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Meléndez-Oliva E, Sánchez-Romero EA, Segura-Ortí E, Gil-Gómez JA, Soto-Goñi XA, Poveda-Pagán EJ. Effect of a Virtual Reality Exercise on Patients Undergoing Haemodialysis: A Randomised Controlled Clinical Trial Research Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4116. [PMID: 36901125 PMCID: PMC10002015 DOI: 10.3390/ijerph20054116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
High levels of inflammatory markers have been associated with a greater deterioration of renal function and cardiovascular morbidity and mortality. For its part, physical exercise has been shown to be beneficial in improving the functional, psychological, and inflammatory states of patients with chronic kidney failure (CKF) undergoing haemodialysis (HD) treatment, improving their health-related quality of life. In recent years, virtual reality (VR) has been studied and described as an effective and safe tool that improves patients' adherence to exercise programs. For these reasons, we propose to analyse the effect of VR exercise on the functional, psychological, and inflammatory states of patients on HD, as well as their levels of adherence to exercise, and compare them with static pedalling exercises. We will randomise 80 patients with CKF into two blind groups: an experimental group, which will carry out an intradialytic exercise program with non-immersive VR (n = 40), and a control group, which will exercise with a static pedal (n = 40). Functional capacity, inflammatory and phycological status, and exercise adherence will be analysed. Higher levels of adherence to exercise are expected in the VR group, which will have greater effects on the patients' functional capacity and psychological and inflammatory status.
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Affiliation(s)
- Erika Meléndez-Oliva
- Center for Translational Research in Physiotherapy, Miguel Hernández University, San Juan, 03550 Alicante, Spain
| | - Eleuterio A. Sánchez-Romero
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, European University of Madrid, 28670 Madrid, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Xabier A. Soto-Goñi
- Department of Psychobiology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Emilio J. Poveda-Pagán
- Center for Translational Research in Physiotherapy, Miguel Hernández University, San Juan, 03550 Alicante, Spain
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Xiong J, Qiao Y, Yu Z, Huang Y, Yang K, He T, Zhao J. T-Lymphocyte Subsets Alteration, Infection and Renal Outcome in Advanced Chronic Kidney Disease. Front Med (Lausanne) 2021; 8:742419. [PMID: 34568395 PMCID: PMC8458643 DOI: 10.3389/fmed.2021.742419] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/17/2021] [Indexed: 12/21/2022] Open
Abstract
Background: T-lymphocyte subsets reflect patients' immune status and are associated with adverse outcomes in various diseases. However, the association between T-lymphocyte subsets and major infection and renal outcome in chronic kidney disease (CKD) patients has not been well-addressed. Methods: Patients diagnosed with stage 3–5 of non-dialysis CKD were recruited, and healthy subjects were selected as the controls. T-lymphocyte subsets (CD3+, CD4+, CD8+) were detected by flow cytometry, and the CD4+/CD8+ T cell ratio was then calculated. Patients were divided into the normal-level group and the low-level group according to the clinical reference value. The primary outcomes were the major infection and renal outcome. Results: A total of 410 CKD patients were enrolled; the average age was 47.25 years. Compared to the healthy controls, the level of CD3+, CD4+, CD8+ T cells, and the CD4+/CD8+ T cell ratio were significantly decreased in CKD patients (p < 0.05). During the median follow-up of 2.56 (quartile interval 1.24–3.46) years, major infections occurred in 15.10% of the CKD patients. The incidence of infection was significantly higher in the low-level group of CD3+, CD4+ T cells, and CD4+/CD8+ T cell ratio compared with the normal level groups. Kaplan-Meier analysis showed that the lower level of CD3+, CD4+ T cells, and CD4+/CD8+T cell ratio is associated with a greater risk of infection. Cox regression analysis further confirmed that low CD3+, CD4+ T cells, and CD4+/CD8+ T cell ratio were independent risk factors of infection in CKD patients. Moreover, during the follow-up, renal events occurred in 37.50% of patients. Kaplan-Meier analysis indicated that low levels of CD3+, CD4+, and CD8+ T cells are significantly associated with renal outcome in CKD patients. Cox regression analysis showed that low level of CD3+ T cells (HR = 2.407, 95% CI: 1.664–3.482, p < 0.001), CD4+ T cells (HR = 2.397, 95% CI: 1.633–3.518, p < 0.001) and CD8+ T cells (HR = 2.416, 95% CI: 1.476–3.955, p < 0.001) were independent risk factors for renal outcome after multivariable-adjusted. Conclusion: CKD patients had a defect in T-lymphocyte subpopulation. T-lymphocyte subsets were closely associated with infection and renal outcome in CKD patients. Suggesting T-lymphocyte subsets are independent predictors of infection and renal outcome in CKD patients.
