Protein-bound Uremic Toxins, Inflammation and Oxidative Stress: A Cross-sectional Study in Stage 3–4 Chronic Kidney Disease

Rossi, Megan; Campbell, Katrina L.; Johnson, David W.; Stanton, Tony; Vesey, David A.; Coombes, Jeff S.; Weston, Kassia S.; Hawley, Carmel M.; McWhinney, Brett; Ungerer, Jacobus P.J.; Isbel, Nicole M.

doi:10.1016/j.arcmed.2014.04.002

Cited by 156 publications

(127 citation statements)

References 45 publications

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“…27 Animal models have demonstrated that uremic toxins such as p-cresyl sulfate (PCS) and indoxyl sulfate (IS) induce proinflammatory cytokine production. 28,29 In addition, recently, Rossi et al 30 have demonstrated that IS and PCS levels were associated with elevated levels of selected inflammatory markers and an antioxidant in 149 predialysis patients with a mean eGFR of 40 ± 9 mL/min/1.73 m 2 . Similarly, we found that there was an association between inflammation and residual renal functions.…”

Section: Discussionmentioning

confidence: 99%

Inflammation is associated to volume status in peritoneal dialysis patients

Ünal¹,

Kavuncuoğlu²,

Duran

et al. 2015

Renal Failure

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Aim: The aim of this study is to investigate whether there is a relationship between inflammation and volume status in patients underwent peritoneal dialysis (PD). Patients and method: This cross-sectional study included 159 PD patients. The median duration of PD was 17 (range, 1-151) months. All patients were examined using bioelectrical impedance analysis to estimate the ratio of extracellular water to total body water (ECW/TBW), which was used to assess their volume status. The patients were categorized as having one of the following three volume statuses: hypervolemic (above +2 SD from the mean, which was obtained from healthy controls), normovolemic (between +2 SD and À2 SD), or hypovolemic (below À2 SD from the mean). Five patients with hypovolemia were excluded from the study. Fifty-six patients were hypervolemic whereas 98 patients were euvolemic. High-sensitive C-reactive protein (hs-CRP) levels were measured to evaluate inflammation in all patients. Results: hs-CRP value levels were significantly higher in hypervolemic patients compared with euvolemic patients [7.1 (3.1-44.0) mg/L vs. 4.3 (3.1-39.6), p: 0.015, respectively]. Left ventricular hypertrophy was more frequent in hypervolemic patients compared with euvolemic patients (53.6% vs. 30.6%, p: 0.004, respectively). ECW/TBW ratio positively correlated with hs-CRP (r: 0.166, p: 0.039). Gender, hs-CRP, and residual Kt/V urea were found to be independent risk factors for hypervolemia in multivariate analysis. Conclusion: Inflammation is associated with hypervolemia in PD patients. Residual renal functions play an important role to maintain euvolemia in PD patients.

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Section: Discussionmentioning

confidence: 99%

Inflammation is associated to volume status in peritoneal dialysis patients

Ünal¹,

Kavuncuoğlu²,

Duran

et al. 2015

Renal Failure

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“…Çalışmanın sonunda serum serbest ve total indoxyl sülfat düzeyleri ile serum IL-6, TNF-α ve IFN-γ arasında; serum serbest ve total p-cresol düzeyleri ile de IL-6 ve arteriyel sertlik markerı olan nabız dalga hızı arasında pozitif ilişki bulunmuştur. Serbest indoxyl sülfat ve p-cresol düzeyleri ile de plazma glutatyon peroksidaz aktivitesi arasında ise negatif ilişki bulunmuştur (59).…”

Section: Kroni̇k Böbrek Hastaliğinda Bağirsak Mi̇krobi̇yotasi Ve üRemi̇k unclassified

