C-reactive protein, lipoprotein(a), homocysteine, and male sex contribute to carotid atherosclerosis in peritoneal dialysis patients

Ohkuma, Toshio; Minagawa, Tomonori; Takada, Nobuyuki; Ohno, Michiya; Oda, Hiroshi; Ohashi, Hiroshige

doi:10.1016/s0272-6386(03)00675-9

Cited by 42 publications

(37 citation statements)

References 38 publications

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“…The study was underpowered to prove such a relation that has been found by other investigators with other experimental settings (27)(28)(29). However, it seems safe to conclude that the effects of ACEexpressing monocytes described in this study are not weaker than a putative effect of CRP.…”

Section: Discussionmentioning

confidence: 48%

Monocyte Angiotensin Converting Enzyme Expression May Be Associated with Atherosclerosis Rather than Arteriosclerosis in Hemodialysis Patients

Ulrich

Seibert

Heine

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Circulating monocytes can be divided into functionally distinct subpopulations according to their surface expression of CD14 and CD16. Monocytes with high-level expression of both antigens (CD14 ϩϩ CD16 ϩ , Mo2 cells) are associated with cardiovascular morbidity and mortality in hemodialysis patients. These cells express angiotensin converting enzyme (ACE) on their surface. They are involved in the association of chronic inflammation and cardiovascular disease in kidney patients. Cardiovascular morbidity results from atherosclerosis (plaque-forming, vessel occluding disease) and arteriosclerosis (loss of arterial dampening function). It is unknown whether ACE-expressing proinflammatory monocytes are related to atherosclerosis, arteriosclerosis, or both.Design, setting, participants, & measurements During baseline examination for a prospective study on monocyte ACE expression and mortality, 60 chronic hemodialysis patients of an academic outpatient center were screened for atherosclerosis by carotid artery ultrasound, for arteriosclerosis by pulse pressure measurement, and for ACE expression on Mo2 cells by flow cytometry.Results ACE expression on Mo2 monocytes was significantly higher in patients with severe compared with those with little or no carotid atherosclerosis. Mo2 ACE correlated with a score to semiquantify atherosclerosis and remained a significant predictor of carotid plaques in multivariate analysis including the other univariately associated variables of age, hemoglobin A1c, and albumin. Mo2 ACE was not related to pulse pressure.Conclusions ACE expression on Mo2, although being a known predictor of mortality and cardiovascular disease in end-stage renal disease patients, may act via enhancement of atherosclerosis rather than arteriosclerosis.

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Section: Discussionmentioning

confidence: 48%

Monocyte Angiotensin Converting Enzyme Expression May Be Associated with Atherosclerosis Rather than Arteriosclerosis in Hemodialysis Patients

Ulrich

Seibert

Heine

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…Although a number of studies had already addressed the issue of IMT determination in ESRD patients 14,15 , we could not find the incidence of IMT ≥ 0.9 mm in a non-selected hemodialysis sample for an appropriate prevalence comparison. It should be emphasized that the rate of 57% was obtained with a cutoff of 0.9 mm, which is associated with increased incidence of cardiovascular events 8 , but is, in some way, conservative.…”

Section: Discussionmentioning

confidence: 84%

Prevalência e correlatos de doença vascular no exame de ultrassom em pacientes em hemodiálise

Miguel¹,

Miguel²,

Velarde³

et al. 2011

Arq. Bras. Cardiol.

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“…Ohkuma et al further demonstrated that Lp(a) and CRP levels have an important role in carotid atherosclerosis in PD patients. 24 Moreover, the incidence of peritonitis was elevated obviously in overweight group. It is well known that peritonitis was a risk factor for mortality in PD patients.…”

Section: Resultsmentioning

confidence: 96%

Survival Advantage of Normal Weight in Peritoneal Dialysis Patients

et al. 2011

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Introduction: A high body mass index (BMI) is a positive predictor of outcome in hemodialysis. But reports for peritoneal dialysis (PD) have been less numerous. The aim of the present investigation was to study the association between BMI and survival among PD patients and to discuss the main risk factors affecting survival. Materials and methods: A total of 159 patients who received PD from 1 January 2006 to 31 December 2010 at the Department of Nephrology in the Third Affiliated Hospital of Soochow University were enrolled in the study. Blood samples and baseline characteristics of the study cohort were obtained at the start of PD. Patient survival status was recorded through 31 December 2010. Results: Patients were stratified into two groups as normal weight (BMI, 18.5-24.9) and overweight (BMI, 25.0-29.9). KaplanMeier survival curve revealed that the normal weight patients had survival advantage over overweight patients (p < 0.01, by log-rank test). Cox proportional hazard models revealed that BMI, age, diabetes mellitus, coronary vascular disease, congestive heart failure and lipoprotein(a) (Lp(a)) were significant risk factors associated with all-cause mortality (p < 0.05). After adjustment for these covariates, survival was consistently higher for normal weight patients (p < 0.01). Furthermore, the study demonstrated that normal weight patients had lower serum Lp(a) (p < 0.05), C-reactive protein (CRP) (p < 0.05), and peritonitis rate (p < 0.05) compared with overweight patients. Conclusion: The results indicated that normal BMI at the commencement of PD had significant survival advantage in our study. The mechanisms for this might be related to lower cardiovascular risk, less chronic inflammation, and peritonitis prevalence.

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C-reactive protein, lipoprotein(a), homocysteine, and male sex contribute to carotid atherosclerosis in peritoneal dialysis patients

Cited by 42 publications

References 38 publications

Monocyte Angiotensin Converting Enzyme Expression May Be Associated with Atherosclerosis Rather than Arteriosclerosis in Hemodialysis Patients

Monocyte Angiotensin Converting Enzyme Expression May Be Associated with Atherosclerosis Rather than Arteriosclerosis in Hemodialysis Patients

Prevalência e correlatos de doença vascular no exame de ultrassom em pacientes em hemodiálise

Survival Advantage of Normal Weight in Peritoneal Dialysis Patients

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