Uremia and Infection: Mechanisms of Impaired Cellular Host Defense

Haag–Weber, Marianne; Hörl, Walter H.

doi:10.1159/000187170

Cited by 92 publications

(47 citation statements)

References 29 publications

(36 reference statements)

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“…In dogs with CRF, PD progression occurred in a different way, confirming the hypotheses raised by several authors (SÖDERHOLM et al, 1974;LARATO, 1975;OSHRAIN et al, 1979;TOLLEFSEN & JOHANSEN, 1985a,b;JAFFE &¨ROBERTS, 1986;MIYASAKI, 1991;YAMALIK et al, 1991;RAHMAN et al, 1992;HAAG-WEBER & HÖRL, 1993;KHOCHT, 1996). At early stages, dental plaque accumulation is much more evident involving the mandibular teeth, including the MbI, while the MxI present both plaque accumulation and gingivitis.…”

Section: Discussionsupporting

confidence: 80%

“…The polymorphonuclear leukocyte (PMN) is important in defending the periodontium against plaque infection (KHOCHT, 1996), and patients presenting PMN defects or low number of PMN often develop severe periodontal disease (MIYASAKY, 1991). Chronic renal failure (CRF) is associated with impairment in PMN function (HAAG-WEBER & HÖRL, 1993). As it occ -1 urs to human beings, dogs will have gingival defense problems when they are under serious stress, such as renal failure (EISNER, 1989a).…”

Section: Introductionmentioning

confidence: 99%

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Periodontal disease characterization in dogs with normal renal function or chronic renal failure

et al. 2004

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The purpose of this study was to evaluate periodontal disease (PD) in dogs with chronic renal failure (CRF) and to compare it to PD in dogs with normal renal function (NRF). Twelve dogs with CRF and 24 dogs with NRF, all presenting dental pocket formation, were compared. In all dogs, serum creatinine, blood urea nitrogen, urine specific gravity and total red and white blood cells were determined. A complete oral examination was also performed including evaluation of bacterial plaque, gingivitis, gingival recession, pocket, calculus, dental mobility, dental loss, and ulcers. These data were used to calculate plaque index (PI), gingival index (GI) and periodontal destruction index (PDI). PD was graded as mild, moderate or severe based on the results. Mild, moderate or severe PD was observed in dogs with NRF, whereas dogs with CRF presented either mild or severe PD. Dogs with NRF showed higher involvement of the maxillary teeth, whereas dogs with CRF showed a higher involvement of the mandibular teeth. Plaque index was significantly higher in dogs with NRF. It was concluded that lesion distribution and periodontal disease progression may be altered in dogs with CRF, and gingival inflammatory response differs in dogs with NRF and CRF regarding to the stage of periodontal disease.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Periodontal disease characterization in dogs with normal renal function or chronic renal failure

et al. 2004

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“…20 -22 Renal dysfunction leads to immunological abnormalities resulting in increased susceptibility to infections and infectious complications. 23 Further, hemodialysis increases the risk of recurrent bacteremia 24,25 and exposes the valvular apparatus to significant hemodynamic stress and elevated transvalvular flow. 26 Vascular access-related infections are major sources of bacteremia,morbidity, and mortality in this population.…”

Section: Valve Perforation Vascular Access and Hemodialysismentioning

confidence: 99%

Valvular Perforation in Left‐sided Native Valve Infective Endocarditis

Bachour¹,

Zmily²,

Kizilbash³

et al. 2009

Clinical Cardiology

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Background: Left-sided native valve infective endocarditis (LNVIE) can result in mitral (MP) and aortic (AP) valve perforation, the prognostic significance of which remains poorly defined. Hypothesis: Valvular perforation is associated with worse outcomes. Methods: Retrospective review of patients with LNVIE during 1998-2005 was performed to examine characteristics and outcome predictors of LNVIE complicated by valve perforation. Patients were stratified as: group A: MP or AP detected by transesophageal echocardiography (TEE) or surgery; group B: no TEE evidence of MP or AP. Results: A total of 123 patients were included (group A = 47, group B = 76). In group A, 35 patients (74.5%) had MP alone, 11 (23.4%) had AP alone, and 1 patient had both. Severe valvular insufficiency was encountered more in group A (85.1% versus 59.2%, p = 0.003), so was hemodialysis (40.4% versus 17.1%, p = 0.004) and indications for valvular surgery (93.6% versus 77.6%, p = 0.02). Group A had a higher rate of in-hospital death (31.9% versus 15.8%, p = 0.04). Among patients who had an indication for valvular surgery, the in-hospital mortality rate for those who underwent valvular surgery was 16.7% in group A, and 7.9% in group B (p = 0.4), compared to those who did not undergo surgery (71.4% versus 33.3%, p = 0.04). Amongst survivors, hospital stay was on average 9.2 d longer in group A (38.9 versus 29.7 d, p = 0.05). Univariate analysis revealed association between lower survival and valvular perforation (odds ratio [OR]: 0.4, 95% confidence interval [CI]: 0.17-0.95), that was lost after adjusting for hemodialysis. Conclusions: Valve perforation complicating LNVIE is associated with hemodialysis, severe valvular insufficiency, and significant morbidity and mortality. Compared to conservative management, early surgical intervention is associated with improved survival.

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“…It must be the object of clinical studies to document whether high levels of these peptides [5,6] are beside elevated intracellular calcium [7] related to infectious complications in dialysed patients and whether this risk can be reduced by removal of such peptides. Detection and analysis of GIP I, GIP II, and DIP was facilitated by the fact that PMN are a well-standardized and readily accessible model.…”

Section: Degranulation Inhibiting Protein (Dip)mentioning

confidence: 99%

GIP and DIP: a new view of uraemic toxicity

1994

Nephrology Dialysis Transplantation

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Uremia and Infection: Mechanisms of Impaired Cellular Host Defense

Cited by 92 publications

References 29 publications

Periodontal disease characterization in dogs with normal renal function or chronic renal failure

Periodontal disease characterization in dogs with normal renal function or chronic renal failure

Valvular Perforation in Left‐sided Native Valve Infective Endocarditis

GIP and DIP: a new view of uraemic toxicity

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