Adipokines, endothelial dysfunction and nutritional status in peritoneal dialysis patients

Małgorzewicz, Sylwia; Lichodziejewska‐Niemierko, Monika; Aleksandrowicz−Wrona, Ewa; Świetlik, Dariusz; Rutkowski, Bolesław; Łysiak−Szydłowska, Wiesława

doi:10.3109/00365599.2010.504191

Cited by 7 publications

(10 citation statements)

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“…The metabolic pathway of leptin is through glomerulus filtration, followed by degradation within the renal tubules; thus, a high serum level of leptin is often observed in kidney disease patients (51). Elevated serum leptin levels may cause weight loss, malnutrition and anorexia, which can deteriorate the symptoms of kidney disease patients and are detrimental for the long-term survival of patients (36,52). PD, as a first-choice RRT, uses the peritoneum as a dialysis membrane, and is a safe and gentle method to correct metabolic and electrolytic disturbances generated in kidney diseases, including the clearance of leptin (53).…”

Section: Discussionmentioning

confidence: 99%

Association between serum leptin levels and peritoneal dialysis: A meta-analysis

Jiang

Song

Feng

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. There is limited information available with regard to the association between serum leptin levels, or other adipokines, and serum lipid levels and insulin sensitivity in patients undergoing peritoneal dialysis (PD). Thus, the aim of the present study was to perform a meta-analysis investigating this association. Potential relevant studies were identified through searching the following databases: MEDLINE, Science Citation Index, Cochrane Library, PubMed, Embase, CINAHL, Chinese Biomedical, Chinese Journal Full-Text and Weipu Journal. Statistical analyses were calculated using version 12.0 STATA software. In total, 21 case-control studies comprising 1,187 subjects (574 patients and 613 controls) were collected for the meta-analysis. The results identified a statistically significant difference in the serum levels of leptin when comparing the PD patients with the healthy controls [controls vs. cases, standardized mean difference (SMD), 2.09; 95% confidence interval (CI), 1.58-2.59; P<0.001]. Furthermore, ethnicity-subgroup analysis indicated that the PD patients of Asian and Caucasian populations were associated with increased serum levels of leptin (Asian population, SMD, 2.05; 95% CI, 1.48-2.62; P<0.001; Caucasian population, SMD, 2.19; 95% CI, 1.19-3.18; P<0.001). Therefore, serum leptin levels may be used as a prognostic marker for PD.

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Section: Discussionmentioning

confidence: 99%

Association between serum leptin levels and peritoneal dialysis: A meta-analysis

Jiang

Song

Feng

et al. 2015

Experimental and Therapeutic Medicine

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“…Although both HD and PD have been established and successful therapies for the treatment of patients with end-stage renal disease (ESRD) have been developed, the mortality rate of dialysis subjects remains unacceptably high. Apart from the traditional risk factors, there are the specific non-traditional ones, such as inflammation, oxidative stress, and endothelial dysfunction that seem to be the major culprits (Malgorzewicz et al, 2010). As stated above, they are also strongly associated with PEW.…”

Section: Introductionmentioning

confidence: 98%

Nutritional predictors of mortality in prevalent peritoneal dialysis patients.

et al. 2016

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Malnutrition remains one of the major predictors of mortality in peritoneal dialysis (PD) patients. The aim of the study was to evaluate the nutritional status of prevalent PD patients, and to determine the best predictors of outcome among anthropometric and laboratory indices of nutrition. The study included 106 prevalent PD patients from a single university-based unit. Anthropometric assessment at baseline included: body mass, body mass index (BMI), skinfold thickness, lean body mass (LBM), content of body fat (%F), mid-arm muscle circumference (MAMC). Laboratory analysis comprised of albumin and total cholesterol. Additionally, each patient underwent a subjective global assessment (SGA). The patients were followed for 36 months. Survival analyses were made with the Kaplan-Meier survival curve and the Cox proportional hazard model. Following SGA, malnutrition was diagnosed in 30 (28%) patients. Importantly, eight of the malnourished patients (27%) were nevertheless overweight or obese. Body weight and BMI showed complete lack of association with the outcome. In Kaplan-Meier analysis low: LBM, MAMC, albumin and cholesterol were significantly related to mortality. Cox analysis revealed that, following adjustment, LBM below median was independently associated with poor outcome (hazard ratio [HR] 3.15, 95% confidence interval [CI] 1.17-8.49, p=0.02). Moreover, the lowest quartile of total cholesterol showed independent association with mortality (HR 8.68, CI 2.14-35.21, p<0.01). Malnutrition is prevalent in patients undergoing PD, and overweight/obesity does not preclude its appearance. The most valuable nutritional indices in predicting outcome in this cohort were LBM and total cholesterol concentration.

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“…[15][16][17] There have been few studies of the relationship between adiponectin and the nutritional status of dialysis patients. 18,19 Although one study showed that increased levels of adiponectin are associated with a worse nutritional-inflammatory status in peritoneal dialysis patients, this correlation was not observed in hemodialysis patients. 19 Therefore, we hypothesized that elevated serum adiponectin levels are related to the nutritional status of hemodialysis patients.…”

Section: Introductionmentioning

confidence: 99%

The Association between Serum Adiponectin Levels and Nutritional Status of Hemodialysis Patients

2011

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Adiponectin plays an important role in the regulation of body weight, insulin sensitivity, lipid metabolism, and the inflammatory response. Adiponectin is elevated in hemodialysis patients. We investigated the association between altered serum adiponectin levels and the nutritional-inflammation status of hemodialysis patients. Forty-four hemodialysis patients (21 men and 23 women; mean age 53.9 ± 9.2 years) were enrolled and 32 healthy volunteers were included as the control group. Serum adiponectin was measured using a commercial radioimmunoassay kit. Serum albumin, cholesterol, triglyceride, high-sensitivity C-reactive protein, urea, creatinine, transferrin, lean body mass, fat mass, body mass index (BMI), the subjective global assessment (SGA) score, and the malnutrition-inflammation score (MIS) were measured in all patients. Adiponectin levels were significantly elevated in the hemodialysis patients compared with the healthy subjects (24.8 ± 10.4 µg/mL and 6.8 ± 4.2 µg/mL, respectively, p < 0.0001). Serum adiponectin correlated positively with SGA (r = 0.47) and MIS (r = 0.38), and negatively with BMI (r = −0.34), triglyceride (r = −0.53), and glucose levels (r = −0.42). Serum adiponectin levels were significantly higher in malnourished patients than in well-nourished patients when assessed with SGA (20.5 ± 10.4 µg/mL and 29.0 ± 8.7 µg/mL, respectively, p = 0.005). In conclusion, serum adiponectin levels reflect the nutritional-inflammation status of hemodialysis patients. Adiponectin may also be associated with insulin resistance, dyslipidemia, and the inflammatory response in these patients.

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Adipokines, endothelial dysfunction and nutritional status in peritoneal dialysis patients

Abstract: The nutritional status of lean and overweight patients was comparable. Signs of malnutrition were detected in both groups. The severity of chronic inflammation and oxidative stress were not related to BMI in PD patients.

Cited by 7 publications

References 20 publications

Association between serum leptin levels and peritoneal dialysis: A meta-analysis

Association between serum leptin levels and peritoneal dialysis: A meta-analysis

Nutritional predictors of mortality in prevalent peritoneal dialysis patients.

The Association between Serum Adiponectin Levels and Nutritional Status of Hemodialysis Patients

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