Association of Low Serum Fetuin A Levels With Poor Arteriovenous Access Patency in Patients Undergoing Maintenance Hemodialysis

Chen, Hung Yuan; Chiu, Yen‐Ling; Chuang, Yi Fang; Hsu, Shih Ping; Pai, Mei Fen; Lai, Chun-Fu; Yang, Ju‐Yeh; Yu, Peng; Tsai, Tun‐Jun; Wu, Mai‐Szu

doi:10.1053/j.ajkd.2010.06.015

Cited by 19 publications

(34 citation statements)

References 31 publications

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“…However, dialysis patients, who differ from the general population in terms of fetuin A metabolism, have a higher frequency of fetuin A deficiency than fetuin A overproduction. Several landmark investigations have pointed out that fetuin A deficiency is linked to CV calcification, atherosclerosis, and consequent CV morbidities in dialysis patients [2,3,5,9,15]. Nevertheless, the clinical implications of ‘abundant' fetuin A production, an unusual condition in dialysis subjects, on CV outcomes remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…The first cohort was composed of 238 prevalent HD patients, while the second cohort was composed of 216 prevalent HD patients. The protocol design for these patient cohorts are described elsewhere in greater detail [5,7,21]. In the two cohorts, patients with available data on fetuin A, albumin, and hs-CRP levels as well as body weight were included in the analysis.…”

Section: Methodsmentioning

confidence: 99%

“…It has been identified as a circulating inhibitor of the calcification process and as a well-known predictor of all-cause and cardiovascular (CV) mortality in dialysis patients [2,3,4]. In our previous investigations, we demonstrated that fetuin A deficiency correlates with poor arteriovenous access patency [5] and the increased incidence of cerebrovascular accidents in hemodialysis (HD) patients [6]. Several outcome studies of dialysis patients, including our previous works, have shown a positive correlation between fetuin A and serum albumin levels, and a negative correlation between fetuin A and high sensitivity C-reactive protein (hs-CRP) levels [5,6,7,8,9,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…In our previous investigations, we demonstrated that fetuin A deficiency correlates with poor arteriovenous access patency [5] and the increased incidence of cerebrovascular accidents in hemodialysis (HD) patients [6]. Several outcome studies of dialysis patients, including our previous works, have shown a positive correlation between fetuin A and serum albumin levels, and a negative correlation between fetuin A and high sensitivity C-reactive protein (hs-CRP) levels [5,6,7,8,9,10,11]. Fetuin A deficiency, through its modulation on cell signaling of atherosclerosis mediators in the process of malnutrition and inflammation complex [12,13], is thought to be associated with systemic atherosclerosis and CV events in the dialysis population [11,14,15].…”

Section: Introductionmentioning

confidence: 99%

“…These results indicate the remarkable relationship between the two important survival predictors of fetuin A and nutritional status, in both general as well as dialysis populations. Notably, fetuin A expression appears to variously affect CV outcomes in HD patients with different nutritional and inflammatory statuses [5,6,20]; therefore, the interaction between fetuin A and nutritional status should be carefully taken into consideration while assessing their effects on outcomes in HD patients. This prospective study aimed to investigate the interaction between serum fetuin A levels and the nutritional status and its predictive value for all-cause mortality and CV outcomes in prevalent HD patients.…”

Section: Introductionmentioning

confidence: 99%

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Fetuin A/Nutritional Status Predicts Cardiovascular Outcomes and Survival in Hemodialysis Patients

