Inflammation and hemodialysis adequacy: are C-reactive protein levels influenced by the dose of dialysis?

Valga, Francisco; Monzón, Tania; Vega-Díaz, Nicanor; Rodríguez‐Pérez, José Carlos; Ruiz‐Santana, Sergio

doi:10.1016/j.nefroe.2021.06.005

Cited by 4 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bio-incompatible dialysis membranes, infections of the fistula or graft used as HD access, endotoxin exposure, malnutrition, poor dental hygiene, dialysate, and back filtration are possible components of inflammatory burden in these patients (5; 16-18). Although CRP is nearly a universal marker of inflammation, our study showed that CRP levels of sufficient and insufficient HD groups were not statistically different (23)(24)(25). Moreover, there was no significant correlation between UHR and CRP levels.…”

Section: Discussioncontrasting

confidence: 60%

Could uric acid to high density lipoprotein-cholesterol ratio be considered as a marker of hemodialysis sufficiency?

Çapraz

Çoşkun

2023

Journal of Contemporary Medicine

View full text Add to dashboard Cite

Aim: Hemodialysis (HD) is one of the most widely utilized renal replacement therapies in individuals with end-stage chronic kidney disease (CKD). The purpose of this study was to compare the Uric acid to HDL cholesterol ratio (UHR) levels of well-treated HD patients to those of those who had inadequate HD therapy. Materials and Methods: Data on HD patients were acquired from patient files and the institution's database. A URR value of more than 70% designated the sufficient HD group, whereas less than 70% defined the insufficient HD group. Furthermore, laboratory data, such as the UHR of the study groups, were compared. Results: The UHRs for adequate and inadequate HD were 0.160±04 and 0.20±0.07, respectively. The UHR of patients with insufficient HD was substantially greater than that of the subjects with sufficient HD (p=0.004). Besides, UHR was substantially and positively connected with urea before HD (r=0.37, p=0.001), urea after HD (r=0.39, p=0.001), serum creatinine before HD (r=0.48, p0.001), serum creatinine after HD (r=0.45, p0.001), and negatively correlated with URR (r=-0.29, p=0.008), according to correlation analyses. In individuals with chronic renal disease, a UHR value higher than 0.16 exhibited 67% sensitivity and 57% specificity in detecting inadequate HD. Conclusion: We propose that UHR, in addition to URR, might be used to determine HS sufficiency in CKD patients undergoing HD therapy.

show abstract

Section: Discussioncontrasting

confidence: 60%

Could uric acid to high density lipoprotein-cholesterol ratio be considered as a marker of hemodialysis sufficiency?

Çapraz

Çoşkun

2023

Journal of Contemporary Medicine

View full text Add to dashboard Cite

show abstract

“…Systemic inflammation is prevalent among HD patients and is correlated with high CRP and low albumin levels. 65 , 66 Patients who experienced tendon rupture in our study exhibited higher CRP and ferritin and lower albumin levels, mainly in those with bilateral rupture. Therefore, they are more susceptible to direct tendon injuries from inflammatory cytokines and decreased healing potential after repeated microtrauma.…”

Section: Discussionmentioning

confidence: 50%

Patellar and quadriceps tendon rupture are associated with hip fracture in hemodialysis patients with severe hyperparathyroidism

Pichone,

Juvencio,

Crespo

et al. 2024

JBMR Plus

View full text Add to dashboard Cite

Spontaneous rupture of the patellar (PTR) and quadriceps (QTR) tendon are infrequent. Systemic diseases such as diabetes mellitus, chronic kidney disease and secondary hyperparathyroidism (SHPT) are risk factors. The present cohort study aimed to evaluate risk factors associated with tendon rupture in hemodialysis (HD) patients with SHPT, as well as outcomes including surgical complications, re-ruptures and fracture. Baseline clinical, laboratorial data and radiographs were analyzed. Patients were followed up from March 2012 to March 2020. One-hundred thirty-one patients (≥18 years of age, on HD ≥ 6 months, with SHPT) were included. Incidence rates of PTR and QTR were 2.3 and 1.7/10000 HD patients/year, respectively. The mean age of patients with tendon rupture was 44.0 ± 11.2 years. These patients exhibited higher serum levels of phosphorus (6.3 ± 1.5 mg/dL vs 5.6 ± 1.1 mg/dL; p = 0.005), parathyroid hormone (2025.7 ± 667.6 pg/mL vs 1728.4 ± 684.8 pg/mL; p = 0.035), and C-reactive-protein (35.4 ± 32.9 mg/dL vs 17 ± 24.5 mg/dL; p = 0.002) compared to the group without tendon rupture. The mean follow-up was 56.7 ± 27.1 months. No patient required a new surgical approach or experienced re-rupture. Of all patients, 31% experienced hip fracture: 50% in the group with rupture (29.5 ± 17.4 months after the tendon rupture) vs 26% without tendon rupture (p = 0.015). After adjustment, the hazard ratio for hip fracture was 2.87 (CI 95% 1.27–6.49; p = 0.012). Patients with SHPT and high levels of phosphorus, parathyroid hormone, and inflammatory markers were at greater risk for tendon rupture. Surgical complication rates were low. However, results suggest that tendon rupture of knee extensor mechanism in hemodialysis patient with SHPT should be regarded as a “red flag” for future hip fracture.

