Mineral and bone disorder biomarkers and inflammation indexes in patients with end stage renal disease

Zhang, Lu; Yu, Qing; Chen, Xing; Zhang, Mengqin; He, Yan; Ji, Zhiqian; Chen, Rongjuan; Zhang, Jun; Zhang, Hengyuan; Shi, Guixiu; Huang, Jian

doi:10.21037/apm-20-2083

Cited by 6 publications

(7 citation statements)

References 31 publications

(85 reference statements)

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“…In line with our findings, Szepietowski et al 11 recognized an inverse correlation between serum albumin levels and pruritus intensity score in HD patients. The association between lack of vitamin D administration and severe UP in the present study is a novel finding which is probably related to the amplified proinflammatory status in HD patients in the presence of low vitamin D levels 17 18…”

Section: Discussionmentioning

confidence: 62%

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Prevalence and determinants of severity of uremic pruritus in hemodialysis patients: a multicentric study

Abdallah

Elsheikh²,

ElBarbary³

2023

Journal of Investigative Medicine

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Uremic pruritus (UP) is a common and distressing symptom in patients with advanced or end-stage renal disease under hemodialysis (HD). The present multicentric study aimed to identify prevalence and determinants of severity of UP among Egyptian patients. Performed investigations included serum urea, creatinine, calcium, phosphorus, parathormone, ferritin and liver enzymes. Pruritus was evaluated using the visual analog scale. The study included 295 patients on maintenance HD. They comprised 151 patients (51.2%) with UP. Independent predictors of UP included associated hypertension (OR: 0.48, 95% CI 0.28 to 0.83, p=0.008), higher calcium levels (OR: 1.29, 95% CI 1.02 to 1.62, p=0.032), higher phosphorus levels (OR: 1.18, 95% CI 1.02 to 1.37, p=0.03) and higher high-sensitivity C-reactive protein (hsCRP) levels (OR: 1.0, 95% CI 1.0 to 1.01, p=0.049). Independent predictors of significant UP included longer HD duration (OR: 1.23, 95% CI 1.1 to 1.38, p<0.001), lack of vitamin D supplementation (OR: 3.71, 95% CI 1.03 to 13.4, p=0.045), lower albumin levels (OR: 0.32, 95% CI 0.14 to 0.74, p=0.008) and higher hsCRP levels (OR (CRP): 1.02 (1.0–1.03), p=0.011). In conclusion, UP is fairly common among Egyptian HD patients. Independent predictors of UP severity include longer HD duration, lack of vitamin D supplementation, lower albumin levels and higher hsCRP levels.

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Section: Discussionmentioning

confidence: 62%

“…The association between lack of vitamin D administration and severe UP in the present study is a novel finding which is probably related to the amplified proinflammatory status in HD patients in the presence of low vitamin D levels. 17 18…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of severity of uremic pruritus in hemodialysis patients: a multicentric study

Abdallah

Elsheikh²,

ElBarbary³

2023

Journal of Investigative Medicine

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“…Increased CRP is significantly associated with an increased risk of renal osteodystrophy in patients with CKD stages IV-V, according to another research [15]. Also, some research concluded the same thing with an adjusted p-value of 0.04 [16]. This relates to patients with renal osteodystrophy who undergo repeated hemodialysis, which can trigger an inflammatory response and increase CRP levels in patients with renal osteodystrophy [17].…”

Section: Discussionmentioning

confidence: 92%

Levels of FGF-23, C-Reactive Protein, Alkaline Phosphatase as A Risk Factor for Renal Osteodystrophy in Chronic Kidney Disease Patients Stage IV-V

