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Zhao X, Li S, Wang X, Fan J, Ai H, Que B, Yan Y, Zhang Z, Wang G, Gong W, Nie S. Clinical outcomes of obstructive sleep apnea in patients with acute coronary syndrome in relation to hyperuricemia status. J Sleep Res 2023; 32:e13898. [PMID: 37020157 DOI: 10.1111/jsr.13898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/15/2023] [Accepted: 03/19/2023] [Indexed: 04/07/2023]
Abstract
The clinical outcome of obstructive sleep apnea in patients with acute coronary syndrome in relation to hyperuricemia is still unclear. We aimed to explore the clinical prognosis of obstructive sleep apnea in patients with acute coronary syndrome in relation to hyperuricemia status. This was a prospective cohort study. We included consecutively eligible patients with acute coronary syndrome who underwent cardiorespiratory polygraphy between June 2015 and January 2020. According to apnea-hypopnea index ≥ 15 events per hr and serum uric acid level, the population was divided into four groups: hyperuricemia with obstructive sleep apnea; hyperuricemia with non-obstructive sleep apnea; no hyperuricemia with obstructive sleep apnea; and no hyperuricemia with non-obstructive sleep apnea. The primary endpoint was major adverse cardiovascular and cerebrovascular events, including cardiovascular death, myocardial infarction, stroke, ischaemia-driven revascularization, and readmission for unstable angina or heart failure. Spearman correlation analysis and Cox regression model were mainly used to estimate the data. The median follow-up was 2.9 years. Among 1925 patients with acute coronary syndrome, 29.6% had hyperuricemia and 52.6% had obstructive sleep apnea. Uric acid was negatively correlated with minimum arterial oxygen saturation and mean arterial oxygen saturation, and positively correlated with apnea-hypopnea index, oxygen desaturation index and the duration of time with arterial oxygen saturation < 90% (p < 0.001). During 2.9 (1.5, 3.6) years of follow-up, obstructive sleep apnea was associated with an increased risk of major adverse cardiovascular and cerebrovascular events in patients with hyperuricemia (23.5% versus 13.4%; adjusted hazard ratio: 1.834; 95% confidence interval: 1.192-2.821, p = 0.006), but not in patients without hyperuricemia (21.9% versus 19.2%; adjusted hazard ratio: 1.131; 95% confidence interval: 0.880-1.453, p = 0.336). There was a correlation between uric acid levels and sleep respiratory indicators. Obstructive sleep apnea was associated with increased risk of major adverse cardiovascular and cerebrovascular events in patients with acute coronary syndrome with hyperuricemia, but not in patients without hyperuricemia.
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Affiliation(s)
- Xuedong Zhao
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Siyi Li
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Xiao Wang
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Jingyao Fan
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Hui Ai
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Bin Que
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Yan Yan
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Zekun Zhang
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Ge Wang
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Wei Gong
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Shaoping Nie
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
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Increased QT Dispersion and High Risk of Ventricular Arrhythmias is Associated with Hyperuricemia in Individuals with Normal Renal Function. JOURNAL OF CARDIOVASCULAR EMERGENCIES 2021. [DOI: 10.2478/jce-2021-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background and aim: Uric acid elevation has been shown to be an important risk factor for cardiovascular and cerebrobascular disease. QT dispersion (QTd) is a parameter that shows the heterogeneity of ventricular repolarization and can be calculated noninvasively from surface electrocardiography. Increased QTd has been associated with severe arrhythmia and risk of sudden death in many patients and disease groups. In this context, we aimed to investigate the effect of uric acid levels on QTd and the effects of decrease in uric acid levels on QTd.
Methods: A total of 225 patients with normal renal function were included in the study; 133 of these patients were hyperuricemic (>7 mg/dL), and the remaining 72 patients were normouricemic (Group 1). The hyperuricemic patients were randomly divided into 2 groups, one group (n = 67) was given placebo (Group 2) for 4 months, and the remaining 66 patients were given allopurinol 300 mg/day (Group 3).
Results: Hyperuricemic patients had higher hsCRP and QTd and lower eGFR values compared to the normouricemic control group. After 4 months of treatment, 66 patients treated with allopurinol showed a significant decrease in serum uric acid, systolic and diastolic blood pressure, and hsCRP levels, and a significant increase in eGFR. Although the QTd values in the treatment group did not decrease to the same levels as in the normouricemic control group, a statistically significant decrease was found compared to their baseline values. In hyperuricemic control and normouricemic control patients, there were no differences in the levels of uric acid, hsCRP, eGFR, systolic and diastolic blood pressure, and QTd values compared to baseline values.
