Peritonitis Incidence Was Correlated with Duration of Peritoneal Dialysis Rather than Leptin or Neutrophil to Lymphocyte (N/L) Ratio in Peritoneal Dialysis Patients

Abstract

Objective: End stage renal disease (ESRD) has a high worldwide prevalence and incidence. Peritonitis is one of the leading causes of hospitalization in peritoneal dialysis patients. Although inflammatory markers show increased inflammatory responses, cellular immune response was decreased in ESRD patients. Leptin is an adipocytederived hormone that has activity in energy, nutrition and immune system. Neutrophil to lymphocyte ratio (N/L) was emerged as a predictive and prognostic criterion in many instances. In this study, we aimed to investigate the relationships between increased inflammation in peritoneal dialysis patients and leptin, N/L ratio. Materials and Methods:Forty-one ESRD patients, who were been at least 12 months of peritoneal dialysis therapy, were included in the study. Patients' demographic properties were recorded. Serum leptin level, WBC count, C-reactive protein, erythrocyte sedimentation rate and biochemical markers were measured. Patients with active viral or bacterial infection, malignancy, inflammatory disease, immunosuppressive medication users were all excluded from the study. Age and sex-matched healthy control group was included in the study only for their leptin levels.Results: The measured mean serum leptin level of the patient group was statistically significantly higher than control group (1624.88±1608.16 and 416±439.85). The calculated mean peritonitis incidence was 0.041±0.047 peritonitis/per year. The number of peritonitis attack was significantly correlated with duration of peritoneal dialysis, body mass index (BMI), age and presence of cardiovascular disease. Serum leptin level was significantly correlated with sex, age, primary cause of ESRD, BMI, blood glucose level and duration of peritoneal dialysis (PD). Conclusion:We detected that ESRD patients have higher serum leptin levels compare to healthy adults. Increased leptin was correlated with sex, age, BMI, primary cause of ESRD and serum glucose level. Number of peritonitis attack and peritonitis incidence was significantly correlated with the duration of PD, BMI and sex. We weren't able to show the predictive N/L value in PD patients in case of peritonitis.Key Words: Leptin, neutrophil to Lymphocyte raito, peritonitis, peritoneal dialysis Özet Amaç: Son dönem böbrek yetersizliği (SDBY) dünya genelinde yüksek bir prevelansa sahiptir. Peritonit, periton diyaliz hastalarının hastane yatış sebepleri arasında en önde gelenlerden bir tanesidir. SDBY hastaların-da inflammatuvar belirteçler artmış inflamatuvar yanıt varlığını gösterse de hücresel ve immün yanıt azalmıştır. Adiposit kaynaklı bir hormone olan leptin, enerji, beslenme ve immün sistem üzerinde etkilere sahiptir. Nötrofil-lenfosit oranı (N/L) çeşitli durumlarda prediktif ve prognostik kriter olarak ortaya çıkmıştır. Biz bu çalışmada periton diyaliz hastalarında artmış enflammasyon, leptin ve N/L ilişkisini araştırmak istedik. Gereç ve Yöntem: En az 12 aydan beri periton diyalizi yapan 41 SDBY hastası çalışmaya dahil edildi. Hastaların demografik özellikleri kay...

Peritonitis Incidence is Correlated with Increased Leptin and CD4/CD8 Ratio in Peritoneal Dialysis Patients

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