show abstract

“…It involves considerations such as the quality of vascular access, the presence of comorbidities, fluid balance management, correction of malnutrition, acidosis, and anemia, maintenance of electrolyte homeostasis, and addressing chronic inflammation. [17][18][19][20] Within this context, a reduced dialysis dose can be seen as a reflection of this intricate interplay of factors, potentially contributing to unfavorable COVID-19 outcomes in patients undergoing HD. However, to the best of our knowledge, only two studies have delved into the relationship between dialysis dose and COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…Second, reduced spKt/V has been shown to be associated with toxins accumulation and potentially indicates the systemic inflammatory stress determined by increased CRP levels, up-regulation of proinflammatory cytokines and chemokines, and downregulation of anti-inflammatory cytokines. 14,20,27 Chronic inflammation is a well-documented characteristic in patients on HD, often stemming from various factors like the accumulation of uremic toxins, oxidative stress, and constant exposure to dialysis membranes, among others. 33 Intriguingly, in the context of COVID-19, chronic inflammation at baseline may have a somewhat paradoxical effect, potentially offering a degree of protection against severe outcomes in patients undergoing HD.…”

Section: Discussionmentioning

confidence: 99%

Hemodialysis dose and long-term COVID-19 outcomes – a retrospective cohort study

Stepanova,

Rysyev,

Snisar

2024

Eur J Clin Exp Med

View full text Add to dashboard Cite

Introduction and aim. Long-term outcomes of COVID-19 pose a global challenge, particularly impacting individuals with un derlying health conditions, including those who have undergone hemodialysis (HD). The study aimed to investigate the rela tionship between preexisting dialysis dose, measured by single pool Kt/V (spKt/V), and long-term outcomes of COVID-19 in patients undergoing HD. Material and methods. Demographic, clinical, and laboratory parameters following COVID-19 recovery, and long-term out comes, including the presence of COVID-19 sequelae, hospitalization, and all-cause mortality during a year after COVID-19 were retrospectively analyzed. Results. Out of the 195 patients included, there were 108 males (55.4%) and 87 females (44.6%), with a median age of 56 (44-63) years and a dialysis duration of 49 (31.3–85.2) months. Patients with spKt/V<1.4 had a significantly increased risk of long-term COVID-19 sequelae (HR 9.1, 95% CI: 3.4; 24.6), hospitalization (HR 7.6, 95% CI: 3.9; 14.6), and all-cause mortality (HR 8.5, 95% CI: 2.9; 25.8) within one year after COVID-19 recovery compared with those with spKt/V≥1.4. spKt/V cutoff point of ≤1.3 emerged as a significant risk factor for one-year hospitalization and mortality within our cohort. Conclusion. Suboptimal dialysis dose, as indicated by spKt/V < 1.4, is associated with adverse long-term COVID-19 outcomes in patients undergoing HD. Optimizing dialysis adequacy may mitigate these risks. Further research is needed to validate these f indings and explore interventions to improve outcomes in this vulnerable population.

show abstract

Inflammation and hemodialysis adequacy: are C-reactive protein levels influenced by the dose of dialysis?

Cited by 4 publications

References 19 publications

Could uric acid to high density lipoprotein-cholesterol ratio be considered as a marker of hemodialysis sufficiency?

Could uric acid to high density lipoprotein-cholesterol ratio be considered as a marker of hemodialysis sufficiency?

Patellar and quadriceps tendon rupture are associated with hip fracture in hemodialysis patients with severe hyperparathyroidism

Hemodialysis dose and long-term COVID-19 outcomes – a retrospective cohort study

Contact Info

Product

Resources

About