Conclusions: There was a significant association between elevated serum uric acid and QTd, as well as with inflammatory biomarkers. Also, patients who had received hypouricemic therapy during the follow-up period presented a significant decrease in inflammatory markers as well as QTd. This indicates the beneficial effects of decreasing uric acid levels in decreasing the risk for future major adverse events related to ventricular arrhythmias.
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Kanbay M, Demiray A, Afsar B, Karakus KE, Ortiz A, Hornum M, Covic A, Sarafidis P, Rossing P. Sodium-glucose cotransporter 2 inhibitors for diabetes mellitus control after kidney transplantation: Review of the current evidence. Nephrology (Carlton) 2021; 26:1007-1017. [PMID: 34263502 DOI: 10.1111/nep.13941] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/21/2022]
Abstract
Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are promising drugs to treat chronic kidney disease patients with or without diabetes mellitus (DM). Besides improving glycemic control, SGLT2i are cardioprotective and kidney protective and decrease bodyweight, serum uric acid, blood pressure, albuminuria and glomerular hyperfiltration. These effects may benefit graft function and survival in kidney transplant (KT) patients. In this review, we evaluate data on the efficacy and safety of SGLT2i for KT patients with DM. Eleven studies with 214 diabetic KT patients treated with SGLT2i have been reported. SGLT2i lowered haemoglobin A1c and bodyweight. While glomerular filtration rate may be reduced in the short-term, it remained similar to baseline after 3-12 months. In two studies, blood pressure decreased and remained unchanged in the others. There were no significant changes in urine protein to creatinine ratio. Regarding safety, 23 patients had urinary tract infections, 2 patients had a genital yeast infection, one had acute kidney injury, and one had mild hypoglycaemia. No cases of ketoacidosis or acute rejection were reported. In conclusion, the limited experience so far suggests that SGLT2i are safe in KT patients with DM, decrease bodyweight and improve glycemic control. However, some of the benefits observed in larger studies in the non-KT population have yet to be demonstrated in KT recipients, including preservation of kidney function, reduction in blood pressure and decreased proteinuria.
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Affiliation(s)
- Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Atalay Demiray
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Baris Afsar
- Division of Nephrology, Department of Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Kagan E Karakus
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Alberto Ortiz
- IIS-Fundacion Jimenez Diaz, Department of Medicine, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Mads Hornum
- Department of Nephrology, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Adrian Covic
- Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania.,Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. Parhon' University Hospital, Iasi, Romania
| | - Pantelis Sarafidis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Copenhagen Denmark and University of Copenhagen, Copenhagen, Denmark
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Demiray A, Afsar B, Covic A, Kuwabara M, Ferro CJ, Lanaspa MA, Johnson RJ, Kanbay M. The Role of Uric Acid in the Acute Myocardial Infarction: A Narrative Review. Angiology 2021; 73:9-17. [PMID: 33902350 DOI: 10.1177/00033197211012546] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increased serum uric acid (SUA) levels have been associated with various pathologic processes such as increased oxidative stress, inflammation, and endothelial dysfunction. Thus, it is not surprising that increased SUA is associated with various adverse outcomes including cardiovascular (CV) diseases. Recent epidemiological evidence suggests that increased SUA may be related to acute myocardial infarction (AMI). Accumulating data also showed that elevated UA has pathophysiological role in the development of AMI. However, there are also studies showing that SUA is not related to the risk of AMI. In this narrative review, we summarized the recent literature data regarding SUA and AMI after providing some background information for the association between UA and coronary artery disease. Future studies will show whether decreasing SUA levels is beneficial for outcomes related to AMI and the optimum SUA levels for best outcomes in CV diseases.
