The Relationship of Residual Renal Function with Cardiovascular Morbidity in Hemodialysis Patients and the Potential Role of Monocyte Chemoattractant Protein-1

Raikou, Vaia D; Kardalinos, Vasilios; Kyriaki, Despina

doi:10.1159/000484603

Cited by 9 publications

(11 citation statements)

References 40 publications

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“…The fact that only HFD effectively clears active MMP-9 might suggest that HFD is more efficient than OL-HDF; however, pre-dialysis active MMP-9 was significantly lower in the OL-HDF group than in HFD patients, indicating that the levels of active MMP-9 are better controlled in patients under OL-HDF. Moreover, residual renal function is associated with lower inflammation in OL-HDF [37,38]. Supporting this, we also observed that active MMP-9 is lower in patients with greater interdialytic urine volume, which is superior to eGFR as an estimate of residual renal function in dialysis [28].…”

Section: Discussionsupporting

confidence: 81%

Variations in Circulating Active MMP-9 Levels during Renal Replacement Therapy

et al. 2020

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Renal replacement therapy (RRT) is complicated by a chronic state of inflammation and a high mortality risk. However, different RRT modalities can have a selective impact on markers of inflammation and oxidative stress. We evaluated the levels of active matrix metalloproteinase (MMP)-9 in patients undergoing two types of dialysis (high-flux dialysis (HFD) and on-line hemodiafiltration (OL-HDF)) and in kidney transplantation (KT) recipients. Active MMP-9 was measured by zymography and ELISA before (pre-) and after (post-) one dialysis session, and at baseline and follow-up (7 and 14 days, and 1, 3, 6, and 12 months) after KT. Active MMP-9 decreased post-dialysis only in HFD patients, while the levels in OL-HDF patients were already lower before dialysis. Active MMP-9 increased at 7 and 14 days post-KT and was restored to baseline levels three months post-KT, coinciding with an improvement in renal function and plasma creatinine. Active MMP-9 correlated with pulse pressure as an indicator of arterial stiffness both in dialysis patients and KT recipients. In conclusion, active MMP-9 is better controlled in OL-HDF than in HFD and is restored to baseline levels along with stabilization of renal parameters after KT. Active MMP-9 might act as a biomarker of arterial stiffness in RRT.

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Section: Discussionsupporting

confidence: 81%

Variations in Circulating Active MMP-9 Levels during Renal Replacement Therapy

et al. 2020

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“…However, it has been suggested that mediators other than endothelin-1 may be responsible for increased intradialytic vascular resistance [ 9 ]. Our recent previous study showed that the loss of residual renal function related to fluid overload was associated with cardiovascular outcomes in dialysis patients, due additionally to the coexistence of increased levels of monocyte chemoattractant protein-1 (MCP-1), a chemokine, which may reflect a progressive inflammation/oxidative stress condition [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Arterial stiffness was measured as carotid-femoral pulse wave velocity (c-fPWV) and carotid augmentation index (AIx) using the SphygmoCor System® (AtCor Medical Pty. Ltd., Sydney, Australia) according to the manufacturer's specifications [ 14 ]. In each subject, two sequences of measurements were performed, and their mean was used for statistical analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Blood samples were obtained just before the start of the mean weekly dialysis session in a twelve-hour fasting state from the vascular access of enrolled subjects and serum was separated and processed for various assays. At the end of the session, blood samples was drawn at 2 min after dialysis from the arterial dialysis tubing after the reduction of blood pump speed to less than 80 ml/min in order for the dose of dialysis session to be calculated using sp Kt / V for urea [ 14 ]. The mean of 12 calculations for sp Kt / V for urea per dialysis session during a treatment month was used for statistical analysis.…”

Section: Methodsmentioning

confidence: 99%

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The Association between Intradialytic Hypertension and Metabolic Disorders in End Stage Renal Disease

