Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients

Choi, Hoon Young; Lee, Jung Eun; Han, Seung Hyeok; Yoo, Tae‐Hyun; Kim, Beom Seok; Park, Hyeong Cheon; Kang, Shin Wook; Choi, Kyu Hun; Ha, Sung Kyu; Lee, Ho Yung; Han, Dae Suk

doi:10.1093/ndt/gfp598

Cited by 35 publications

(33 citation statements)

References 42 publications

(40 reference statements)

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“…Glucose and glucose degradation products in the PD solutions can increase CRP levels of PD patients (35,36). CRP is known to positively correlate with cardiovascular events and mortality in PD patients (3,7,(14)(15)(16)(17). In our study, although the CRP polymorphism did not correlate with survival for the entire cohort, we found that the polymorphism had a significant interaction with plasma cholesterol levels.…”

Section: Discussioncontrasting

confidence: 59%

“…Most patients undergoing PD enjoy excellent survival rates, as well as a good quality of life during treatment (2). Nonetheless, PD imposes oxidative stress, which may lead to systemic inflammation and aggravate atherosclerotic lesions (3)(4)(5)(6)(7). Glucose, glucose degradation products, and advanced glycation end products are probably the major causative factors of inflammation in PD patients (8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

“…There is a strong correlation between serum CRP levels and the risk for cardiovascular events in PD patients (3,7,(14)(15)(16)(17). Recently, a single-nucleotide polymorphism (SNP), rs2794521, was reported to be associated with the -717A→G substitution in the promoter of the CRP gene.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between CRP Polymorphism and Cardiovascular Events in Chinese Peritoneal Dialysis Patients

Poon

Szeto

Kwan

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The single-nucleotide polymorphism (SNP) -717A→G substitution, rs2794521, was found in the promoter of the C-reactive protein (CRP) gene. Functional studies showed that A allele promoter has higher transcriptional activity than the G allele. This study investigated the association between this SNP and the outcome of Chinese patients undergoing peritoneal dialysis (PD).Design, setting, participants, & measurements The study included 441 new PD patients (232 men; mean age 6 SD, 56.7613.5 years). CRP genotyping was determined; patients were followed for 41.3618.3 months for cardiovascular events.Results For the entire cohort, 5-year event-free survival rates did not differ between the AA and AG/GG groups (35.7% and 31.9%, respectively; P=0.64). However, there was significant interaction between plasma cholesterol levels and CRP genotype groups on event-free survival (P=0.04 for interaction). For patients with cholesterol levels of 200 mg/dl or greater, the 5-year event-free survival rate in the AG/GG group was significantly better than that in the AA group (54.7% versus 40.0%; P=0.04), whereas there was no difference in event-free survival between genotype groups for patients with cholesterol levels less than 200 mg/dl.Conclusions CRP gene -717AG or GG genotypes is associated with cardiovascular benefit to Chinese PD patients with cholesterol levels of 200 mg/dl or greater. These findings suggest a complex interaction among cholesterol, CRP, and cardiovascular disease in PD patients.

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Section: Discussioncontrasting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

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Relationship between CRP Polymorphism and Cardiovascular Events in Chinese Peritoneal Dialysis Patients

Poon

Szeto

Kwan

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…Numerous in vitro and animal studies showed superior biocompatibility of multichamber PD solutions (1)(2)(3)(4)(5). Recent randomized controlled trials suggest improved preservation of residual renal function (6,7) and ultrafiltration capacity (8) and lowering of systemic concentrations of advanced glycation end products (9,10), which contribute to accelerated vasculopathy and amyloidosis. Registry findings suggest an improved patient survival with low-GDP fluids (11,12).…”