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Affiliation(s)
- Atalay Demiray
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Baris Afsar
- Division of Nephrology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Adrian Covic
- Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Masanari Kuwabara
- Intensive Care Unit and Department of Cardiology, Toranomon Hospital, Tokyo, Japan
| | - Charles J Ferro
- Department of Renal Medicine, University Hospitals Birmingham, Edgbaston, Birmingham, the United Kingdom
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
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Song B, Dai D, Liu S, Zhu Z, Ding F, Zhu J, Zhang R. Optimal timing of coronary angiograms for patients with chronic kidney disease: association between the duration of kidney dysfunction and SYNTAX scores. Ren Fail 2021; 43:307-312. [PMID: 33538236 PMCID: PMC8901285 DOI: 10.1080/0886022x.2021.1880936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Chronic kidney disease (CKD) is associated with an increased risk of the progression of coronary artery disease (CAD). However, there are few data on the relationship between CAD severity and the duration of CKD. This study assessed the predictive value of the duration of kidney dysfunction in CKD patients with CAD severity. Methods In 145 patients (63.4% male, n = 92; mean age, 68.8 ± 12.8 years) with CKD, severity of CAD was assessed by coronary angiography and quantified by SYNTAX scores, and duration of kidney dysfunction was either assessed by checking historical biochemical parameters of individuals or was based on enquiries. Results Patients with high SYNTAX scores (≥ 22) had a greater prevalence of cardiovascular risk factors including age, gender, history of heart failure and smoking. In CKD patients, SYNTAX scores were positively correlated to duration of CKD and serum uric acid (UA), and negatively correlated to high-density lipoprotein-cholesterol (HDL-C) and ApoA1 levels. Univariate binary logistic regression and multivariate logistic analyses showed that SYNTAX scores correlated significantly with CKD duration, UA, and HDL-C. Receiver-operating characteristic analysis was used to explore a time point when coronary angiography application was economical and effective and yielded a Youden index of 6.5 years. Conclusions Together, our results demonstrated that the duration of kidney dysfunction was an independent correlate of the severity of CAD in patients with CKD. Our findings suggest that coronary angiography should be considered for CKD patients with renal insufficiency having lasted for more than 6.5 years.
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Affiliation(s)
- Bei Song
- Department of Vascular & Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Daopeng Dai
- Department of Vascular & Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Shengjun Liu
- Department of Vascular & Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Zhengbin Zhu
- Department of Vascular & Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Fenghua Ding
- Department of Vascular & Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Jinzhou Zhu
- Department of Vascular & Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Ruiyan Zhang
- Department of Vascular & Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
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Yang Y, Lin LH, Gao M, Tang RN, Ma KL, Tu Y, Liu H, Liu BC. Association Between the Serum Uric Acid Level and the Severity of Coronary Artery Disease in a Retrospective Study of China Nondialysis CKD Patients. Metab Syndr Relat Disord 2020; 18:206-211. [PMID: 32069163 DOI: 10.1089/met.2019.0114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Hyperuricemia has been associated with increased cardiovascular events in the general population. However, the role of serum uric acid (SUA) level on the severity of coronary artery stenosis (CAS) in nondialysis chronic kidney disease (CKD) patients is obscure. Methods: We implement a retrospective cohort study of 734 patients diagnosed with stage 3-5 CKD. All selected patients underwent coronary artery angiography. The associations of SUA with the present, and severity of coronary artery disease (CAD) were analyzed. Results: Of these 734 patients, 511 patients had angiographically proven CAD. Compared with non-CAD group, the SUA level in CAD group was much higher (388.00 vs. 363.00 μmol/l, P < 0.01). After adjusting for multiple confounding factors, a multivariate logistic regression analysis demonstrated that SUA was relevant to the presence of CAD when SUA as a continuous variable. However, this relationship was not observed with SUA as a categorical variable. In a subgroup analysis for the CAD group, we found that the rates of severe CAS in the third tertile of SUA (58.6%) was higher than that in the first tertile (41.6%) (P < 0.01). Compared with the first tertile of SUA, the third tertile of SUA was an independent risk factor for severe arterial stenosis (odds ratio, OR, 1.976 [1.203-3.248]), a pattern that was recapitulated by multivariate logistic regression analysis with SUA as a continuous variable (1.002 [1.000-1.004]). Conclusions: The SUA level may serve as a predictor of the severity of CAS among nondialysis CKD patients with CAD.