Raikou

Kyriaki

2018

International Journal of Hypertension

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Background Intradialytic hypertension was associated with a high mortality risk. We examined the relationship between intradialytic hypertension and metabolic disorders in hemodialysis treatment patients. Methods We studied 76 patients in online hemodiafiltration. Dialysis adequacy was defined by Kt/V for urea. Normalized protein catabolic rate (nPCR), as a marker of protein intake, was calculated. Sodium removal was determined as percent sodium removal. Metabolic acidosis was determined by serum bicarbonate less than 22 mmol/L. Interdialytic urine volume more than 100 ml was recorded. Intradialytic hypertension was defined by an increase in systolic blood pressure equal to 10 mmHg from pre- to posthemodialysis. Arterial stiffness was assessed as carotid-femoral pulse wave velocity (c-fPWV) and carotid augmentation index (AIx). Chi-square tests and logistic regression analysis were applied for intradialytic hypertension prediction. Results Patients with intradialytic hypertension were older and had significantly lower hemoglobin, nPCR, urine output, and serum bicarbonate and significantly higher c-fPWV, though similar Kt/V for urea, than patients without intradialytic hypertension. They also had increased sodium removal and pulse pressure related to less urine output. Serum bicarbonate was inversely associated with c-fPWV (r = −0.377, p = 0.001). Chi-square test showed significant association between intradialytic hypertension and serum bicarbonate < 22 mmol/L (x2 = 5.6, p = 0.01), which was supported by an adjusted model. Conclusion The intradialytic hypertension was significantly associated with metabolic disorders including malnutrition/inflammation and uncontrolled metabolic acidosis in hemodialysis treatment patients. Severe metabolic acidosis may reflect sodium imbalance and hemodynamic instability of these patients resulting in volume overload and increased vascular resistance.

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“…In a study conducted by Raikou VD showed the similar significant higher level of diastolic dysfunction, LVH but non-significant higher level of systolic dysfunction between without preserved RRF and preserved RRFgroup. [14][15][16][17] Mean age was similar in the two group (43.22±16.93 vs 41.95±15.35, p=0.74). Highest of patients were in age group <30 years and ˃60 years.…”

Section: Discussionmentioning

confidence: 79%

The Relationship of Residual Renal Function with Cardiovascular Morbidity in Twice Weekly and Thrice Weekly Hemodialysis Patient

Rr¹

2020

TUNR

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Background: Chronic kidney disease is a non-communicable global problem. In patients of chronic kidney disease especially in Hemodialysis patient mortality and morbidity due to atherosclerosis induced cardiovascular complications is very high despite the advances of Hemodialysis procedure. Residual renal function contributes significantly to the overall health and cardiovascular morbidity of dialysis patients. So, the loss of residual renal function, especially in patients on Hemodialysis, is a powerful predictor of mortality. Preserving residual renal function is the goal of nephrologists. Objective: To find the association between residual renal function and cardiovascular morbidity in twice weekly and thrice weekly Hemodialysis patient. Methodology: This cross sectional study was conducted on 72 Hemodialysis patients received dialysis more than three months in the dialysis centre of BSMMU and DMCH, Dhaka, Bangladesh during the period of October 2018 to September 2019. Study populations were divided into two groups on the basis of residual renal function (RRF). RRF was defined by interdialytic 24 hours urine volume and average of urinary urea and creatinine clearance. Preserved RRF was defined 24 hours urine volume more than 100ml. Chi-square test (χ2), Student’s paired t-test and multiple regression analysis were used to find association between cardiovascular morbidity and RRF. Result: A significant difference of diastolic dysfunction, systolic dysfunction, LVH (p=0.001, p=0.001, p=0.004 respectively) was seen in between preserved RRF and without preserved RRF group but the difference of regional wall motion abnormality and valvular heart disease was found to be non-significant. In regression analysis, loss of RRF was found to be a significant predictor of cardiovascular morbidity. Conclusion: Preserved RRF was significantly associated with less frequent diastolic dysfunction, left ventricular hypertrophy and higher level of left ventricular ejection fraction compared to without preserved residual renal function in both twice weekly and thrice weekly HD patient.

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The Relationship of Residual Renal Function with Cardiovascular Morbidity in Hemodialysis Patients and the Potential Role of Monocyte Chemoattractant Protein-1

Cited by 9 publications

References 40 publications

Variations in Circulating Active MMP-9 Levels during Renal Replacement Therapy

Variations in Circulating Active MMP-9 Levels during Renal Replacement Therapy

The Association between Intradialytic Hypertension and Metabolic Disorders in End Stage Renal Disease

The Relationship of Residual Renal Function with Cardiovascular Morbidity in Twice Weekly and Thrice Weekly Hemodialysis Patient

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