Linkage of hypoalbuminemia, inflammation, and oxidative stress in patients receiving maintenance hemodialysis therapy

Danielski, Michael; İkizler, T. Alp; McMonagle, Ellen; Kane, Jane; Pupim, Lara B.; Morrow, Jason D.; Himmelfarb, Jonathan

doi:10.1016/s0272-6386(03)00653-x

Cited by 160 publications

(129 citation statements)

References 47 publications

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“…A previous study showed that lower albumin was associated with an adjusted risk of 4-year mortality that was 2.1-fold higher than in healthy subjects with higher serum albumin levels who did not have evidence of inflammation 14) . Danielski et al found significantly higher oxidative stress in a hypoalbuminemia group of HD patients than in a normoalbuminemia group 15) . Increased oxidative stress, in turn, may accelerate the atherosclerotic process, and hypoalbuminemia has also been found to be closely associated with endothelial dysfunction in HD patients 16) .…”

Section: Discussionmentioning

confidence: 96%

Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Amemiya

Ogawa

Otsuka

et al. 2011

JAT

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Aim:Although serum albumin and C-reactive protein (CRP) levels and pulse wave velocity (PWV) are known to be associated with the clinical outcome of hemodialysis (HD) patients, it is unknown which of these parameters are more predictive of the long-term mortality of such patients. Methods: We measured biochemical parameters, including serum albumin and CRP, and the PWV of 202 patients on maintenance HD therapy and followed their course for 4 years, and 186 of the patients were enrolled in the current study analyses. We divided the 186 patients into three tertiles according to their serum albumin and CRP levels and PWV values, and conducted multivariate analyses to examine the impact of the tertiles on 4-year mortality. Results: Twenty-three (12.4%) patients died during the follow-up period, and the serum albumin of the group that died was significantly lower than in the group that survived, but the CRP levels and PWV were significantly higher in the group that died. The results of Kaplan-Meier analyses revealed a significantly higher risk of all-cause mortality in HD patients with higher CRP based on the results of Cox proportional hazards analyses; however, the serum albumin and PWV values were not associated with all-cause mortality. Conclusion:The results of this study suggest that serum CRP levels are a better mortality predictor than serum albumin or PWV values of chronic HD patients.

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Section: Discussionmentioning

confidence: 96%

Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Amemiya

Ogawa

Otsuka

et al. 2011

JAT

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“…Glycoxidation products and advanced oxidation protein products show a close relationship with inflammatory markers such as CRP and IL-6 (11)(12)(13). Therefore, the end products of these processes could act as inflammatory markers.…”

Section: Oxidative Stressmentioning

confidence: 99%

Inflammatory Syndrome in Patients on Hemodialysis

Jofre

Rodríguez-Benítez²,

López‐Gómez³

et al. 2006

Journal of the American Society of Nephrology

209

169

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Mortality is markedly elevated in hemodialysis (HD) patients. Between 30 and 50% of prevalent patients have elevated serum levels of inflammatory markers such as C-reactive protein and IL-6. The presence of inflammation, chronic or episodic, has been found to be associated with increased mortality risk. The causes of inflammation are multifactorial and include patient-related factors, such as underlying disease, comorbidity, oxidative stress, infections, obesity, and genetic or immunologic factors, or on the other side, HD-related factors, mainly depending on the membrane biocompatibility and dialysate quality. The adequate knowledge of these causes and their prevention or treatment if possible may contribute to improving the inflammatory state of patients who are on HD and possibly their mortality.

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“…4 In addition, the circulating biomarkers of oxidative stress and chronic inflammatory cytokines such as malondialdehyde (MDA), C-reactive protein (CRP) or interleukin-6 (IL-6) are significantly elevated in maintenance HD patients. 5,6 There is increasing evidence that increased oxidative stress and inflammatory cytokines play a key role in the pathogenesis of malnutrition, 7 resistance to erythropoietin, 8 …”

Section: Introductionmentioning

confidence: 99%

Effects of vitamin E-coated dialysis membranes on anemia, nutrition and dyslipidemia status in hemodialysis patients: a meta-analysis

Huang

et al. 2015

Renal Failure

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Background: This was controversial whether vitamin E-coated dialyzer therapy was beneficial for the complications associated with hemodialysis. Therefore, we performed this systematic review to evaluate the effects of vitamin E-coated dialyzer. Methods: Related trials were searched from multiple electronic databases. We conducted meta-analysis to assess changes in the predefined outcomes using RevMan 5.3 software. Results: Meta-analysis showed vitamin E-coated dialyzer therapy could decrease erythropoietin (EPO) resistance index (SMD, À0.24; 95% CI, À0.47 to À0.01; p ¼ 0.04). However, pooled-analysis showed vitamin E-coated dialyzer therapy could not decrease weekly EPO dose (SMD, À0.11; 95% CI, À0.32 to 0.09; p ¼ 0.28) and intima-media thickness (IMT) of the carotid artery (MD, À0.09; 95% CI, À0.2 to 0.01; p ¼ 0.09), and vitamin E-coated dialyzer therapy did not improve the serum hemoglobin (MD, À0.03; 95% CI, À0.18 to 0.13; p ¼ 0.74), albumin levels (SMD, À0.64; 95% CI, À1.62 to 0.34; p ¼ 0.2), in addition, there was no significant difference in serum cholesterol (SMD, À0.07; 95% CI, À0.45 to 0.31; p ¼ 0.71), triglycerides (MD, À2.77; 95% CI, À32.42 to 26.87; p ¼ 0.85), high density lipoprotein (HDL) (SMD, 0.24; 95% CI, À0.14 to 0.62; p ¼ 0.22) and low density lipoprotein (LDL) (SMD, 0.00; 95% CI, À0.38 to 0.37; p ¼ 0.98) levels. Conclusions: Vitamin E-coated dialyzer may reduce the EPO resistance, but there is no conclusive evidence that vitamin E-coated dialyzer can improve the renal anemia, malnutrition, dyslipidemia and atherosclerosis status in hemodialysis (HD) patients. However, high-quality trials with hard clinical endpoints are required to fully elucidate the clinical value of vitamin E-coated dialyzer therapy.

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Linkage of hypoalbuminemia, inflammation, and oxidative stress in patients receiving maintenance hemodialysis therapy

Cited by 160 publications

References 47 publications

Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Inflammatory Syndrome in Patients on Hemodialysis

Effects of vitamin E-coated dialysis membranes on anemia, nutrition and dyslipidemia status in hemodialysis patients: a meta-analysis

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