Kronik Böbrek Hastalığında Bağırsak Mikrobiyotası ve Diyet Posasının Rolü

Melekoğlu¹,

Samur²

2017

Turk Neph Dial Transpl

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“…Ez a plazma F2-izoprosztán, malondialdehid, különböző urémiás toxinok és oxidált fehérjék mennyiségének emelkedésében mutatkozik meg [14,15]. A megemelkedett oxidatív behatásokról -közöttük az oxidált alacsony sűrűségű lipoprotein (oxLDL) formákról -ismert, hogy elősegítik a vascularis simaizomsejt osteoblastsejtté történő transzdifferenciációját.…”

Section: A Vascularis Kalcifi Káció Egyik Előidézője: Oxidatív Stresszunclassified

Az oxidatív stressz hozzájárul a krónikus vesebetegeket érintő vascularis kalcifikáció kialakulásához

Nyitrai

Balla

2015

Orvosi Hetilap

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A rendszeres dialíziskezelésre szoruló vesebetegek körében a halálozási ok leggyakrabban valamilyen cardiovascularis megbetegedés. A cardiovascularis események egyik előidézője a vascularis kalcifi káció, amelynek kialakulási esélye a krónikus vesebetegek körében extrém magas. A kalcifi káció nemcsak az évtizedek óta dialízisterápiában részesülő idősebb korosztályban jelentkezik, hanem a fi atal korosztályt is érinti. Az érrendszerben megjelenő masszív, nagy kiterjedésű kalcifi káció aktív, jól szabályozott komplex folyamat eredményeként alakul ki. Előidézői között szerepel az oxidatív stressz, amely a beteg szervezetében a vese működési zavara következtében nagymértékben fokozódik. A megemelkedett oxidatív terhelést tovább fokozzák a képződő oxidált LDL-formák, amelyek előidézői az endothelialis diszfunkciónak és az érben található simaizomsejtek csontszerű sejtté történő transzdifferenciációjának. Az oxidált hemoglobinból kiszabaduló szabad hem is képes az LDL oxidációjára és ezzel hozzájárul az atherosclerosis kialakulásához. A hemoxigenáz-1/ferritin rendszer indukciója mérsékli a szabad hem ezen káros hatásait. Orv. Hetil., 2015Hetil., , 156(47), 1926Hetil., -1931 Kulcsszavak: vascularis kalcifi káció, krónikus veseelégtelenség, oxidatív stressz, oxidált LDL Oxidative stress: one of the major causes of vascular calcifi cation in chronic kidney disease patientsThe leading cause of high mortality in dialyzed patients is cardiovascular disease. One of the main contributors of cardiovascular event is vascular calcifi cation, which occurs even in very young patients. Multiple factors and complex mechanisms are involved in the formation of robust vascular calcifi cation which affects a large vascular area observed in chronic kidney diseases. Patients on dialysis are exposed to enhanced oxidative stress as a result of increased prooxidant activity and reduced anti-oxidant systems. The oxidation of lipoprotein particles is implicated in the development of vascular damage representing oxidative threat, which leads to endothelial dysfunction. Moreover, in a prooxidant environment osteoblastic trans-differentiation of smooth muscle cells was shown to occur. Heme derived from oxidized hemoglobin might contribute to the formation of reactive lipid metabolites. This oxidative burden contributes to the development of atherosclerosis and vascular calcifi cation. Heme oxygenase-1 and ferritin may serve as intracellular defense mechanisms against such an insult.Keywords: vascular calcifi cation, renal insuffi ciency, oxidative stress, oxidized LDL Nyitrai, M., Balla, Gy., Balla, J. [Oxidative stress: one of the major causes of vascular calcifi cation in chronic kidney disease patients].

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Protein-bound Uremic Toxins, Inflammation and Oxidative Stress: A Cross-sectional Study in Stage 3–4 Chronic Kidney Disease

Cited by 156 publications

References 45 publications

Inflammation is associated to volume status in peritoneal dialysis patients

Inflammation is associated to volume status in peritoneal dialysis patients

Kronik Böbrek Hastalığında Bağırsak Mikrobiyotası ve Diyet Posasının Rolü

Az oxidatív stressz hozzájárul a krónikus vesebetegeket érintő vascularis kalcifikáció kialakulásához

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