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Affiliation(s)
- Jiachuan Xiong
- The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Department of Nephrology, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yu Qiao
- The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Department of Nephrology, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhikai Yu
- The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Department of Nephrology, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yinghui Huang
- The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Department of Nephrology, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ke Yang
- The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Department of Nephrology, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ting He
- The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Department of Nephrology, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinghong Zhao
- The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Department of Nephrology, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Zou G, Gao H. The relationship between neutrophil-lymphocyte ratio and early renal fibrosis and renal prognosis in patients with lupus nephritis. Am J Transl Res 2021; 13:1710-1716. [PMID: 33841693 PMCID: PMC8014417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the relationship between neutrophil-lymphocyte ratio (NLR) and early renal fibrosis and renal prognosis in patients with lupus nephritis. METHODS A total of 186 patients with lupus nephritis admitted to our hospital were enrolled and grouped according to the standard of "NLR=3.175". There were 90 patients in the higher NLR group and 96 patients in the lower NLR group. The correlation and independent relationship between NLR/estimated glomerular filtration rate (eGFR) and pathological indicators were explored by comparing the differences of physiological indicators between the two groups. The correlation between NLR/eGFR and renal insufficiency and renal prognosis were explored. RESULTS The higher NLR group showed increased levels of hs-CRP, white blood cells, neutrophils, platelets, PLR values, eGFR, D-dimer, crescent compared with the lower NLR group, while lymphocyte count in the higher NLR group was lower than that in the lower NLR group. Platelets, neutrophils, white blood cells, serum anhydride, serum C4 and vascular cellulose had positive correlations with NLR. eGFR, age, systolic blood pressure, diastolic blood pressure, neutrophils, leukocytes, NLR, blood uric acid, triglycerides, crescent ratio, endothelial hyperplasia, spherical sclerosis ratio, intraglomerular leukocyte infiltration, platinum loop, microthrombus, nuclear fragmentation, interstitial inflammatory cell infiltration, renal tubular atrophy, interstitial fibrosis, and mesangial cell showed negative correlation with matrix hyperplasia, arteriolar wall thickening and pathological activity scores, but showed positive correlation with hemoglobin and low-density lipoprotein. CONCLUSION NLR affects some important renal functions to a certain extent and is not the only risk factor for renal prognosis in patients with LN.
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Affiliation(s)
- Guming Zou
- Department of Nephrology, China-Japan Friendship Hospital Beijing 100029, China
| | - Hongmei Gao
- Department of Nephrology, China-Japan Friendship Hospital Beijing 100029, China
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Yang PS, Liu CL, Liu TP, Chen HH, Wu CJ, Cheng SP. Parathyroidectomy decreases neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios. J Surg Res 2018; 224:169-175. [PMID: 29506836 DOI: 10.1016/j.jss.2017.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/19/2017] [Accepted: 12/13/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Systemic inflammation has been implicated in complications and heightened mortality of patients with secondary hyperparathyroidism. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are widely available surrogate markers of inflammation. This study sought to delineate the changes in NLR and PLR after parathyroidectomy. METHODS A total of 213 patients undergoing initial parathyroidectomy from 2010 to 2015 for secondary hyperparathyroidism were identified from a prospectively maintained clinical database. Among 183 patients free of persistent or recurrent disease, follow-up NLR and PLR were available for analysis in 85 patients. RESULTS In the whole study population, the baseline NLR was positively correlated with male sex, total white blood cell count, height, serum phosphorus, and calcium-phosphorus product levels. The baseline PLR was positively correlated with platelet count, serum phosphorus, and calcium-phosphorus product levels and negatively associated with patient age. Postoperative parathyroid hormone levels were positively correlated with NLR and PLR at follow-up. For patients who had successful parathyroidectomy, there was a decrease in NLR (P = 0.0006), PLR (P = 0.0003), and platelet count (P = 0.033), whereas hemoglobin significantly increased (P = 0.0002) after surgery. Those with persistent or recurrent hyperparathyroidism had no change in NLR, PLR, hemoglobin, total white blood cell, or platelet count. CONCLUSIONS Successful parathyroidectomy is associated with a decrease in NLR and PLR. The modulatory effects of parathyroidectomy on systemic inflammation may partially explain the benefits of surgery in secondary hyperparathyroidism.
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Affiliation(s)
- Po-Sheng Yang
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Chien-Liang Liu
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Tsang-Pai Liu
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Han-Hsiang Chen
- Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Chih-Jen Wu
- Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Department of Pharmacology, Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan
| | - Shih-Ping Cheng
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Department of Pharmacology, Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan.
