Association between Neopterin and Carotid Intima-Media Thickness in Hemodialysis Patients

Erten, Yasemin; Ma, Oztürk; Oktar, Suna Özhan; Paşaoğlu, Hatîce; Ka, Reis; Derici, Ülver; Elbeğ, Şehri; Güz, Galip; Bali, Musa; Arınsoy, Turgay; Sindel, Şükrü

doi:10.1159/000086684

Cited by 7 publications

(5 citation statements)

References 40 publications

(44 reference statements)

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“…Carotid arterial changes can reflect the progression of systemic atherosclerosis in asymptomatic general population. Erten et al 20 reported a significant positive correlation between serum NP levels and carotid intima media thickness (IMT) in hemodialysis patients. They suggested that NP could be associated with the severity of carotid atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Association between serum neopterin, obesity and daytime sleepiness in patients with obstructive sleep apnea

Ursavaş

Karadağ

Oral

et al. 2008

Respiratory Medicine

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Section: Discussionmentioning

confidence: 99%

Association between serum neopterin, obesity and daytime sleepiness in patients with obstructive sleep apnea

Ursavaş

Karadağ

Oral

et al. 2008

Respiratory Medicine

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“…Atherosclerosis seems to be more common in individuals with CKD (111) and ESRD (112)(113)(114)(115)(116). The atherosclerotic lesions in ESRD have a distinct morphology, with a more calcified appearance (as opposed to fibroatheromatous) and relatively increased medial thickness (as opposed to intimal) as compared with the general population (117).…”

Section: Pathophysiology Of Cvd In Ckdmentioning

confidence: 99%

The Unique Character of Cardiovascular Disease in Chronic Kidney Disease and Its Implications for Treatment with Lipid-Lowering Drugs

Nogueira

Weir

2007

Clinical Journal of the American Society of Nephrology

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D uring the past several decades, the advent and refinement of maintenance dialysis and kidney transplantation have essentially eliminated kidney failure per se as a cause of death in developed countries. However, as patients survive many years after the development of renal failure, comorbidities develop, progress, and ultimately cause death in these individuals. Cardiovascular disease (CVD) has ranked prominent among these comorbidities, accounting for nearly half of the deaths (1). All along the continuum of chronic kidney disease (CKD)-from microalbuminuria to ESRD-a higher risk for CVD has been observed (see Epidemiology of CVD in CKD). In fact, individuals with early CKD are more likely to die of CVD than to develop ESRD (2,3). Then, among those who survive to ESRD, the all-cause CVD mortality in patients with ESRD is many-fold higher than in the general population (4). Unfortunately, the reasons for the association of CKD with CVD are not clearly understood, and the role of various clinical interventions in stemming the CVD epidemic are not well defined. Complicating the issue is the potential variation in the pathophysiology and clinical behavior of CVD through the stages of CKD.3-Hydroxyl-3-methylglutaryl CoA reductase inhibitors (statins) and other lipid-lowering drugs (LLD) have been clearly demonstrated to lessen the morbidity and mortality of CVD in the general population; therefore, there is hope that the use of these drugs may likewise help patients with CKD (In addition, it has been theorized that dyslipidemia may contribute to the progression of CKD, such that LLD may prove to slow CKD progression.) Nevertheless, given differences in epidemiology and pathophysiology of CVD in CKD, there are reasons to question whether the cardiovascular benefits of LLD that are observed in the general population will also be realized in the CKD population. It is widely acknowledged that the current medical literature provides insufficient data to guide the use of LLD in the CKD population, in large part because renal insufficiency has been an exclusion criterion for most of the randomized, controlled studies that have addressed this issue. Although consensus-based guidelines on the treatment of dyslipidemias in individuals with CKD and with kidney transplants have been published by the National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (K/DOQI) Work Groups, the nephrology and cardiology communities recognize the urgent need for high-quality clinical studies on this issue, and this has fueled the publication of subgroup analyses of previous large studies in the general population and the launching of large-scale clinical trials in the CKD population, as summarized in Table 1. To provide the reader with a better appreciation of the important issues that are germane to management of dyslipidemia in CKD, this article (1) briefly summarizes the literature on the benefits of LLD in the general population, (2) demonstrates the limited involvement of individuals with CKD in the studies in the ge...

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“…Study by Malatino et al [3 ]showed that arterial systolic pressure, smoking and serum albumin were independent factors associated with carotid atherosclerosis in chronic dialysis patients. In hemodialysis patients, inflammation as denoted by C-reactive protein (CRP), interleukin-6, neopterin or hepatocyte growth factor [4,5,6,7] has been associated with carotid atherosclerosis. Carotid atherosclerosis in hemodialysis patients has also been described to be associated with hyperhomocysteinemia [8].…”

Section: Introductionmentioning

confidence: 99%

Differential Associations of Traditional and Non-Traditional Risk Factors with Carotid Intima-Media Thickening and Plaque in Peritoneal Dialysis Patients

Wang

Liu

et al. 2007

Am J Nephrol

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Background: This study sought to examine the associations of traditional and non-traditional cardiovascular risk factors with carotid intima-media thickening and plaque in peritoneal dialysis (PD) patients. Methods: A cross-sectional study was performed in 147 PD patients with carotid intima-media thickness (IMT) and plaque assessed by B-mode ultrasonography and fasting blood collected for biochemical measurements. Results: On univariate analysis, age, smoking history, fibrinogen, C-reactive protein (CRP), adiponectin, fetuin-A, lipoprotein(a) and diastolic blood pressure were associated with carotid IMT while age, smoking history, diabetes, CRP and diastolic blood pressure were associated with carotid plaque. Using multivariate analysis, elevated CRP (p = 0.015) and serum calcium (p = 0.022) were associated with carotid plaque but not with IMT. CRP and serum calcium were synergistically associated with carotid plaque in that those with CRP > median and serum calcium > median showed the highest prevalence of carotid plaque than either factor alone (p = 0.003). Conclusions: An elevated CRP appeared to be a better biomarker of presence of carotid plaque than intima-media thickening. Furthermore, CRP and serum calcium showed synergistic association with presence of carotid plaque. However, our study was limited by the cross-sectional design and baseline laboratory abnormalities were inevitably confounded by the treatment already given, resulting in difficulty to distinguish cause and effect relationship. Nevertheless, these observations warrant further investigation as it may potentially have important implications on differentiating therapeutic strategies for reducing carotid IMT and plaque progression in PD patients.

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Association between Neopterin and Carotid Intima-Media Thickness in Hemodialysis Patients

Cited by 7 publications

References 40 publications

Association between serum neopterin, obesity and daytime sleepiness in patients with obstructive sleep apnea

Association between serum neopterin, obesity and daytime sleepiness in patients with obstructive sleep apnea

The Unique Character of Cardiovascular Disease in Chronic Kidney Disease and Its Implications for Treatment with Lipid-Lowering Drugs

Differential Associations of Traditional and Non-Traditional Risk Factors with Carotid Intima-Media Thickening and Plaque in Peritoneal Dialysis Patients

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