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Affiliation(s)
- Yan Yang
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Li-Hua Lin
- Department of Nephrology, People's Hospital of Suzhou New District, Suzhou, Jiangsu, China
| | - Min Gao
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Ri-Ning Tang
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Kun-Ling Ma
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Yan Tu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Hong Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
| | - Bi-Cheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China
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Aslan G, Afsar B, Sag AA, Camkiran V, Erden N, Yilmaz S, Siriopol D, Incir S, You Z, Garcia ML, Covic A, Cherney DZI, Johnson RJ, Kanbay M. The Effect of Urine pH and Urinary Uric Acid Levels on the Development of Contrast Nephropathy. Kidney Blood Press Res 2019; 45:131-141. [PMID: 31865342 DOI: 10.1159/000504547] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/01/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Hyperuricemia may cause acute kidney injury by activating inflammatory, pro-oxidative and vasoconstrictive pathways. In addition, radiocontrast causes an acute uricosuria, potentially leading to crystal formation. We therefore aimed to investigate the effect of urine acidity and urine uric acid level on the development of contrast-induced nephropathy (CIN) in patients undergoing elective coronary angiography. METHODS We enrolled 175 patients who underwent elective coronary angiography. CIN was defined as a >25% increase in the serum creatinine levels relative to basal values 48-72 h after contrast use. Prior to coronary angiography and 48-72 h later, serum uric acid, urea, creatinine, bicarbonate levels, and spot uric acid to creatinine ratio (UACR) were measured. RESULTS Of the 175 subjects included, 29 (16.6%) developed CIN. Those who developed CIN had a higher prevalence of diabetes, higher UACR (0.60 vs. 0.44, p = 0.014), higher contrast volume, and lower serum sodium level. With univariate analysis of a logistic regression model, the risk of CIN was found to be associated with diabetes (p = 0.0016, OR = 3.8 [95% CI: 1.7-8.7]), urine UACR (p = 0.0027, OR = 9.6 [95% CI: 2.2-42.2]), serum sodium (p = 0.0079, OR = 0.8 [95% CI: 0.77-0.96]), and contrast volume (p = 0.0385, OR = 1.8 [95% CI: 1.03-3.09]). In a multiple logistic regression model with stepwise method of selection, diabetes (p = 0.0120, OR = 3.2 [95% CI: 1.3-8.1]) and UACR (p = 0.0163, OR = 6.9 [95% CI: 1.4-33.4]) were the 2 risk factors finally identified. CONCLUSIONS We have demonstrated that higher urine UACR is associated with the development of CIN in patients undergoing elective coronary angiography.
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Affiliation(s)
- Gamze Aslan
- Department of Cardiology, Koc University Hospital, Istanbul, Turkey,
| | - Baris Afsar
- Division of Nephrology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Alan A Sag
- Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Volkan Camkiran
- Department of Cardiology, Koc University Hospital, Istanbul, Turkey
| | - Nihan Erden
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sezen Yilmaz
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Dimitrie Siriopol
- Department of Nephrology, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania
| | - Said Incir
- Department of Biochemistry, Koc University School of Medicine, Istanbul, Turkey
| | - Zhiying You
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora, Colorado, USA
| | - Miguel L Garcia
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora, Colorado, USA
| | - Adrian Covic
- Department of Nephrology, University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania
| | - David Z I Cherney
- Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora, Colorado, USA
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
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Selcukbiricik F, Ozdogan E, Dagel T, Tanju S, Erus S, Ertuglu LA, Kapdağlı M, Tural D, Bilici A, Dilege S, Mandel NM, Kanbay M. Elevation in serum uric acid levels predicts favourable response to erlotinib treatment in patients with metastatic non-small-cell lung cancer. J Clin Pharm Ther 2019; 45:303-308. [PMID: 31778239 DOI: 10.1111/jcpt.13071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/01/2019] [Accepted: 10/18/2019] [Indexed: 12/13/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Erlotinib is a small molecule tyrosine kinase inhibitor which blocks the activation of epidermal growth factor receptor (EGFR), a transmembrane receptor that is upregulated in many cancer types. Inhibition of angiogenesis with consequent impairments in intratumoral microcirculation is one of the mechanisms through which EGFR inhibition halts the progression of cancer. A consequence of impaired microcirculation is intratumoral hypoxia, which results in increases in serum uric acid levels. The goal of this study was to investigate the relationship between serum uric acid levels and response to erlotinib in metastatic non-small-cell lung cancer (NSCLC). METHODS A total of 56 patients with metastatic non-small-cell lung cancer who received erlotinib for a duration of at least 3 months were included in this retrospective cohort study. Demographic characteristics, progression status, baseline serum uric levels and 3-month serum uric acid levels were recorded and analysed. RESULTS AND DISCUSSION Of the study population, 21 (37.5%) were female and 35 (62.5%) were male patients. No significant difference in above demographic characteristics was observed among exitus, survivor with progression and survivor without progression groups. Patients who responded favourably to erlotinib with no progression of their disease had significantly increased uric acid levels at 3-month follow-up (P = .01). Such a correlation was not observed if the patient was exitus (P = .47) or had progressed on erlotinib therapy (P = .19). WHAT IS NEW AND CONCLUSION In conclusion, this study is the first to demonstrate significant increases in serum uric acid levels in patients with metastatic NSCLC who responded favourably to erlotinib and had no progression under erlotinib therapy. Further studies are required to confirm and characterize serum uric acid as a novel biomarker in predicting the outcome in those with metastatic NSCLC.