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Zhang W, Wang L, Chen Y, Tang F, Xue F, Zhang C. Identification of Hypertension Predictors and Application to Hypertension Prediction in an Urban Han Chinese Population: A Longitudinal Study, 2005-2010. Prev Chronic Dis 2015; 12:E184. [PMID: 26513440 PMCID: PMC4663898 DOI: 10.5888/pcd12.150192] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction Research suggests that targeting high-risk, nonhypertensive patients for preventive intervention may delay the onset of hypertension. We aimed to develop a biomarker-based risk prediction model for assessing hypertension risk in an urban Han Chinese population. Methods We analyzed data from 26,496 people with hypertension to extract factors from 11 check-up biomarkers. Then, depending on a 5-year follow-up cohort, a Cox model for predicting hypertension development was built by using extracted factors as predictors. Finally, we created a hypertension synthetic predictor (HSP) by weighting each factor with its risk for hypertension to develop a risk assessment matrix. Results After factor analysis, 5 risk factors were extracted from data for both men and women. After a 5-year follow-up, the cohort of participants had an area under receiver operating characteristic curve (area under the curve [AUC]) with an odds ratio (OR) of 0.755 (95% confidence interval [CI], 0.746–0.763) for men and an OR of 0.801 (95% CI, 0.792–0.810) for women. After tenfold cross validation, the AUC was still high, with 0.755 (95% CI, 0.746–0.763) for men and 0.800 (95% CI, 0.791–0.810) for women. An HSP-based 5-year risk matrix provided a convenient tool for risk appraisal. Conclusion Hypertension could be explained by 5 factors in a population sample of Chinese urban Han. The HSP may be useful in predicting hypertension.
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Affiliation(s)
- Wenchao Zhang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Linping Wang
- Health Management Center, Shandong Provincial QianFoShan Hospital, Jinan, China
| | - Yafei Chen
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Fang Tang
- Health Management Center, Shandong Provincial QianFoShan Hospital, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China>
| | - Chengqi Zhang
- Health Management Center, Shandong Provincial QianFoShan Hospital, Jinan 250014, China.
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Lee AT, Wang YY, Lin SY, Liang JT, Sheu WHH, Song YM, Chang WD. Higher serum total bilirubin concentration is associated with lower risk of renal insufficiency in an adult population. Int J Clin Exp Med 2015; 8:19212-19222. [PMID: 26770557 PMCID: PMC4694457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 08/01/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Chronic inflammation is proposed to play a central role in the pathogenesis of chronic kidney disease (CKD), and serum bilirubin has antioxidant and anti-inflammatory effects. We investigated the association between serum total bilirubin (Tb) concentration and renal function in an adult population. METHODS We conducted a cross-sectional study and collected anthropometric measurements, fasting blood tests, lifestyle habits and medical history of 3876 subjects attending a health examination. Renal insufficiency was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) calculated by using the CKD-EPI equation. RESULTS Serum Tb concentrations were higher in subjects without renal insufficiency than in those with renal insufficiency. Multivariable linear regression analysis showed that Tb concentration was positively associated with eGFR after adjusting for important CKD risk factors (P=0.04). Multivariable logistic regression analysis also revealed that higher Tb concentration (each increment of 1.71 μmol/L) (0.1 mg/dL) was associated with a reduced risk of renal insufficiency: odds ratios were 0.94 (P=0.005) for men and 0.90 (P=0.015) for women, respectively. When subjects were divided into quartiles of serum Tb, multivariable-adjusted odds ratios for renal insufficiency comparing the fourth to the first Tb quartile were 0.49 (P=0.001) for men and 0.35 (P=0.003) for women. A stepwise exclusion of subjects, first those with possible liver disease and second, those with CKD stage 4 and 5, showed consistent results. CONCLUSION Higher serum Tb concentration was associated with lower risk of renal insufficiency, regardless of other conventional CKD risk factors.
