4 research outputs found
Serum asymmetric-dimethylarginine, apelin and NT-pro BNP levels in dialysis patients
No full textBackground: The relationships among serum Apelin, Asymmetric- dimethylarginine (ADMA), N-terminal probrain natriureticpeptide (NT-proBNP) levels, and blood pressures in dialysis patients are not well known. Materials and Methods: Age and sex matched 30 hemodialysis (HD), 30 peritoneal dialysis (PD) patients, and 20 healthy controls were recruited. Serum apelin-36, ADMA, NT-proBNP levels, and blood pressures of both patients and healthy controls were measured and compared. Results: Serum ADMA and Apelin levels in HD patients were significantly higher than in PD patients. In multiple regression analyses the predictors of higher serum apelin levels were higher BMI, higher ADMA and lower systolic blood pressure. The predictors of serum ADMA levels were being on HD. The predictors of serum NT-proBNP levels were lower serum albumin and higher systolic blood pressure. Conclusion: Being on HD is a predictor of high ADMA levels. HD might be less effective on ADMA removal than PD. It seems that higher serum apelin levels related with lower sytolic blood pressure levels, whereas higher NT-proBNP levels related with higher sytolic blood pressure levels indicating potential roles as independent prognostic factors for systolic hypertension in dialysis patients.Inonu University Medical Research CenterThis study was supported by Inonu University Medical Research Center
Brain natriuretic peptide and its relationship to left ventricular hypertrophy in patients on peritoneal dialysis or hemodialysis less than 3 years
No full textAn increase of brain natriuretic peptide (BNP) levels is commonly observed in patients on dialysis. Increased circulating levels of BNP are related to future cardiac events and associated with shorter survival in patients on chronic hemodialysis (HD). During the first I or 2 years on dialysis, patients on peritoneal dialysis (PD) have been shown to have an improvement in left ventricular hypertrophy, blood pressure, and volume status. This study compares BNP levels and cardiac status of PD and HD patients without cardiovascular disease and on dialysis for less than 36 months. The correlation between plasma BNP concentration and findings of echocardiography before HD scans were examined and compared with findings of PD. Twenty-two HD patients (15 men, 7 women; mean age, 52.5 +/- 13.9 years) and 19 PD patients (10 men, 9 women; mean age, 47.6 +/- 11.3 years) were studied. There were no significant differences between HD and PD patients with regard to age, gender, duration of dialysis, left ventricular mass, left ventricular mass index (p > 0.05). Plasma BNP levels were markedly greater in HD patients (467.8 +/- 466.5 pg/ mL) than those of PD patients (143.1 +/- 165.2 pg/mL). Urine output was significantly higher in PD patients compared with HD patients (p < 0.05). A positive correlation between systolic blood pressure, diastolic blood pressure, and plasma BNP in HD patients (r: 0.653, p: 0.001; r: 0.493, p: 0.023, respectively) was detected. Additional studies are needed to investigate whether lower BNP level in PD patients is an advantage
Vascular calcification is not related to serum fetuin-A and osteopontin levels in hemodialysis patients
No full textIntroduction: Vascular calcification (VC) in hemodialysis (HD) patients is a sign of severe cardiovascular disease and can predict cardiovascular outcomes. Fetuin-A and osteopontin (OPN) inhibit VC. Serum fetuin-A levels are lower in patients with end-stage kidney disease (ESKD) and in those who are on chronic HD therapy. However, there are limited data concerning OPN in patients who are on dialysis. The aim of our study was to determine VC in HD patients, the relationship between VC and 25-OH-vitamin D, fetuin-A, and OPN levels, and independent predictors of VC. Materials and methods: Ninety-three patients with ESKD on HD therapy were recruited. Among these patients, 44 were male and 49 were female. The patient group was compared with a group of 20 healthy controls of similar age and sex. A plain radiograph of the hand was taken using a mammography machine for the evaluation of VC. Serum fetuin-A, OPN, and 25-OH-vitamin D levels of both patients and controls were measured. Results: VC was detected in 45 (48.4%) HD patients. When patients were compared with healthy controls, fetuin-A levels (p < 0.029) were significantly lower in patients, whereas OPN (p < 0.000) and VC (p < 0.002) were significantly higher in the patient group. Age [odds ratio (OR) 1.036], the presence of diabetes mellitus (DM) (OR 17.527), and high parathyroid hormone (PTH) levels (OR 1.002) were independent predictors of VC in a logistic regression model including the following factors: age, the presence of DM, HD duration, and serum albumin, phosphate, PTH, 25-OH-vitamin D, fetuin-A, OPN, and calcium levels. No significant correlation was found between patients with VC and patients without VC in terms of fetuin-A, OPN, and 25-OH-vitamin D levels. Conclusions: VC is a frequent sign in patients undergoing HD and is not related to serum fetuin-A and osteopontin levels. Age, the presence of DM, and high PTH levels were independent predictors of VC in patients undergoing HD. Further studies are warranted to understand the mechanism underlying and the factors contributing to VC
The Longitudinal Effect of Impaired Kidney Function on Bone Mineral Density and the Association of Body Composition on Biomarkers of Kidney Function Among Afro-Caribbean Men of West African Ancestry
No full textBackground: Chronic kidney disease (CKD) is a rising global health problem. African Americans bear a greater proportion of CKD burden compared to Caucasians. Little is known about the relationship of CKD with bone loss and body composition distribution with biomarkers of CKD in blacks.
Objective: The prevalence of CKD among Tobago black, African American and Caucasian men, aged 40 years and older were determined and compared. The risk factors of CKD, the association of body composition with biomarkers of CKD and the effect of CKD on longitudinal bone loss were examined among Tobago black males.
Methods: Tobago men were recruited from Tobago Island in 2004-2007. Counterparts from U.S were obtained from the National Health and Nutrition Examination Survey (NHANES) 2003-2006. Standardized serum creatinine, cystatin C and urinary albumin were measured using Jaffè reaction, Dade Behring nephelometer and fluorescent immunoassay respectively. Longitudinal Bone Mineral Density changes in trochanter, femoral neck and total hip from 2004/2007-2012 were measured using Dual X-Ray Absorptiomertry (DXA). Body composition was measured using DXA and Peripheral Quantitative Computed Tomography (PQCT). Covariates were assessed from questionnaires in 2004-2007.
Results: The prevalence of CKD was 19.7%, 23.4% and 19.7% in Tobago black, African American and Caucasian men respectively. Age, hypertension and diabetes were significantly associated with CKD in Tobago men. Lean body mass and calf muscle area were positively associated with serum creatinine. All adiposity measures were positively associated with cystatin C, but not with calf muscle area. There was consistent greater decline in BMD across quartiles of ACR, serum creatinine and cystatin C in trochanter, femoral neck and total hip bones. The rate of bone loss in Tobago men was similar to that in Caucasian men.
Public Health Significance: The biomarkers used for assessing CKD (serum creatinine and cystatin C) are influenced by body composition. Future CKD screening among blacks with high lean or muscle mass should include cystatin C assessment due to the influence of muscle mass on serum creatinine.
CKD is associated with bone loss. Proper management of bone minerals and DXA screenings are necessary in order to reduce bone loss among individuals with CKD