Section: Introductionmentioning

confidence: 99%

Effect of the Dialysis Fluid Buffer on Peritoneal Membrane Function in Children

Schmitt

Nau

Gemulla

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Double-chamber peritoneal dialysis fluids exert less toxicity by their neutral pH and reduced glucose degradation product content. The role of the buffer compound (lactate and bicarbonate) has not been defined in humans.Design, setting, participants, & measurements A multicenter randomized controlled trial in 37 children on automated peritoneal dialysis was performed. After a 2-month run-in period with conventional peritoneal dialysis fluids, patients were randomized to neutral-pH, low-glucose degradation product peritoneal dialysis fluids with 35 mM lactate or 34 mM bicarbonate content. Clinical and biochemical monitoring was performed monthly, and peritoneal equilibration tests and 24-hour clearance studies were performed at 0, 3, 6, and 10 months.Results No statistically significant difference in capillary blood pH, serum bicarbonate, or oral buffer supplementation emerged during the study. At baseline, peritoneal solute equilibration and clearance rates were similar. During the study, 4-hour dialysis to plasma ratio of creatinine tended to increase, and 24-hour dialytic creatinine and phosphate clearance increased with lactate peritoneal dialysis fluid but not with bicarbonate peritoneal dialysis fluid. Daily net ultrafiltration, which was similar at baseline (lactate fluid=5.462.6 ml/g glucose exposure, bicarbonate fluid=4.961.9 ml/g glucose exposure), decreased to 4.661.0 ml/g glucose exposure in the lactate peritoneal dialysis fluid group, whereas it increased to 5.161.7 ml/g glucose exposure in the bicarbonate content peritoneal dialysis fluid group (P=0.006 for interaction).Conclusions When using biocompatible peritoneal dialysis fluids, equally good acidosis control is achieved with lactate and bicarbonate buffers. Improved long-term preservation of peritoneal membrane function may, however, be achieved with bicarbonate-based peritoneal dialysis fluids.

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“…Most PD patients can enjoy an impressive survival rate and an excellent quality of life during the treatment [2]. However, PD is known to cause inflammation and oxidative stress, which may aggravate atherosclerotic lesions [3,4,5,6,7]. In fact, cardiovascular disease is the major cause of morbidity and mortality in PD patients [8,9].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Myeloid-Related Protein 8/14 and Survival of Chinese Peritoneal Dialysis Patients

Poon¹,

Szeto²,

Kwan³

et al. 2012

Kidney Blood Press Res

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Background: Myeloid-related protein 8/14 (MRP8/14) is released by cells of myeloid lineage upon inflammatory challenges. Experimental data suggested that MRP8/14 is important in the initiation and progression of inflammation and cardiovascular diseases. We examined the relation between serum MRP8/14 level and cardiovascular disease in Chinese peritoneal dialysis (PD) patients. Methods: We studied 102 new PD patients (58 males, mean age 57.3 ± 11.9 years). Baseline serum MRP8/14 was determined and grouped to quartiles for analysis. All patients were then followed for an average of 23.9 ± 6.9 months. Results: There was a trend of lower 3-year cardiovascular event-free survival for patient quartiles with high serum MRP8/14 levels (log-rank test, p = 0.064). The 3-year actuarial survival was significantly lower for quartile groups with higher MRP8/14 levels (96.0, 94.7, 72.9, and 62.5% for quartiles 1–4, respectively, p = 0.003). Cox regression analysis showed that serum MRP8/14 level and Kt/V were independent predictors of actuarial survival; in this model, every 1 µg/ml increase in serum MRP8/14 level confers a 25.1% increase in risk of death (95% confidence interval, 1.3–54.4%, p = 0.037). There was no significant difference in technique survival between the MRP8/14 quartile groups. Conclusion: A high baseline serum MRP8/14 level was associated with a lower actuarial survival in Chinese PD patients. The pathogenic role of MRP8/14 in the cardiovascular disease of PD patients needs further investigation.

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Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients

Cited by 35 publications

References 42 publications

Relationship between CRP Polymorphism and Cardiovascular Events in Chinese Peritoneal Dialysis Patients

Relationship between CRP Polymorphism and Cardiovascular Events in Chinese Peritoneal Dialysis Patients

Effect of the Dialysis Fluid Buffer on Peritoneal Membrane Function in Children

Relationship between Myeloid-Related Protein 8/14 and Survival of Chinese Peritoneal Dialysis Patients

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