Homocysteine, C-reactive protein, lipid peroxidation and mortality in haemodialysis patients

Bayés, Beatriu; Pastor, M.C.; Bonal, Jordi; Juncà, Jordi; Hernández, José M. de la Torre; Riutort, Nadal; Foraster, Andreu; Romero, R.

doi:10.1093/ndt/18.1.106

Cited by 90 publications

(76 citation statements)

References 26 publications

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“…However, in a different study, there was no significant correlation between lipid oxidation and endothelial dysfunction in CKD patients before or after the initiation of dialysis treatment (124). So far, only a few small, prospective, epidemiological studies that evaluate the association between surrogate markers of oxidative stress and CVD are available in CKD patients (43,(125)(126)(127). This is in contrast to the larger number of prospective epidemiologic studies in the general population, which links low intake of dietary antioxidants to cardiovascular risk (128).…”

Section: Oxidative Stress-an Intricate But Promising Area In Ckdmentioning

confidence: 99%

Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient

Stenvinkel¹,

Carrero²,

Axelsson³

et al. 2008

Clinical Journal of the American Society of Nephrology

487

373

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Premature cardiovascular disease (CVD), including stroke, peripheral vascular disease, sudden death, coronary artery disease, and congestive heart failure, is a notorious problem in patients with chronic kidney disease (CKD). Because the presence of CVD is independently associated with kidney function decline, it appears that the relationship between CKD and CVD is reciprocal or bidirectional, and that it is this association that leads to the vicious circle contributing to premature death. As randomized, placebo-controlled trials have so far been disappointing and unable to show a survival benefit of various treatment strategies, such a lipid-lowering, increased dialysis dose and normalization of hemoglobin, the risk factor profile seems to be different in CKD compared with the general population. Indeed, seemingly paradoxical associations between traditional risk factors and cardiovascular outcome in patients with advanced CKD have complicated our efforts to identify the real cardiovascular culprits. This review focuses on the many new pieces that need to be fit into the complicated puzzle of uremic vascular disease, including persistent inflammation, endothelial dysfunction, oxidative stress, and vascular ossification. Each of these is not only highly prevalent in CKD but also more strongly linked to CVD in these patients than in the general population. However, a causal relationship between these new markers and CVD in CKD patients remains to be established. Finally, two novel disciplines, proteomics and epigenetics, will be discussed, because these tools may be helpful in the understanding of the discussed vascular risk factors.

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Section: Oxidative Stress-an Intricate But Promising Area In Ckdmentioning

confidence: 99%

Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient

Stenvinkel¹,

Carrero²,

Axelsson³

et al. 2008

Clinical Journal of the American Society of Nephrology

487

373

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“…[1][2][3][4][5][6][7][8][9][10][11] Elevated biomarkers of the inflammatory response-serum high-sensitivity C-reactive protein (hsCRP) and serum IL-6 concentrations, which are also highly prevalent in this population-are robust predictors of cardiovascular events and mortality and have been linked to increased oxidative stress. [12][13][14][15][16][17][18] Further, the systemic inflammatory response and increased oxidative stress are associated with poor response to erythropoietinstimulating agent (ESA) therapy.…”

mentioning

confidence: 99%

Provision of Antioxidant Therapy in Hemodialysis (PATH)

Himmelfarb

İkizler²,

Ellis³

et al. 2014

Journal of the American Society of Nephrology

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Increased markers of oxidative stress and acute-phase inflammation are prevalent in patients undergoing maintenance hemodialysis therapy (MHD), and are associated with increased mortality and hospitalization rates and decreased erythropoietin responsiveness. No adequately powered studies have examined the efficacy of antioxidant therapies on markers of inflammation and oxidative stress. We tested the hypothesis that oral antioxidant therapy over 6 months would decrease selected biomarkers of acute-phase inflammation and oxidative stress and improve erythropoietic response in prevalent MHD patients. In total, 353 patients were enrolled in a prospective, placebo-controlled, double-blind clinical trial and randomly assigned to receive a combination of mixed tocopherols (666 IU/d) plus a-lipoic acid (ALA; 600 mg/d) or matching placebos for 6 months (NCT00237718); 238 patients completed the study. High-sensitivity C-reactive protein (hsCRP) and IL-6 concentration were measured as biomarkers of systemic inflammation, and F2 isoprostanes and isofurans were measured as biomarkers of oxidative stress. The groups did not significantly differ at baseline. At 3 and 6 months, the treatment had no significant effect on plasma hsCRP, IL-6, F2 isoprostane, or isofuran concentrations and did not improve the erythropoietic response. No major adverse events were related to the study drug, and both groups had similar mortality and hospitalization rates during the study. In conclusion, the administration of mixed tocopherols and ALA was generally safe and well tolerated, but did not influence biomarkers of inflammation and oxidative stress or the erythropoietic response.

