative complications and mortality (19).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of nutritional status in lung transplant recipients and its correlation with post-transplant short-term prognosis: a retrospective study

Ding¹,

Chen²,

Chen³

et al. 2022

Ann Transl Med

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Background: Lung transplantation is an effective treatment for saving the lives of patients with end-stage lung disease (ESLD). Lung transplant-related morbidity and mortality has significantly higher than other solid organ transplants. Among the pre-transplant variables that affect the survival rate after transplantation, nutritional status are associated with poor survival rate. In order to provide basis for formulating nutritional evaluations for lung transplant recipients in the future, we retrospectively analyzed the nutritional status of lung transplantation recipients and explore its correlation with the short-term prognosis.Methods: This retrospective cohort study included patients who were hospitalized in 2020 and underwent lung transplant surgery at Shanghai Pulmonary Hospital. Inclusion criteria: (I) aged ≥18 years; (II) have been diagnosed with ESLD; (III) have received no other effective treatments; (IV) have undergone a transplantation at Shanghai Pulmonary Hospital. We summarized the patients' general information, including their sex, age, major lung disease etc. And we also collected nutritional status, such as Nutritional Risk Screening 2002 (NRS 2002), subjective global assessment (SGA) and nutritionalrelated indicators, including albumin, prealbumin, retinol-binding protein etc. before surgery and 1 month after surgery. In addition, we collected postoperative drainage volume, length of stay in intensive care unit (ICU), total hospital days, and hospitalization costs to evaluate the short-term prognosis.Results: A total of 33 lung transplant recipients were included and successfully underwent surgery. Of the patients, 16 had preoperative NRS 2002 scores ≥3 points, of whom 7 were assessed by the SGA as having mild-moderate malnutrition and 9 as having severe malnutrition. The albumin indexes of these 16 patients, including their prealbumin, and calcium contents, were significantly lower than those of patients with NRS scores <3. Patients with preoperative NRS scores ≥3 had higher drainage volumes, longer hospitalization times, and higher total hospitalization costs than those with NRS scores <3.Conclusions: Lung transplant recipients have a higher incidence of nutritional risk and malnutrition, which seriously affects their short-term prognosis. Thus, in clinical practice, lung transplant recipients should be screened for nutritional risk and provided preoperative nutritional support to maintain a good preoperative status to improve their prognosis.

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Time‐dependent lipid profile inversely associates with mortality in hemodialysis patients – independent of inflammation/malnutrition

Cited by 12 publications

References 44 publications

Lipid disorders – the comparison between general population and haemodialyzed patients. Will the Oral Fat Tolerance Test improve the diagnostic?

Lipid disorders – the comparison between general population and haemodialyzed patients. Will the Oral Fat Tolerance Test improve the diagnostic?

Lipid Profile Is Negatively Associated with Uremic Toxins in Patients with Kidney Failure—A Tri-National Cohort

Evaluation of nutritional status in lung transplant recipients and its correlation with post-transplant short-term prognosis: a retrospective study

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