Background and aims
Malnutrition and inflammation are closely linked to vascular calcification (VC), the severity of which correlate with adverse outcome. However, there were few studies on the interplay between malnutrition, inflammation and VC progression, rather than VC presence per se. We aimed to determine the relationship of malnutrition, inflammation, abdominal aortic calcification (AAC) progression with survival in hemodialysis (HD) patients.
Methods
Malnutrition and inflammation were defined as low serum albumin (< 40 g/L) and high hs-CRP (≥ 28.57 nmol/L), respectively. We defined AAC progression as an increase in AAC score using lateral lumbar radiography at both baseline and one year later. Patients were followed up to investigate the impact of AAC progression on all-cause and cardiovascular mortality.
Results
AAC progressed in 54.6% of 97 patients (mean age 58.2±11.7 years, 41.2% men) at 1-year follow-up. Hypoalbuminemia (Odds ratio 3.296; 95% confidence interval 1.178–9.222), hs-CRP (1.561; 1.038–2.348), low LDL-cholesterol (0.976; 0.955–0.996), and the presence of baseline AAC (10.136; 3.173–32.386) were significant risk factors for AAC progression. During the mean follow-up period of 5.9 years, 38(39.2%) patients died and 27(71.0%) of them died of cardiovascular disease. Multivariate Cox regression analysis adjusted for old age, diabetes, cardiovascular history, and hypoalbuminemia determined that AAC progression was an independent predictor of all-cause mortality (2.294; 1.054–4.994).
Conclusions
Malnutrition and inflammation were significantly associated with AAC progression. AAC progression is more informative than AAC presence at a given time-point as a predictor of all-cause mortality in patients on maintenance HD.
An eco-friendly approach is described for the green synthesis of gold nanoparticles using catechin as a reducing and capping agent. The reaction occurred at room temperature within 1 h without the use of any external energy and an excellent yield (99%) was obtained, as determined by inductively coupled plasma mass spectrometry. Various shapes of gold nanoparticles with an estimated diameter of 16.6 nm were green-synthesized. Notably, the capping of freshly synthesized gold nanoparticles by catechin was clearly visualized with the aid of microscopic techniques, including high-resolution transmission electron microscopy, atomic force microscopy, and field emission scanning electron microscopy. Strong peaks in the X-ray diffraction pattern of the as-prepared gold nanoparticles confirmed their crystalline nature. The catalytic activity of the as-prepared gold nanoparticles was observed in the reduction of 4-nitrophenol to 4-aminophenol in the presence of NaBH4. The results suggest that the newly prepared gold nanoparticles have potential uses in catalysis.
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