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“…A strong association between plasma CRP levels and all-cause and cardiovascular mortality in renal patients was established already in early studies (31,32). CRP is an acute-phase reactant synthesized in the liver in response to proinflammatory cytokines IL-1, IL-6 and TNF-a, which are all also significantly increased in ESRD and predict mortality (23).…”

Section: Systemic Inflammationmentioning

confidence: 97%

“…In hemodialysis patients, there is an increased production of oxidized low density lipoproteins (LDL), and autoantibody titer against oxLDL is a predictor of mortality in ESRD patients on vitamin supplementation. Increased LDL oxidation seen in uremic patients can play a significant role in atherogenesis via multiple pathophysiological mechanisms (31). Additionally, studies on effects of hemodialysis treatment on oxidative stress in ESRD have suggested that malondialdehyde (MDA) levels should be measured as a marker of oxidative damage of lipids and ALA-D (d-Aminolevulinate dehydratase) reactivation index as a marker of oxidative damage of thiol protein (39).…”

Section: Oxidative Stressmentioning

confidence: 99%

“…It is characterized by accu mulation of triglyceride-rich particles and decreased HDL-cholesterol concentrations, due to impaired triglyceride removal and/or increased triglyceride synthesis rate or VLDL apoB-100 overproduction (46). Cholesterol concentrations are typically similar to or lower than those in the general population (31,43), but this pattern often conceals a highly abnormal lipid subfraction profile with a predominance of athero genic small, dense LDL (sd LDL) and HDL particles (47). Furthermore, elevated serum Lp(a) concen trations have also been reported (48).…”

Section: Dyslipidemiamentioning

confidence: 99%

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Cardiovascular Biomarkers in Chronic Kidney Disease

Đerić¹,

Čabarkapa²

2010

Journal of Medical Biochemistry

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Kratak sadr`aj: Kod pacijenata sa hroni~nim oboljenjem bubrega, kardiovaskularni morbiditet i mortalitet su zn a ~aj -no povi{eni. Iako se ne mo`e smatrati ekvivalentom rizika za kar dio vaskularne bolesti, veruje se da je bubre`na insufici jencija nezavisni prediktor pove}anog kardiovasku lar nog rizika i da se taj rizik pove}ava sa slabljenjem bubre`ne funkcije. Ova udru`enost je veoma kompleksna i danas se {iroko koristi termin kardiorenalni sindrom. Kardiovaskularna bolest u hroni~noj bolesti bubrega obi~no se ispoljava kao ishemijska bolest srca (u obliku angine, akutnog koronarnog sindroma ili nagle sr~ane smrti), cerebrovaskularna bolest, periferna vaskularna bolest i kongestivna bolest srca. Vaskularna bolest obuhvata aterosklerozu i vaskularne kalcifikacije, dok kardio miopatija obuhvata hipertrofiju leve komore, kardijalnu fibrozu i sistolnu i dijastolnu disfunkciju leve komore. Pored dobro poznatih tradicionalnih faktora rizika kao {to su hipertenzija, dislipidemija, insulinska rezistencija i diabetes mellitus, u osnovi ove udru`enosti je i siner gi sti~ko delovanje netradicionalnih faktora rizika kao {to su pove}anje odnosa kalcijum-fosfor, hiperparatireoidizam, anemija, hemodinamsko optere}enje, pothranjenost, za pa ljenje, hiperhomocisteinemija, izmenjena sinteza azot-mo noksida i pove}an oksidativni stres. U radu se razma traju dosada{nja saznanja o zna~aju pojedinih ure mijskih toksi na, natriureti~kih peptida, biohemijskih marke ra poreme}aja u homeostazi kalcijuma i fosfora, sistem ske inflamacije, oksidativnog stresa i dislipidemije.Klju~ne re~i: hroni~na bubre`na insuficijencija, kardiovaskularna bolest, biohemijski markeri

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Homocysteine, C-reactive protein, lipid peroxidation and mortality in haemodialysis patients

Cited by 90 publications

References 26 publications

Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient

Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient

Provision of Antioxidant Therapy in Hemodialysis (PATH)

Cardiovascular Biomarkers in Chronic Kidney Disease

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