Endothelial dysfunction, inflammation and malnutrition markers as predictors of mortality in dialysis patients: multimarker approach

Ignjatović, Aleksandra; Cvetković, Tatjana; Pavlović, Radmila; Đorđević, Vidojko; Milošević, Zoran; Đorđević, Vesna; Pavlović, Dušica; Stojanović, Ivana; Bogdanović, Dragan

doi:10.1007/s11255-013-0439-6

Cited by 18 publications

(16 citation statements)

References 38 publications

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“…Moderate heterogeneity (I 2 = 71%) existed for these studies. After excluding the four studies11212629 with fewer participants that might have come from the same study group used in four other studies9222730, circulating ADMA was still associated with all-cause mortality (RR = 1.25, 95% CI: 1.18–1.31), and the level of between-study heterogeneity was moderate (I 2 = 71%).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 34 studies reporting a total of 39137 participants were included in the final analysis (Table 1)791113141516171819202122232425262728293031323334353637383940414243. Eleven studies were based on 9319 participants with pre-existing renal diseases including 2533 renal transplant recipients715192122252628383943.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies were based on 9319 participants with pre-existing renal diseases including 2533 renal transplant recipients715192122252628383943. Nineteen studies included participants at high cardiovascular events risk9111317182026272930313235363740414244.…”

Section: Resultsmentioning

confidence: 99%

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Asymmetric dimethylarginine and all-cause mortality: a systematic review and meta-analysis

Zhou

Zhu

et al. 2017

Sci Rep

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Asymmetrical dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase (NOS), impairs the beneficial effect of NO. The predictive value of ADMA for all-cause mortality remains controversial, though it is important in the development of cardiovascular disease (CVD) and progression to dialysis in renal disease. This systematic review and meta-analysis was conducted to investigate the association between circulating ADMA and all-cause mortality. Studies with data pertinent to the association between circulating ADMA and all-cause mortality were reviewed and OR, HR or RR with 95% CI derived from multivariate Cox’s proportional-hazards analysis were extracted. A total of 34 studies reporting 39137 participants were included in final analysis. The results demonstrated that circulating ADMA was independently associated with all-cause mortality (RR = 1.27, 95% CI: 1.20–1.34). The association was still statistically significant in patients with pre-existing renal disease (RR = 1.30, 95% CI: 1.19–1.43) and pre-existing CVD (RR = 1.26, 95% CI: 1.16–1.37). In those without pre-existing renal or CVD, ADMA also predicted all-cause mortality (RR = 1.31, 95% CI: 1.13–1.53). The present study suggests a positive association of circulating ADMA with all-cause mortality. Further studies are needed to investigate the effects of interventions on ADMA, and the value of ADMA as a biomarker.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Asymmetric dimethylarginine and all-cause mortality: a systematic review and meta-analysis

Zhou

Zhu

et al. 2017

Sci Rep

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“…The simultaneous use of BNP, CRP and asymmetric dimethyl arginine increased the predictive value of all-cause and cardiovascular mortalities by about 10% compared with a single biomarker in patients with end-stage kidney disease [28]. Another recent study has suggested that a combination of markers including asymmetric dimethyl arginine, CRP, serum amyloid A protein and albumin results in better cardiovascular risk stratification for HD patients [29]. In addition, 2 studies have demonstrated the usefulness of the multimarker approach consisting of PlGF and other biomarkers in patients with acute coronary syndrome [30,31].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Placental Growth Factor on Mortality and Cardiovascular Events in Dialysis Patients

Matsui

Samejima²,

Takeda³

et al. 2015

Am J Nephrol

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Background: Placental growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, has recently emerged as a predictor of survival and cardiovascular risk. Along with others, we have shown an independent association between PlGF and cardiovascular events in CKD patients, but not much is known about patients receiving dialysis. Methods: We studied 205 dialysis patients undergoing cardiac catheterization at the Nara Medical University between April 1, 2004, and December 31, 2012. Serum levels of PlGF and VEGF were measured with ELISA in all the patients. Results: During a median follow-up of 20 months, 121 participants died from any cause or experienced a cardiovascular event. In the fully adjusted analysis, having an above-median PlGF or VEGF level was associated with a hazards ratio for adverse outcomes of 2.55 (1.72-3.83) and 1.39 (0.95-2.04), respectively. Using a multimarker strategy in a model with age, serum albumin, history of coronary artery disease, brain natriuretic peptide and PlGF, patients with 2, 3 and 4 positive markers had a 3.82-, 5.77- and 6.59-fold higher risk of mortality or a cardiovascular event, respectively, compared to those with no positive markers. The model with PlGF had a significantly higher c-statistic, integrated discrimination improvement index and category-free net reclassification improvement index than the model without PlGF. Conclusion: PlGF is independently associated with mortality and cardiovascular events, but the association between VEGF and adverse events was attenuated with covariate adjustment. The addition of PlGF to models with established clinical predictors provides additional useful prognostic information in patients receiving dialysis.

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“…Inflammatory condition is common in patients with CKD and undergoing hemodialysis. Serum levels of CRP are a common marker of inflammation and are well-known predictors of cardiovascular disease or survival in MHD patients [21][22][23]. Several causes for inflammation in MHD patients were considered, such as decreased clearance of inflammatory cytokines, decreased levels of antioxidants, use of a bioincompatible dialysis membrane, impurity of the dialysate, and use of a catheter [2].…”

Section: Correlation Between Change In Inflammatory Conditions and Admentioning

confidence: 99%

Effect of Progression in Malnutrition and Inflammatory Conditions on Adverse Events and Mortality in Patients on Maintenance Hemodialysis

Toyoda¹,

Kuragano

Kawada³

et al. 2019

Blood Purif

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Background/Aim: In maintenance hemodialysis (MHD), protein-energy malnutrition and chronic inflammation can be critical and are two of the main causes of mortality. Method: We compared the change in nutrition and inflammatory conditions between younger and older MHD patients during a 2-year period. Furthermore, using Kaplan-Meier analysis, we evaluated the correlations between changes in each parameter and any adverse events. Result: During the observational period, body mass index (BMI) and serum albumin levels decreased significantly in older patients. In Kaplan-Meier analysis, patients who showed a decline in BMI had an associated elevated risk for cerebro-cardiovascular disease and hospitalization. Moreover, patients who showed a decline in albumin also had an associated higher risk for infectious disease and hospitalization. Conclusion: This study revealed that the downward trend in nutritional status was prominent in elderly patients. Furthermore, changes in nutritional and inflammatory conditions during MHD were associated with adverse events in MHD patients.

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Endothelial dysfunction, inflammation and malnutrition markers as predictors of mortality in dialysis patients: multimarker approach

Cited by 18 publications

References 38 publications

Asymmetric dimethylarginine and all-cause mortality: a systematic review and meta-analysis

Asymmetric dimethylarginine and all-cause mortality: a systematic review and meta-analysis

Prognostic Impact of Placental Growth Factor on Mortality and Cardiovascular Events in Dialysis Patients

Effect of Progression in Malnutrition and Inflammatory Conditions on Adverse Events and Mortality in Patients on Maintenance Hemodialysis

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