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Affiliation(s)
- Fatih Selcukbiricik
- Department of Medical Oncology, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Elif Ozdogan
- Koc University School of Medicine, Istanbul, Turkey
| | - Tuncay Dagel
- Department of Nephrology, Koc University Hospital, Istanbul, Turkey
| | - Serhan Tanju
- Department of Thoracic Surgery, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Suat Erus
- Department of Thoracic Surgery, Koc University Hospital, Istanbul, Turkey
| | | | - Murat Kapdağlı
- Department of Thoracic Surgery, VKV American Hospital, Istanbul, Turkey
| | - Deniz Tural
- Department of Medical Oncology, Bakırköy Sadi Konuk Education and Training Hospital, Istanbul, Turkey
| | - Ahmet Bilici
- Department of Medical Oncology, Faculty of Medicine, Medipol University, Istanbul, Turkey
| | - Sukru Dilege
- Department of Thoracic Surgery, Faculty of Medicine, Koc University, Istanbul, Turkey
| | - Nil M Mandel
- Department of Medical Oncology, Faculty of Medicine, Koc University, Istanbul, Turkey.,Department of Medical Oncology, VKV American Hospital, Istanbul, Turkey
| | - Mehmet Kanbay
- Department of Nephrology, Faculty of Medicine, Koc University, Istanbul, Turkey
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9
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Kanbay M, Yerlikaya A, Sag AA, Ortiz A, Kuwabara M, Covic A, Wiecek A, Stenvinkel P, Afsar B. A journey from microenvironment to macroenvironment: the role of metaflammation and epigenetic changes in cardiorenal disease. Clin Kidney J 2019; 12:861-870. [PMID: 31807301 PMCID: PMC6885688 DOI: 10.1093/ckj/sfz106] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Indexed: 12/11/2022] Open
Abstract
Chronic non-communicable diseases have become a pandemic public problem in the 21st century, causing enormous burden on the economy, health and quality of life of societies. The role of a chronic inflammatory state in the pathogenesis of chronic disease has been more comprehensively recognized by recent findings. The new paradigm ‘metaflammation’ focuses on metabolism-induced (high fat or fructose-based diet or excessive calorie intake) chronic inflammation. There is a close correlation between the increased incidence of chronic kidney disease (CKD) and chronic heart failure with both increased inflammatory marker levels and western-type diet. In this review we describe the concept of metaflammation, its role in the development of CKD and chronic heart disease, the molecular and signalling pathways involved and the therapeutic consequences.
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Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
| | - Aslihan Yerlikaya
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Alan A Sag
- Department of Radiology, Division of Vascular and Interventional Radiology, Duke University Medical Center, Durham, NC, USA
| | - Alberto Ortiz
- Dialysis Unit, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Adrian Covic
- Nephrology Department, Dialysis and Renal Transplant Center, "Dr. C.I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Andrzej Wiecek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Peter Stenvinkel
- Department of Clinical Science Intervention and Technology, Division of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
| | - Baris Afsar
- Department of Medicine, Division of Nephrology, Suleyman Demirel University School of Medicine, Isparta, Turkey
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10
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Armutcu F, Demircan K, Yildirim U, Namuslu M, Yagmurca M, Celik HT. Hypoxia causes important changes of extracellular matrix biomarkers and ADAMTS proteinases in the adriamycin-induced renal fibrosis model. Nephrology (Carlton) 2019; 24:863-875. [PMID: 30719800 DOI: 10.1111/nep.13572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2019] [Indexed: 12/12/2022]
Abstract
AIM Renal fibrosis is a common cause of renal dysfunction with chronic kidney diseases. This process is characterized by excessive production of extracellular matrix (ECM) or inhibition of ECM degradation. A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) proteinases, which are widely presented in mammals, have very critical roles in ECM remodelling. We aimed to study the role of ADAMTS proteinases and some of the ECM markers in the pathogenesis of renal fibrosis and to investigate the effects of hypoxia on these biomarkers. METHODS In addition to the control group, Adriamycin (ADR) treated rats were divided into four groups as ADR, sham and two hypoxia groups. Renal nephropathy was assessed biochemical assays, pathological and immunohistochemical staining methods. The expression of ADAMTSs and mRNA were determined using Western blotting and real-time PCR, respectively. RESULTS Renal dysfuntion and tissue damage in favour of ECM accumulation and renal fibrosis were observed in the ADR group. This was approved by remarkable changes in the expression of ADAMTS such as increased ADAMTS-1, -12 and -15. In addition, it was found that hypoxia and duration of hypoxia enhanced markers of tubulointerstitial fibrosis in the rat kidney tissues. Also, expression differences especially in ADAMTS-1, -6 and -15 were observed in the hypoxia groups. The variable and different expression patterns of ADAMTS proteinases in the ADR-induced renal fibrosis suggest that ADAMTS family members are involved in the development and progression of fibrosis. CONCLUSION The expression changes of ADAMTS proteinases in kidney and association with hypoxia have potential clues to contribute to the early diagnosis and treatment options of renal fibrosis.
