Serum leptin concentration can predict cardiovascular outcomes and all-cause death in maintenance hemodialysis patients

Zheng, Qin; Yang, Qinbo; Yang, Mei; Han, Mei; Xiong, Yang; Liao, Ri-Qiang; Su, Baihai

doi:10.1016/j.cca.2021.06.003

Cited by 10 publications

(11 citation statements)

References 37 publications

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“…In literature, LVH is present in 68–89% of incident HD patients [ 11 – 14 ]. Chronic volume overload, hypertension, high output of AV fistulae, anemia, and uremic toxin accumulation all contribute to LVH in MHD [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic left ventricular hypertrophy and geometry in Chinese chronic hemodialysis patients: the prevalence and determinants

Zhao

Zhu

Jin

et al. 2022

BMC Cardiovasc Disord

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Background To investigate the prevalence of left ventricular hypertrophy (LVH) and explore left ventricular geometry in maintenance hemodialysis (MHD) patients, and to explore the risk factors of LVH which is an important predictor of cardiovascular events. Methods The subjects were patients who are on MHD for more than 3 months in Peking University People's Hospital from March 2015 to February 2017. Demographic and clinical data were retrospectively collected. Left ventricular mass was measured by echocardiography. LVH is defined by Left ventricular mass index (LVMI) > 115 g/m2 for men and > 95 g/m2 in women. LVMI and relative wall thickness were used to determine left ventricular geometry. Logistic regression was used to analyze the risk factors of LVH. Results Altogether, 131 patients including 77 males were enrolled. The median age was 60 (47, 69) years, with a median dialysis vintage of 48 (18, 104) months. There were 80 patients with LVH, the prevalence rate was 61.1%, and 66.3% of them were moderate to severe LVH. We found that (1) most of the patients were concentric hypertrophy; (2) one-third of the patients were concentric remodeling; (3) only 4 cases with normal geometry. The pre-dialysis serum sodium level and time average pre-dialysis systolic blood pressure (SBP) were independent risk factors of LVH. Conclusion LVH is prevalent in MHD patients. Concentric hypertrophy and concentric remodeling are the most common geometric patterns. Attention should be paid to long-term pre-dialysis SBP management and pre-dialysis sodium control as they might be potentially modifiable risk factors for LVH.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic left ventricular hypertrophy and geometry in Chinese chronic hemodialysis patients: the prevalence and determinants

Zhao

Zhu

Jin

et al. 2022

BMC Cardiovasc Disord

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“…Unlike healthy individuals, dialysis patients with obesity or higher BMI have better nutritional status and clinical outcomes [ 105 ]. However, leptin is a hormone that can regulate appetite [ 106 ]. High levels of leptin suppress appetite in patients with ESRD and can lead to increased energy expenditure [ 107–109 ].…”

Section: Risk Factors Of Malnutrition In Dialysis Patientsmentioning

confidence: 99%

Progress in the study of nutritional status and selenium in dialysis patients

et al. 2023

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Malnutrition is very common in patients with chronic kidney disease, especially in those on maintenance dialysis. Malnutrition is one of the major factors affecting survival and death of dialysis patients, and reducing their activity tolerance and immunity. There are numerous and interacting risk factors for malnutrition, such as reduced nutritional intake, increased energy expenditure, hormonal disorders, and inflammation. Selenium, in the form of selenoproteins, is involved in many physiological processes in the body and plays an important role in maintaining redox homeostasis. Oxidative stress and infection are very common in dialysis patients, and selenium levels in dialysis patients are significantly lower than those in the healthy population. It has been shown that there is a correlation between selenium levels in hemodialysis patients and their nutrition-related indicators, and that selenium supplementation may improve malnutrition in patients. However, further studies are needed to support this conclusion and there is a lack of basic research to further characterize the potential mechanisms by which selenium may improve malnutrition in dialysis patients. The purpose of this review is to provide a comprehensive overview of factors associated with malnutrition in dialysis patients and to describe the progress of research on nutritional status and selenium levels in dialysis patients.

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“…Even in prevalent kidney transplant recipients, lower leptin was found to be an independent predictor of death [ 111 ]. In maintenance hemodialysis patients, decreased circulating levels of leptin were associated with a higher risk of CV events and death, probably contributing to LVH and peripheral vascular disease development [ 112 ]. Qin et al described that decreased leptin levels were an independent risk factor for LVH development in patients on hemodialysis [ 112 ].…”

Section: Leptinmentioning

confidence: 99%

“…In maintenance hemodialysis patients, decreased circulating levels of leptin were associated with a higher risk of CV events and death, probably contributing to LVH and peripheral vascular disease development [ 112 ]. Qin et al described that decreased leptin levels were an independent risk factor for LVH development in patients on hemodialysis [ 112 ]. Curiously, in ESRD, patients with a history of stroke presented higher leptin levels than those without stroke history, while patients with congestive heart failure showed lower leptin values that those without history of congestive heart failure [ 113 ].…”

Section: Leptinmentioning

confidence: 99%

New Insights into Adiponectin and Leptin Roles in Chronic Kidney Disease

et al. 2022

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Chronic kidney disease (CKD) is commonly associated with a high burden of comorbidities and poor clinical outcomes. Malnutrition–inflammation–atherosclerosis syndrome is common in the more severe stages of CKD, suggesting a close interplay for these three comorbid conditions. Both malnutrition and obesity are associated with a disturbed adipokine profile and inflammation, contributing to a higher risk of cardiovascular disease (CVD) events. Adiponectin and leptin have important roles in carbohydrate and lipid metabolism, and in the inflammatory process. The effects of adiponectin and leptin alterations in CKD, which are usually increased, and their association with the different comorbidities found in CKD, will be focused on to understand their crosstalk with the risk of CVD events. Nonetheless, although adiponectin and leptin contribute to a higher risk of CVD events, further studies are warranted to fully clarify their roles, especially when different comorbidities exist.

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Serum leptin concentration can predict cardiovascular outcomes and all-cause death in maintenance hemodialysis patients

Cited by 10 publications

References 37 publications

Echocardiographic left ventricular hypertrophy and geometry in Chinese chronic hemodialysis patients: the prevalence and determinants

Echocardiographic left ventricular hypertrophy and geometry in Chinese chronic hemodialysis patients: the prevalence and determinants

Progress in the study of nutritional status and selenium in dialysis patients

New Insights into Adiponectin and Leptin Roles in Chronic Kidney Disease

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