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Affiliation(s)
- Ang-Tse Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General HospitalTaichung, Taiwan
| | - Ya-Yu Wang
- Department of Family Medicine, Taichung Veterans General HospitalTaichung, Taiwan
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing UniversityTaichung, Taiwan
- School of Medicine, National Yang Ming UniversityTaipei, Taiwan
| | - Shih-Yi Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General HospitalTaichung, Taiwan
- School of Medicine, National Yang Ming UniversityTaipei, Taiwan
- Center for Geriatrics and Gerontology, Taichung Veterans General HospitalTaichung, Taiwan
| | - Jiin-Tsae Liang
- Division of Biochemistry, Department of Pathology and Laboratory Medicine, Taichung Veterans General HospitalTaichung, Taiwan
| | - Wayne Huey-Herng Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General HospitalTaichung, Taiwan
- School of Medicine, National Yang Ming UniversityTaipei, Taiwan
- School of Medicine, National Defense Medical CenterTaipei, Taiwan
| | - Yuh-Min Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General HospitalTaichung, Taiwan
| | - Wen-Dau Chang
- Department of Family Medicine, Taichung Veterans General HospitalTaichung, Taiwan
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Micanovic R, Chitteti BR, Dagher PC, Srour EF, Khan S, Hato T, Lyle A, Tong Y, Wu XR, El-Achkar TM. Tamm-Horsfall Protein Regulates Granulopoiesis and Systemic Neutrophil Homeostasis. J Am Soc Nephrol 2015; 26:2172-82. [PMID: 25556169 DOI: 10.1681/asn.2014070664] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 10/30/2014] [Indexed: 12/16/2022] Open
Abstract
Tamm-Horsfall protein (THP) is a glycoprotein uniquely expressed in the kidney. We recently showed an important role for THP in mediating tubular cross-talk in the outer medulla and in suppressing neutrophil infiltration after kidney injury. However, it remains unclear whether THP has a broader role in neutrophil homeostasis. In this study, we show that THP deficiency in mice increases the number of neutrophils, not only in the kidney but also in the circulation and in the liver, through enhanced granulopoiesis in the bone marrow. Using multiplex ELISA, we identified IL-17 as a key granulopoietic cytokine specifically upregulated in the kidneys but not in the liver of THP(-/-) mice. Indeed, neutralization of IL-17 in THP(-/-) mice completely reversed the systemic neutrophilia. Furthermore, IL-23 was also elevated in THP(-/-) kidneys. We performed real-time PCR on laser microdissected tubular segments and FACS-sorted renal immune cells and identified the S3 proximal segments, but not renal macrophages, as a major source of increased IL-23 synthesis. In conclusion, we show that THP deficiency stimulates proximal epithelial activation of the IL-23/IL-17 axis and systemic neutrophilia. Our findings provide evidence that the kidney epithelium in the outer medulla can regulate granulopoiesis. When this novel function is added to its known role in erythropoiesis, the kidney emerges as an important regulator of the hematopoietic system.
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Affiliation(s)
| | - Brahmananda R Chitteti
- Hematology, Microbiology, and Immunology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Edward F Srour
- Hematology, Microbiology, and Immunology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | | | | | - Yan Tong
- Divisions of Nephrology and Hematology, Microbiology, and Immunology, Indiana University School of Medicine, Indianapolis, Indiana; Department of Biostatistics, Indiana University Schools of Medicine and Public Health, Indianapolis, Indiana; Departments of Urology and Pathology, New York University School of Medicine and Veterans Affairs New York Harbor Healthcare System Manhattan Campus, New York, New York; and Roudebush Indianapolis Veterans Affairs Medical Center, Indianapolis, Indiana
| | - Xue-Ru Wu
- Departments of Urology and Pathology, New York University School of Medicine and Veterans Affairs New York Harbor Healthcare System Manhattan Campus, New York, New York; and
| | - Tarek M El-Achkar
- Divisions of Nephrology and Roudebush Indianapolis Veterans Affairs Medical Center, Indianapolis, Indiana
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Results from the Atherosclerosis Risk in Communities study suggest that low serum magnesium is associated with incident kidney disease. Kidney Int 2014; 87:820-7. [PMID: 25272232 PMCID: PMC4382401 DOI: 10.1038/ki.2014.331] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 08/01/2014] [Accepted: 08/14/2014] [Indexed: 12/15/2022]
Abstract
Low serum magnesium has been associated with kidney function decline in persons with diabetes as well as cardiovascular disease in the general population. Since the association of serum magnesium with incident kidney disease in the general population is unknown, we assessed this in 13,226 participants (aged 45 to 65) in the Atherosclerosis Risk in Communities study with baseline estimated glomerular filtration rate of at least 60 ml/min/1.73m2 in years 1987–89 and followed through 2010. The risks for incident chronic kidney disease (CKD) and end-stage renal disease (ESRD) associated with baseline total serum magnesium levels were evaluated using Cox regression. There were 1,965 CKD and 208 ESRD events during a median follow-up of 21 years. In adjusted analysis, low serum magnesium levels (0.7mmol/L or less) had significant associations with incident CKD and ESRD compared with the highest quartile with adjusted hazard ratio of 1.58 (95% CI: 1.35–1.87) for CKD and 2.39 (95% CI: 1.61–3.56) for ESRD. These associations remained significant after excluding users of diuretics and across subgroups stratified by hypertension, diabetes, and self-reported race. Thus, in a large sample of middle-aged adults, low total serum magnesium was independently associated with incident CKD and ESRD. Further studies are needed to determine whether modification of serum magnesium levels might alter subsequent incident kidney disease rates.
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Lippi G, Cervellin G. Neutrophil Gelatinase-Associated Lipocalin (NGAL), Neutrophils, and CKD: Which Comes First? Am J Kidney Dis 2013; 61:184. [DOI: 10.1053/j.ajkd.2012.06.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 06/11/2012] [Indexed: 11/11/2022]
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