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Affiliation(s)
- Ferah Armutcu
- Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Kadir Demircan
- Department of Medical Biology, Turgut Ozal University, Faculty of Medicine, Ankara, Turkey
| | - Umran Yildirim
- Department of Pathology, Turgut Ozal University, Faculty of Medicine, Ankara, Turkey
| | - Mehmet Namuslu
- Department of Biochemistry, Turgut Ozal University, Faculty of Medicine, Ankara, Turkey
| | - Murat Yagmurca
- Health Sciences University, Higher Specialization Training and Research Hospital, Histology and Embryology Clinic, Bursa, Turkey
| | - Hüseyin T Celik
- Department of Biochemistry, Turgut Ozal University, Faculty of Medicine, Ankara, Turkey
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11
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Afsar B, Sag AA, Oztosun C, Kuwabara M, Cozzolino M, Covic A, Kanbay M. The role of uric acid in mineral bone disorders in chronic kidney disease. J Nephrol 2019; 32:709-717. [DOI: 10.1007/s40620-019-00615-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/24/2019] [Indexed: 01/28/2023]
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12
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Lee R, Shin MH, Kim HN, Lee YH, Choi SW, Ahn HR, Kweon SS. Relationship between plasma pentraxin 3 level and risk of chronic kidney disease in the Korean elderly: the Dong-gu study. Int Urol Nephrol 2017; 49:2027-2033. [PMID: 28733767 DOI: 10.1007/s11255-017-1662-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 07/17/2017] [Indexed: 12/13/2022]
Abstract
Purpose This study investigated the cross-sectional association between chronic kidney disease (CKD) and plasma pentraxin 3 (PTX3) levels in a Korean population, in a community-based cohort study. METHODS A total of 1816 (891 men, 925 women) subjects were randomly selected from the cohort of participants for the final analyses. Plasma PTX3 concentration was determined using enzyme-linked immunosorbent assays. The participants were divided into four quartiles according to the PTX3 levels. Multivariate logistic regression was performed to evaluate the association between plasma PTX3 level and CKD. Covariates inserted into the multivariate model included smoking status, systolic blood pressure, body mass index, waist circumference, high-density lipoprotein, low-density lipoprotein uric acid, white blood cell count, and carotid intima-media thickness. RESULTS Compared to the lowest PTX3 group (Q1), a significantly higher risk of CKD was found in the highest group (Q4), with an odds ratio of 1.58 and 95% confidence interval of 1.18-2.11 (P for trend <0.001). CONCLUSIONS This study showed that higher plasma PTX3 levels are significantly associated with CKD risk. The biological mechanism remains unclear; therefore, further molecular investigation of association between CKD and PTX3 is needed.
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Affiliation(s)
- Ran Lee
- Department of Preventive Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 501-746, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 501-746, Korea.,Center for Creative Biomedical Scientists, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju, Korea
| | - Hee-Nam Kim
- Center for Creative Biomedical Scientists, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju, Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, 460 Iksandae-ro, Iksan, Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, 375 Seosuk-dong, Gwangju, Korea
| | - Hye-Ran Ahn
- Department of Nursing, Nambu University, 23 Cheomdanjungang-ro, Gwangsan-gu, Gwangju, Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju, 501-746, Korea. .,Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun, Jeonnam, Korea.
