Potential impact of renin–angiotensin system inhibitors and calcium channel blockers on plasma high-molecular-weight adiponectin levels in hemodialysis patients

Nakagawa, Naoki; Yao, Naoyuki; Hirayama, Tomoya; Ishida, Mari; Ishida, Hironori; Wada, Atsushi; Fujino, Takayuki; Saijo, Yasuaki; Kikuchi, Kenjiro; Hasebe, Naoyuki

doi:10.1038/hr.2010.282

Cited by 12 publications

(7 citation statements)

References 35 publications

(39 reference statements)

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“…However, in peritoneal dialysis patients, there was no association between adipokines, statins, or RAS inhibitors . In our HD patients, those on RAS blockade had lower arm muscle area, higher PEW scores and adiponectin levels, similar to the report by Nakagawa et al . These discrepancies between dialysis and heart failure patients may be due to the uremic milieu, and the different effects on adipokines and PEW from various types of RAS blockade agents (ACEi, ARB) .…”

Section: Discussionsupporting

confidence: 86%

Gelsolin and Adipokines Are Associated With Protein‐Energy Wasting in Hemodialysis Patients

et al. 2014

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Protein-energy wasting (PEW) contributes to mortality in hemodialysis (HD) patients. Adipokines regulate energy homeostasis and body weight. Circulating gelsolin can modulate inflammation and is correlated with HD mortality. Whether adipokines and gelsolin play important roles in PEW remains unclear. Based on the criteria proposed by the International Society of Renal Nutrition and Metabolism, we examined the associations between PEW and biomarkers (gelsolin, leptin, adiponectin, interleukin-6, tumor necrosis factor alpha [TNF-α]) in 188 stable HD patients. Patients with PEW had significantly lower serum leptin levels, and tended to have higher adiponectin, TNF-α, and lower gelsolin levels. Logistic regression analysis revealed that gelsolin, leptin, adiponectin, and blood urea nitrogen were independently associated with PEW score. Serum creatinine, TNF-α, gender, renin-angiotensin system (RAS) blockade, and lipid-lowering agents were not associated with PEW score. Patients on lipid-lowering agents had lower PEW scores and those with RAS blockade had higher PEW scores. Our study confirms that gelsolin, adiponectin, and leptin are significant associates with PEW in HD patients. Further understanding of how these factors contribute to PEW may help design novel therapeutic strategies for PEW in chronic kidney disease.

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Section: Discussionsupporting

confidence: 86%

Gelsolin and Adipokines Are Associated With Protein‐Energy Wasting in Hemodialysis Patients

et al. 2014

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“…However, commonly used antihypertensive agents have different effects on insulin sensitivity, which is associated with abdominal fat. Plasma angiotensin is associated with adiposity [36], and RAS blockers can improve glucose homeostasis [37] and reduce abdominal fat [19,20]. Although we conducted a retrospective analysis of patients’ medication use, our PD patients appeared to experience similar RAS blocker–induced effects on VFA.…”

Section: Discussionmentioning

confidence: 99%

“…Renin-angiotensin system (RAS) blockers have been reported to reduce VFA and decrease vascular inflammation [19,20]. Traditional beta blockers can reduce insulin sensitivity and increase the risk of DM and dyslipidemia [21].…”

Section: Introductionmentioning

confidence: 99%

Metabolic syndrome and abdominal fat are associated with inflammation, but not with clinical outcomes, in peritoneal dialysis patients