Chen

Chiu²,

Hsu³

et al. 2014

Am J Nephrol

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Background: Fetuin A - a predictor of cardiovascular (CV) outcomes in dialysis patients - is correlated with over-nutrition in the general population. Whether fetuin A and nutritional status interact with each other to alter CV outcomes and survival in hemodialysis (HD) patients remains unknown. Methods: We performed a prospective study on 388 prevalent HD patients. We used the geriatric nutritional risk index (GNRI) for the evaluation of nutritional status. Study outcomes included the occurrence of CV event, CV death, and all-cause mortality during follow-up; interactions between parameters for predicting outcomes were assessed by the interaction terms in a Cox regression model. Results: Overall, 131 patients experienced CV events and 92 patients died, with 51 CV deaths. HD patients with higher fetuin A levels had lower numbers of CV events (adjusted hazard ratio [HR], 0.9; 0.81-0.99) and all-cause mortality (adjusted HR, 0.97; 0.91-0.99). However, patients with higher GNRI had lower all-cause mortality (adjusted HR, 0.79; 0.51-0.98, for every 10-unit increase). Fetuin A levels and GNRI showed a significant interaction in the prediction of CV events (adjusted HR, 1.01; 1.008-1.02) but not for all-cause or CV mortality. In patients with poor nutritional status, higher fetuin A levels were associated with fewer CV events; however, in contrast, in subjects with better nutritional status, higher fetuin A levels appeared to lead to a higher number of CV events. Conclusions: Fetuin A showed a remarkable interaction with nutritional status in evaluating the risks of CV morbidities in prevalent HD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fetuin A/Nutritional Status Predicts Cardiovascular Outcomes and Survival in Hemodialysis Patients

Chen

Chiu²,

Hsu³

et al. 2014

Am J Nephrol

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Elevated plasma leptin levels are associated with vascular access dysfunction in patients on maintenance hemodialysis

Yu,

Tang,

Hung

et al. 2023

Clinical Laboratory Analysis

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BackgroundInflammation has been associated with vascular access (VA) dysfunction. The adipocytokine leptin can directly induce pro‐inflammatory T helper 1 immune responses and the pathogenesis of chronic inflammation. We explored the association between plasma leptin and VA dysfunction in patients on maintenance hemodialysis (HEMO).MethodsA total of 344 consecutive patients who received anastomosis for VA at a single HEMO center between June 1, 2010 and December 31, 2021 were screened. Of these patients, 267 met the inclusion criteria and were included. ELISA was used to measure circulating levels of leptin.ResultsThe VA dysfunction group had a higher leptin level than the patent VA group. A higher concentration of leptin was independently and significantly associated with an elevated risk of VA dysfunction. Multiple logistic regression analysis showed that leptin, female sex, and hypertension were independently associated with VA dysfunction, even after adjusting for known biomarkers. We then evaluated the ability of leptin, female sex, and hypertension to predict the risk of VA dysfunction, and the area under the curve (AUC) for leptin was 0.626 (p = 0.0001). When leptin, female sex, and hypertension were added to this multivariate model, the AUC increased to 0.679 (p = 0.001) for leptin and hypertension, and 0.690 for leptin, hypertension, and female sex (p = 0.004). In addition, plasma leptin levels were associated with sex, body mass index, and hemoglobin.ConclusionsIn addition to the association between leptin and VA dysfunction, hypertension and female sex independently predicted VA dysfunction in patients with HEMO.

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Osteoprotegerin, inflammation and dyslipidemia are associated with abdominal aortic calcification in non-diabetic patients on peritoneal dialysis

Huang

Lien

Yang

et al. 2014

Nutrition, Metabolism and Cardiovascular Diseases

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Association of Low Serum Fetuin A Levels With Poor Arteriovenous Access Patency in Patients Undergoing Maintenance Hemodialysis

Cited by 19 publications

References 31 publications

Fetuin A/Nutritional Status Predicts Cardiovascular Outcomes and Survival in Hemodialysis Patients

Fetuin A/Nutritional Status Predicts Cardiovascular Outcomes and Survival in Hemodialysis Patients

Elevated plasma leptin levels are associated with vascular access dysfunction in patients on maintenance hemodialysis

Osteoprotegerin, inflammation and dyslipidemia are associated with abdominal aortic calcification in non-diabetic patients on peritoneal dialysis

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