Body fat mass and lean mass as predictors of survival in hemodialysis patients

Kakiya, Ryusuke; Shoji, Tetsuo; Tsujimoto, Yoshihiro; Tatsumi, Noriyuki; Hatsuda, Sawako; Shinohara, K.; Kimoto, Eiji; Tahara, Hideki; Koyama, Hideki; Emoto, Masanori; Ishimura, Eiji; Miki, Takami; Tabata, Tsutomu; Nishizawà, Yoshiki

doi:10.1038/sj.ki.5000331

Cited by 144 publications

(124 citation statements)

References 51 publications

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“…In the general population, increases in body fat mass causes increases in proinflammatory cytokine levels and decreases in anti-proinflammatory cytokine levels. However, in maintenance hemodialysis patients, it is reported that there is no difference in proinflammatory cytokines based on body fat mass, and the inverse relationship between body fat mass and plasma adiponectin levels are no longer significant (21,24,25). Such changes in adipocytokine profile may be related to survival advantage in maintenance hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Body fat mass is correlated with serum transthyretin levels in maintenance hemodialysis patients

Matsuura

Shirai²,

Kubo

et al. 2017

J. Med. Invest.

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: Serum transthyretin (TTR), also known as prealbumin, is a reliable nutritional indicator and an independent prognostic factor for maintenance hemodialysis patients. However, we recently reported that serum TTR levels did not affect protein−energy wasting (PEW). In this study, we investigated factors affecting serum TTR levels in 60 maintenance hemodialysis patients. The patients were divided into High-TTR and Low-TTR groups according to the median serum TTR level. Albumin levels were significantly higher and C-reactive protein (CRP) levels were significantly lower in the High-TTR group than in the Low-TTR group. Although body fat mass was significantly higher in the High-TTR group than in the Low-TTR group, no significant difference in body fat ratio were observed. These findings suggest that body fat mass is related to serum TTR levels, apart from factors such as albumin and CRP levels, which showed correlations with serum TTR levels. Because body fat mass is related to better survival in maintenance hemodialysis patients, it may contribute to the prognostic value of serum TTR levels. In addition, in such patients, it may be important to evaluate body fat mass rather than body fat ratio and to maintain the minimum necessary body fat mass.

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Section: Discussionmentioning

confidence: 99%

Body fat mass is correlated with serum transthyretin levels in maintenance hemodialysis patients

Matsuura

Shirai²,

Kubo

et al. 2017

J. Med. Invest.

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“…35,36 Loss of muscle mass is frequently observed in other catabolic diseases as well. 24 It is now widely accepted that muscle atrophy results from the activation of multiple proteolytic systems, including the ubiquitin-proteasome pathway.…”

Section: Discussionmentioning

confidence: 99%

XIAP Reduces Muscle Proteolysis Induced by CKD

Hu¹,

Zhang

et al. 2010

Journal of the American Society of Nephrology

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X-chromosome-linked inhibitor of apoptosis protein (XIAP) is an endogenous caspase inhibitor. Caspase-3 contributes to the muscle wasting associated with chronic kidney disease (CKD) and other systemic illnesses, but whether XIAP modulates muscle wasting in CKD is unknown. Here, overexpression of XIAP in cultured skeletal muscle cells decreased protein degradation induced by serum deprivation, suggesting that caspase-mediated proteolysis contributes to muscle atrophy. We generated transgenic mice that overexpress human XIAP specifically in skeletal muscle (mXIAP) and evaluated muscle protein degradation induced by CKD. mXIAP mice with normal kidney function exhibited mild skeletal muscle hypertrophy. Muscle weights of mXIAP mice with CKD (mXIAP-CKD) were indistinguishable from wild-type mice, suggesting that overexpression of XIAP in skeletal muscle protects from CKD-induced muscle atrophy. The rate of total protein degradation, proteasome chymotrypsin-like activity, and caspase-3-mediated actin cleavage all were lower in muscle isolated from mXIAP-CKD mice compared with wild-type CKD mice. Concomitant with the reduction in overall proteolysis, mRNA levels of ubiquitin, muscle-specific ring finger 1, and atrogin-1/muscle atrophy F-box were lower in mXIAP-CKD mice, suggesting that decreased expression of the ubiquitin-proteasome pathway components may contribute to the protein-sparing effects of XIAP. In summary, these results demonstrate that XIAP inhibits multiple aspects of protein degradation in skeletal muscle during CKD.

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“…Because decline in serum albumin concentration is more closely associated with Among the subjects with incident MI (n ϭ 632), incident CI (n ϭ 1119), incident CB (n ϭ 473), and any of the three (n ϭ 2098), we examined the factors associated with death after these vascular events by univariate and multivariate logistic regression models including the nine factors in the acute phase proteins rather than dietary protein intake in hemodialysis patients (34), these data may indicate that inflammation was positively associated with incident atherosclerotic CVD in hemodialysis patients. Because BMI correlates positively with both fat mass index and lean mass index in hemodialysis patients (12), a low BMI serves as an integrated index for PEW. In this study, BMI was positively associated with incident MI and inversely with incident CI.…”

Section: Discussionmentioning

confidence: 99%

Elevated Non-high-density Lipoprotein Cholesterol (Non-HDL-C) Predicts Atherosclerotic Cardiovascular Events in Hemodialysis Patients

Shoji

Masakane²,

Watanabe

et al. 2011

Clinical Journal of the American Society of Nephrology

116

102

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SummaryBackground and objectives Dialysis patients show "reverse causality" between serum cholesterol and mortality. No previous studies clearly separated the risk of incident cardiovascular disease (CVD) and the risk of death or fatality after such events. We tested a hypothesis that dyslipidemia increases the risk of incident atherosclerotic CVD and that protein energy wasting (PEW) increases the risk of fatality after CVD events in hemodialysis patients. Design, setting, participants, & measurementsThis was an observational cohort study in 45,390 hemodialysis patients without previous history of myocardial infarction (MI), cerebral infarction (CI), or cerebral bleeding (CB) at the end of 2003, extracted from a nationwide dialysis registry in Japan. Outcome measures were new onsets of MI, CI, CB, and death in 1 year. ResultsThe incidence rates of MI, CI, and CB were 1.43, 2.53, and 1.01 per 100 person-years, and death rates after these events were 0.23, 0.21, and 0.29 per 100 person-years, respectively. By multivariate logistic regression analysis, incident MI was positively associated with non-HDL cholesterol (non-HDL-C) and inversely with HDL cholesterol (HDL-C). Incident CI was positively associated with non-HDL-C, whereas CB was not significantly associated with these lipid parameters. Among the patients who had new MI, CI, and/or CB, death risk was not associated with HDL-C or non-HDL-C, but with higher age, lower body mass index, and higher C-reactive protein levels. ConclusionsIn this hemodialysis cohort, dyslipidemia was associated with increased risk of incident atherosclerotic CVD, and protein energy wasting/inflammation with increased risk of death after CVD events.

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Body fat mass and lean mass as predictors of survival in hemodialysis patients

Cited by 144 publications

References 51 publications

Body fat mass is correlated with serum transthyretin levels in maintenance hemodialysis patients

Body fat mass is correlated with serum transthyretin levels in maintenance hemodialysis patients

XIAP Reduces Muscle Proteolysis Induced by CKD

Elevated Non-high-density Lipoprotein Cholesterol (Non-HDL-C) Predicts Atherosclerotic Cardiovascular Events in Hemodialysis Patients

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