Glucose-Based Peritoneal dialysis solution suppresses adiponectin synthesis through oxidative stress in an experimental model of peritoneal dialysis

Huh, Joo Young; Seo, Eun Young; Lee, Hi Bahl; Ha, Hunjoo

doi:10.3747/pdi.2009.00228

Cited by 17 publications

(15 citation statements)

References 43 publications

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“…Two recent studies comparing oxidative stress in various dialysis modalities showed increased levels of advanced oxidation protein products in HD patients compared with PD patients (18,19), and three other studies found similar or lower levels of oxidative stress markers (advanced oxidation protein products, myeloperoxidase, and 8-OHdG) in HD patients than in PD patients (20)(21)(22). Although the HD procedure might induce repetitive bouts of oxidative stress, primarily through dialyzer membrane incompatibility and endotoxin contaminants (28,29), glucose degradation products in glucose-based PD fluids are also thought to increase oxidative stress (30). The marker of oxidative stress used in the present study, 8-OHdG, is freely filtered in the glomeruli, partly reabsorbed in the proximal tubules, and then excreted in urine.…”

Section: Discussionmentioning

confidence: 99%

Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

Watanabe

Qureshi

et al. 2015

Perit Dial Int

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Section: Discussionmentioning

confidence: 99%

Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

Watanabe

Qureshi

et al. 2015

Perit Dial Int

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“…The causes of increased fat mass in patients undergoing PD have not been completely clarified, although intraperitoneal glucose absorption does seem to play a role [ 30 – 32 ]. PD solutions involve glucose overload and can provide up to 500 kcal/day.…”

Section: Discussionmentioning

confidence: 99%

“…However, some studies found an association between increased fat mass and total energy (intake plus absorbed glucose), but not with absorbed glucose [ 27 , 34 ]. Mechanisms other than energy overload generated by glucose may be involved [ 32 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Fat tissue and inflammation in patients undergoing peritoneal dialysis

et al. 2016

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BackgroundBody weight has been increasing in the general population and is an established risk factor for hypertension, diabetes, and all-cause and cardiovascular mortality. Patients undergoing peritoneal dialysis (PD) gain weight, mainly during the first months of treatment. The aim of this study was to assess the relationship between body composition and metabolic and inflammatory status in patients undergoing PD.MethodsThis was a prospective, non-interventional study of prevalent patients receiving PD. Body composition was studied every 3 months using bioelectrical impedance (BCM®). We performed linear regression for each patient, including all BCM® measurements, to calculate annual changes in body composition. Thirty-one patients in our PD unit met the inclusion criteria.ResultsMedian follow-up was 26 (range 17–27) months. Mean increase in weight was 1.8 ± 2.8 kg/year. However, BCM® analysis revealed a mean increase in fat mass of 3.0 ± 3.2 kg/year with a loss of lean mass of 2.3 ± 4.1 kg/year during follow-up. The increase in fat mass was associated with the conicity index, suggesting that increases in fat mass are based mainly on abdominal adipose tissue. Changes in fat mass were directly associated with inflammation parameters such as C-reactive protein (r = 0.382, P = 0.045) and inversely associated with high-density lipoprotein cholesterol (r=−0.50, P = 0.008).ConclusionsFollow-up of weight and body mass index can underestimate the fat mass increase and miss lean mass loss. The increase in fat mass is associated with proinflammatory state and alteration in lipid profile.

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“…Acidic milieu has also been shown to lower circulating ADPN levels through inhibition of ADPN gene transcription in adipocytes [ 31 ]. Furthermore, one PD animal study demonstrated oxidative stress induced by glucose-based solutions may suppress ADPN synthesis through pathological changes in abdominal fat tissue [ 32 ]. In accordance with aforementioned studies and our findings, longer exposure to conventional glucose- or lactate-based solutions might reduce ADPN levels.…”

Section: Discussionmentioning

confidence: 99%

Association of Adiponectin with High-Sensitivity C-Reactive Protein and Clinical Outcomes in Peritoneal Dialysis Patients: A 3.5-Year Follow-Up Study

et al. 2015

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IntroductionAdiponectin (ADPN), one of most abundant fat-derived biologically active substances, plays an important role in anti-atherosclerotic process. There are conflicting results about the impact of ADPN on cardiovascular (CV) outcomes and mortality, particularly in patients undergoing peritoneal dialysis (PD). Moreover, the relationship between ADPN and inflammatory mediators has been seldom explored in this population. Therefore, we examined the relationship between ADPN and longitudinal high-sensitivity C-reactive protein (hs-CRP) changes and investigated whether ADPN or hs-CRP levels could predict CV outcomes and mortality in prevalent PD patients after comprehensive adjustment of possible confounders.MethodsIn this prospective cohort study, 78 PD patients were enrolled and followed from February 2009 to August 2012. During follow-up, CV events and all-cause mortality were recorded.ResultsThe mean baseline ADPN value was 29.46±18.01 μg/ml and duration of PD treatment was 37.76±36.96 months. In multiple linear regression analysis, plasma ADPN levels positively correlated with high-density lipoprotein and negatively associated with hs-CRP, body mass index, D4/D0 glucose, triglyceride, and duration of PD treatment. After stratified by genders, the inverse association between baseline ADPN and hs-CRP was more significant in the female group. The hs-CRP levels were followed up annually and remained significantly lower in the high ADPN group in the first 2 years. Patients were then stratified into two groups according to the median ADPN value (23.8 μg/ml). The results of Kaplan-Meier survival analysis demonstrated less CV events and better survival in high ADPN group. On multivariate Cox regression analysis, only ADPN level (HR: 0.93, 95% CI: 0.88–0.98, p = 0.02), age and history of CV diseases were independent risk factors for future CV events. Furthermore, hs-CRP (HR: 1.11, 95% CI:1.001–1.22, p = 0.04) was identified as independent predictor of all-cause mortality.ConclusionsSerum hs-CRP levels were consistently lower in the high ADPN group during 2-year follow-up. We also demonstrated the importance of ADPN and hs-CRP in predicting CV events and all-cause mortality in PD population during 3.5-year follow-up.

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Glucose-Based Peritoneal dialysis solution suppresses adiponectin synthesis through oxidative stress in an experimental model of peritoneal dialysis

Abstract: Our data suggest that ROS induced by conventional glucose-based PDS may contribute to pathophysiological changes in abdominal fat and downregulate adiponectin secreted from adipocytes during long-term PD.

Cited by 17 publications

References 43 publications

Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

Oxidative Dna Damage and Mortality in Hemodialysis and Peritoneal Dialysis Patients

Fat tissue and inflammation in patients undergoing peritoneal dialysis

Association of Adiponectin with High-Sensitivity C-Reactive Protein and Clinical Outcomes in Peritoneal Dialysis Patients: A 3.5-Year Follow-Up Study

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