Plasma oxalic acid and cardiovascular risk in end-stage renal disease patients: a prospective, observational cohort pilot study

Abstract

Background/Aims: It was hypothesized that oxalate might be strongly involved in atherogenesis and the inflammatory pathway that could result in an increased risk of cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients. Therefore, this study aimed to address two primary research questions: to characterize the lipid profile and the pattern of pro-inflammatory cytokines according to plasma oxalic acid (POx) concentration in ESRD patients; to evaluate the potential role of elevated POx concentration in the development of CVD risk. Methods: A total of 73 participants were enrolled in this prospective, observational cohort pilot study. Among them, there were 50 ESRD patients and 23 healthy volunteers. The lipid profile and the pro-inflammatory cytokines were analyzed according to the distribution of POx concentration into tertiles. After the clinical examination, 29 hemodialysis patients and 21 peritoneal dialysis patients without prevalent CVD were observed for CVD events for 2 years. The Cox regression analysis and a set of different types of sensitivity analyses were used to determine whether elevated POx was associated with an increased risk of CVD. Results: An increasing trend in the atherogenic lipoprotein fractions and the pro-inflammatory markers as well as a linear decrease in high-density lipoprotein was significantly associated with elevated POx. POx concentration ≥ 62.9 µmol/L was significantly associated with CVD events independently of other examined CVD risk factors. Conclusions: This pilot study firstly demonstrated a potential contribution of POx to atherogenesis, inflammation and CVD risk in ESRD patients.

Oxalate Balance in Peritoneal Dialysis Patients: A Potential Role of Dialysis-related Peritonitis

“…Notwithstanding these limitations, our study is the first to our knowledge that reports a strong association between dialysis-related peritonitis and elevated POx in PD patients. Although the clinical significance of hyperoxalemia in PD patients remains unclear, recent studies have demonstrated that oxalate is involved in the activation of oxidative stress, chronic inflammation, and atherogenesis (1,8,9,11), which may explain the high cardiovascular and overall mortality in PD-related peritonitis. Quite possible that further research to investigate the effect of dietary oxalate restriction or the gut microbiota correction may open up a new pathway to improve PD-related peritonitis outcomes.…”

Long COVID-19 laboratory findings in hemodialysis patients: Should they be considered post-COVID syndrome?

“…The greatest risk of morbidity and mortality from COVID-19 is in older people, diabetics, and patients with immune dysfunction or chronic cardiovascular or kidney diseases (2). Hemodialysis (HD) is the most common modality of dialysis kidney replacement therapy worldwide (3,4). Patients treated with HD are at high risk for adverse outcomes of COVID-19 because a significant number of them are elderly and have a high prevalence of comorbidities (3)(4)(5), which not only increases the risk of infection with COVID-19 but also the formation of life-threatening complications (6,7).…”

Post-COVID syndrome in dialysis patients and kidney transplant recipients

“…Хворі на ХХНV Д та реципієнти ниркового трансплантату (РНТ) належать до групи високого ризику тяжкого перебігу COVID-19 та формування ПКС [1,3,5,14]. Адже усі вище згадані фактори ризику розвитку ПКС притаманні цій популяції [15][16][17]. Проте, достеменно невідомо, чи є вплив COVID-19 на хворих цієї когорти унікальним, чи є подібним до сепсису, оскільки деякі дослідження свідчать про подібність симптомів ПКС до наслідків сепсису та гострого дистрес-синдрому [1].…”