Trisaputra

Ridia

Suyasa

et al. 2023

EJMED

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The condition of CKD is closely related to the existence of systemic disorders that affect various organs, including organs that often experience effects are the kidneys and musculoskeletal. Cases of osteoporosis are often found in patients with CKD who are commonly known as having Renal Osteodystrophy, which is defined by the presence of disorders or pathological conditions in the bones associated with CKD conditions. FGF-23, CRP, ALP are markers that have been associated with the occurrence of a renal osteodystrophy. By conducting this research, it is expected to know the relationship between the three markers and the occurrence of renal osteodystrophy. This study used a case-control design with a cross-sectional method to determine the relationship between FGF-23, CRP, ALP and renal osteodystrophy. From the CKD population with or without renal osteodystrophy, the sample was selected by consecutive sampling. After that, statistical tests were carried out in the form of descriptive tests, normality tests, risk factor assessment using 2x2 cross-tabulations, and predictive analysis of proportions using logistic regression tests. FGF-23 levels > 30 pg/ml (p-value <0.001; CI = 1.4-6.7), CRP > 3 mg/L (p-value <0.001; CI = 1.3-4.8), ALP > 120 U/L (p-value <0.001; CI = 1.7-10.6) in patients with stage IV-V CKD significantly increased the risk of renal osteodystrophy. In the multivariate analysis, ALP had the most significant value compared to these three variables. Based on this study, increased serum ALP is the most influential risk factor for renal osteodystrophy, both based on bivariate and multivariate analysis.

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“…PTH activates osteoblast and increases ALP level (28). Previous studies showed the positive association between the two variables in HD patients, but the strength of association differs according to i-PTH level (29,30). In addition, there were different results in the association between each variable and outcomes in HD patients.…”

Section: Discussionmentioning

confidence: 96%

Association Between Alkaline Phosphatase and Muscle Mass, Strength, or Physical Performance in Patients on Maintenance Hemodialysis

2021

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Introduction: Alkaline phosphatase (ALP) is an indicator for checking liver or bone disorders, but recent studies have shown the possibility of an additive indicator beyond the simple mineral-bone status in dialysis patients. The aim of the study was to evaluate the ALP level and various indicators for malnutrition, physical performance, or hospitalization in patients on hemodialysis (HD).Methods: This study was an observational study (n = 84). We included all patients undergoing HD with the following criteria: age ≥ 20 years, duration of dialysis ≥ 6 months, ability to ambulate without an assistive device, ability to communicate with the interviewer, and no hospitalization within the last 3 months before enrollment. Furthermore, none of the patients had liver disease. We recommended abstinence of alcohol for ≥ 1 month for the duration of the study. The patients were divided into tertiles based on the ALP level. Muscle mass [appendicular muscle mass index using dual-energy X-ray absorptiometry (ASM/Ht2), thigh muscle area index using computed tomography (TMA/Ht2)], strength [handgrip strength (HGS)], and physical performance [gait speed (GS), sit-to-stand for 30-s test (STS30), 6-min walk test (6-MWT), or Short Physical Performance Battery test (SPPB)] were evaluated. The number of hospitalizations was also evaluated.Results: The ALP level in the low, middle, and high tertiles was 50.5 ± 7.5, 69.8 ± 5.4, and 113.3 ± 47.3 IU/l, respectively. The high tertile group showed the poorest trends in ASM/Ht2, TMA/Ht2, HGS, GS, STS30, and 6-MWT compared to the other tertile groups. Logistic regression analysis showed that the high tertile group for low HGS, low GS, or low SPPB had a higher odds ratio compared to the other tertiles. Subgroup analyses according to age, sex and diabetes mellitus showed similar trends as in the total cohort. Hospitalization-free survival rates after 300 days in the high tertile and the other tertiles were 53.8 and 77.2%, respectively (P = 0.105).Conclusion: The present study demonstrated that ALP is associated with muscle mass, strength, and physical performance in patients on maintenance HD. In addition, the trend showed better hospitalization-free survival in the low or middle tertiles than in the high tertile. ALP can be considered as a simple and useful indicator to detect malnutrition, physical performance, or hospitalization in patients on HD.

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Mineral and bone disorder biomarkers and inflammation indexes in patients with end stage renal disease

Cited by 6 publications

References 31 publications

Prevalence and determinants of severity of uremic pruritus in hemodialysis patients: a multicentric study

Prevalence and determinants of severity of uremic pruritus in hemodialysis patients: a multicentric study

Levels of FGF-23, C-Reactive Protein, Alkaline Phosphatase as A Risk Factor for Renal Osteodystrophy in Chronic Kidney Disease Patients Stage IV-V

Association Between Alkaline Phosphatase and Muscle Mass, Strength, or Physical Performance in Patients on Maintenance Hemodialysis

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