Huang

Yang

et al. 2013

Cardiovasc Diabetol

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BackgroundIn the general population, metabolic syndrome (MetS) is correlated with visceral fat and a risk factor for cardiovascular disease (CVD); however, little is known about the significance of abdominal fat and its association with inflammation and medication use in peritoneal dialysis (PD) patients. We investigated the relationship of visceral fat area (VFA) with C-reactive protein (CRP) levels and medication use in PD patients and followed their clinical outcomes.MethodsIn a prospective study from February 2009 to February 2012, we assessed diabetes mellitus (DM) status, clinical and PD-associated characteristics, medication use, CRP levels, components of MetS, and VFA in 183 PD patients. These patients were categorized into 3 groups based on MetS and DM status: non-MetS (group 1, n = 73), MetS (group 2, n = 65), and DM (group 3, n = 45). VFA was evaluated by computed tomography (CT) and corrected for body mass index (BMI).ResultsPatients in group 1 had smaller VFAs than patients in groups 2 and 3 (3.2 ± 1.8, 4.6 ± 1.9, and 4.9 ± 2.0 cm2/[kg/m2], respectively, P < 0.05) and lower CRP levels (0.97 ± 2.31, 1.27 ± 2.57, and 1.11 ± 1.35 mg/dL, respectively, P < 0.05). VFA increased with the number of criteria met for MetS. After adjusting for age, body weight, and sex, CRP and albumin levels functioned as independent positive predictors of VFA; on other hand, the use of renin-angiotensin system blockers was inversely correlated with VFA in PD patients without DM. In the survival analysis, DM patients (group 3) had the poorest survival among the 3 groups, but no significant differences were found between groups 1 and 2.ConclusionThis study showed that VFA and MetS are associated with CRP levels but cannot predict survival in PD patients without DM. The complex relationship of nutritional parameters to VFA and MetS may explain these results. The type of antihypertensive medication used was also associated with the VFA. The mechanisms behind these findings warrant further investigation.

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“…Increasing plasma adiponectin levels or the activity of the receptors (including thiazolidinedione, renin-angiotensin system inhibitor or calcium channels blocker) for the specific population may become a new therapeutic target and may play a significant role in clinical intervention and treatment. 9,10 In this study, we have studied changes in adiponectin levels and Adipo R expression of renal tissues in rat CRF model. We have also discussed the observed correlation between Adipo R and adiponectin levels to provide the basis for understanding the function and mechanism of adiponectin following CRF.…”

Section: Introductionmentioning

confidence: 99%

Changes of adiponectin and its receptors in rats following chronic renal failure

Bao

Fan

et al. 2013

Renal Failure

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Objective: To investigate changes of adiponectin and its receptors (Adipo R) in rats following chronic renal failure. Methods: Male SD rats were randomly divided into two groups: control group and chronic renal failure (CRF) group. The CRF group were gavaged with adenine (300 mg/kg/d) for 4 weeks and the control group with drinking water. All rats were anesthetized at 2nd or 4th week and blood and urine samples were collected for detection of renal function, 24 h urine protein and adiponectin concentration. Renal tissues were also collected for HE staining, immunohistochemistry and RT-PCR screening. Results: Compared with control group, the serum concentrations of urea and creatinine, 24 h urine protein excretion in the CRF group were significantly higher at 2nd week and further increased at 4th week (p50.05). The adiponectin levels in serum and urine in the CRF group were significantly higher than those of control group (p50.01). The renal expressions of Adipo R1 and Adipo R2 in CRF group were also significantly increased compared to control group (p50.01). The increased expressions of Adipo R1 and Adipo R2 were positively related to the adiponectin levels in serum, urine, and 24 h urine protein. Conclusion: The significant changes in expression of adiponectin and its receptors in rat CRF model could be an adaptive response that may provide the basis to understand pathological changes in chronic kidney disease.

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Potential impact of renin–angiotensin system inhibitors and calcium channel blockers on plasma high-molecular-weight adiponectin levels in hemodialysis patients

Cited by 12 publications

References 35 publications

Gelsolin and Adipokines Are Associated With Protein‐Energy Wasting in Hemodialysis Patients

Gelsolin and Adipokines Are Associated With Protein‐Energy Wasting in Hemodialysis Patients

Metabolic syndrome and abdominal fat are associated with inflammation, but not with clinical outcomes, in peritoneal dialysis patients

Changes of adiponectin and its receptors in rats following chronic renal failure

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