Relationship between serum albumin level before initiating haemodialysis and angiographic severity of coronary atherosclerosis in end-stage renal disease patients

Joki, Nobuhiko; Hase, Hiroki; Tanaka, Yuri; Takahashi, Yasunori; Saijyo, Tomokatsu; Ishikawa, H; Inishi, Yoji; Imamura, Yoshihiko; Hara, Hisao; Tsunoda, Taro; Nakamura, Masato

doi:10.1093/ndt/gfl037

Cited by 39 publications

(29 citation statements)

References 29 publications

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“…Kalantar-Zadeh et al [16] showed an association between serum albumin level and CVD in hemodialysis patients and stated that hypoalbuminemia could be a strong predictor of mortality in dialysis patients. Similar results were obtained by Joki et al [17] who demonstrated that patients in predialysis chronic renal failure with carotid plaque had lower serum albumin level and that hypoalbuminemia was an excellent reflection of cardiovascular diseases.…”

Section: Discussionsupporting

confidence: 88%

Relationship Between Asymmetric Dimethylarginine (ADMA) and Atherosclerosis in Chronic Renal Failure Patients

Rashed¹,

Soliman²,

Aun³

et al. 2017

J Nephrol Ther

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Section: Discussionsupporting

confidence: 88%

Relationship Between Asymmetric Dimethylarginine (ADMA) and Atherosclerosis in Chronic Renal Failure Patients

Rashed¹,

Soliman²,

Aun³

et al. 2017

J Nephrol Ther

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“…Recent studies show that hypoalbuminemia may result from inflammation and contribute to morbidity in chronic renal patients, constituting an important predictor of coronary heart disease. [37,38] A possible implication of cystatin C in the inflammation procedure was also seen by the highly significant correlation with CRP. The mechanism that could explain this correlation may be that during vascular injury in HD patients, the increased production of inflammatory CRP and cytokines stimulate the production of elastolytic cysteine proteases.…”

Section: Discussionmentioning

confidence: 91%

Relationship of Serum Cystatin C with C-Reactive Protein and Apolipoprotein A1 in Patients on Hemodialysis

Samouilidou

Grapsa

2008

Renal Failure

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Cystatin C is considered an indicator of acute renal failure and also a risk factor of cardiovascular disease. This study was undertaken to examine the relationship of serum cystatin C with C-reactive protein (CRP), lipids, and lipid-related compounds in patients on hemodialysis (HD). Cystatin C, CRP, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and apolipoprotein A1 and B were analyzed in serum of 30 patients on HD for 118 ± 18 months with low-flux dialyzers, before and after HD. The results were compared with those obtained by 21 healthy individuals (NC). Multiple regression analysis was performed to evaluate the association of cystatin C concentration before HD with clinical and laboratory parameters. The results showed that cystatin C before HD was not associated with age, body mass index (BMI), or duration of HD. However, it was significantly correlated with creatinine (r = 0.435, p = 0.021) and albumin (r = 0.483, p = 0.009) concentrations. Moreover, a highly significant association was shown with logCRP (r = 0.692, p < 0.0001). Among the lipid and lipid-related compounds studied, a significant correlation was found between cystatin C and apolipoprotein A1 concentrations (r = 0.402, p = 0.034). None of those correlations were observed in the NC group. In conclusion, it seems that cystatin C levels before HD are related with CRP, an important inflammatory factor, and also with apolipoprotein A1, which has been proved to accelerate the atherosclerosis process. However more studies are needed to confirm these findings.

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“…As a surrogate marker of the nutritional status and malnutrition, this parameter represents a powerful risk factor for atherosclerotic disease combined with chronic inflammation in patients with CKD 24) . We previously identified a significant inverse relationship between the angiographic severity of coronary atherosclerosis and the BMI values among patients newly treated with hemodialysis 25) . Based on these findings, dyslipidemia, malnutrition and inflammation are potential modifiable factors for retarding the progression of coronary atherosclerosis in patients with conservative CKD.…”

Section: Discussionmentioning

confidence: 99%

Declining Prevalence of Coronary Artery Disease in Incident Dialysis Patients Over the Past Two Decades

Iwasaki

Joki

Tanaka

et al. 2014

JAT

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Aim:The medical management of patients with chronic kidney disease (CKD) has changed within the past 20 years. We speculate that this change has resulted in a decrease in the prevalence of atherosclerotic cardiovascular disease in patients with CKD. The aim of the present study was to analyze changes in the prevalence of coronary artery disease (CAD) in patients newly started on hemodialysis, as well as trends in clinical factors and medications over the past two decades. Methods: This single-center cross-sectional study examined data for 315 consecutive patients starting hemodialysis (age, 64±12 years; men, 73%; diabetic nephropathy, 57%) between January 1993 and December 2010. All patients were routinely screened for CAD within three months of starting hemodialysis, regardless of whether ischemic heart disease was suspected. The patients were categorized into six groups based on the date of the initial dialysis session in order to compare the historical prevalence of unidentified CAD (uCAD) in association with the clinical factors. In addition, we performed a subgroup analysis among 222 patients without known cardiac disease. Results: The prevalence of uCAD gradually declined from 69% to 25% over 18 years (p＜0.001 for trend). The mean high-density lipoprotein cholesterol (HDL-C) concentration increased (p＜0.001 for trend), while the median C-reactive protein (CRP) level decreased over time. In parallel with these trends, the proportion of statin users significantly increased over time (p＜0.001 for trend). The use of erythropoiesis-stimulating agents (ESAs) and renin angiotensin aldosterone system inhibitors (RAS-Is) also increased during the same period (both p＜0.001 for trend). A univariate logistic regression analysis identified a significant association between the prevalence of uCAD and the use of ESAs (OR: 0.565, p= 0.016) or RAS-Is (OR: 0.501, p = 0.004). In addition, a lower BMI, lower HDL-C level and higher CRP level were found to be closely associated with uCAD, independent of confounding variables. The findings for the new dialysis patients without cardiac disease were similar. Conclusions: The prevalence of uCAD in patients with end-stage kidney disease has remarkably decreased over the past two decades. Major improvements in the medical management of CKD may modify the prevalence of coronary atherosclerosis. J Atheroscler Thromb, 2014; 21:593-604.

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Relationship between serum albumin level before initiating haemodialysis and angiographic severity of coronary atherosclerosis in end-stage renal disease patients

Abstract: Hypoalbuminaemia at the initiation of dialysis is an important predictor of advanced CAD, particularly in male and in diabetic patients. It may reflect mainly a state of inflammation. However, malnutrition as a confounding factor cannot be entirely excluded.

Cited by 39 publications

References 29 publications

Relationship Between Asymmetric Dimethylarginine (ADMA) and Atherosclerosis in Chronic Renal Failure Patients

Relationship Between Asymmetric Dimethylarginine (ADMA) and Atherosclerosis in Chronic Renal Failure Patients

Relationship of Serum Cystatin C with C-Reactive Protein and Apolipoprotein A1 in Patients on Hemodialysis

Declining Prevalence of Coronary Artery Disease in Incident Dialysis Patients Over the Past Two Decades

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