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13
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Yerlikaya A, Dagel T, King C, Kuwabara M, Lanaspa MA, Andres-Hernando A, Covic A, Manitius J, Sag AA, Kanbay M. Dietary and commercialized fructose: Sweet or sour? Int Urol Nephrol 2017; 49:1611-1620. [DOI: 10.1007/s11255-017-1544-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 02/09/2017] [Indexed: 12/11/2022]
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14
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Hahn K, Kanbay M, Lanaspa MA, Johnson RJ, Ejaz AA. Serum uric acid and acute kidney injury: A mini review. J Adv Res 2016; 8:529-536. [PMID: 28748118 PMCID: PMC5512150 DOI: 10.1016/j.jare.2016.09.006] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/17/2016] [Accepted: 09/18/2016] [Indexed: 12/22/2022] Open
Abstract
Acute kidney injury causes great morbidity and mortality in both the community and hospital settings. Understanding the etiological factors and the pathophysiological principles resulting in acute kidney injury is essential in prompting appropriate therapies. Recently hyperuricemia has been recognized as a potentially modifiable risk factor for acute kidney injury, including that associated with cardiovascular surgery, radiocontrast administration, rhabdomyolysis, and associated with heat stress. This review discussed the evidence that repeated episodes of acute kidney injury from heat stress and dehydration may also underlie the pathogenesis of the chronic kidney disease epidemic that is occurring in Central America (Mesoamerican nephropathy). Potential mechanisms for how uric acid might contribute to acute kidney injury are also discussed, including systemic effects on renal microvasculature and hemodynamics, and local crystalline and noncrystalline effects on the renal tubules. Pilot clinical trials also show potential benefits of lowering uric acid on acute kidney injury associated with a variety of insults. In summary, there is mounting evidence that hyperuricemia may have a significant role in the development of acute kidney injury. Prospective, placebo controlled, randomized trials are needed to determine the potential benefit of uric acid lowering therapy on kidney and cardio-metabolic diseases.
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Affiliation(s)
- Kai Hahn
- Center for Nephrology, Dialysis and Hypertension, Dortmund 69120, Germany
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul 34010, Turkey
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado, Denver 80045, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado, Denver 80045, USA
| | - A Ahsan Ejaz
- Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, FL 32610, USA
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15
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Tekeoğlu İ, Harman H, Sağ S, Altındiş M, Kamanlı A, Nas K. Levels of serum pentraxin 3, IL-6, fetuin A and insulin in patients with rheumatoid arthritis. Cytokine 2016; 83:171-175. [DOI: 10.1016/j.cyto.2016.04.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 12/14/2022]
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16
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Relevance of uric acid and asymmetric dimethylarginine for modeling cardiovascular risk prediction in chronic kidney disease patients. Int Urol Nephrol 2016; 48:1129-36. [DOI: 10.1007/s11255-016-1271-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 03/13/2016] [Indexed: 02/04/2023]
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17
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Mendi MA, Afsar B, Oksuz F, Turak O, Yayla C, Ozcan F, Johnson RJ, Kanbay M. Uric Acid is a Useful Tool to Predict Contrast-Induced Nephropathy. Angiology 2016; 68:627-632. [PMID: 27006404 DOI: 10.1177/0003319716639187] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Developing contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (pPCI) has a negative impact on survival and morbidity. We assessed the predictive value of serum uric acid (SUA) for the development of CIN in patients with ST-segment elevation myocardial infarction (STEMI) who underwent pPCI. Contrast-induced nephropathy was defined an increase of ≥25% or ≥0.5 mg/dL in creatinine concentrations within 72 hours after pPCI. Patients were divided into 2 groups according to admission median SUA level. Serum uric acid level was <5.4 mg/dL (group 1; n = 222) and ≥5.4 mg/dL (group 2; n = 228). Compared to group 1, development of CIN (12% vs 20%, P < .001) was significantly greater in group 2. Using a cut point of >5.45 mg/dL, the SUA level predicted development of CIN with a sensitivity of 70% and specificity of 67%. In multiple logistic regression analysis, SUA level, diabetes mellitus, left ventricular ejection fraction <50%, contrast volume, estimated glomerular filtration rate, and C-reactive protein level emerged as independent predictors of CIN. In conclusion, elevated SUA is an independent risk factor for the development of CIN after pPCI in patients with STEMI.
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Affiliation(s)
- Mehmet Ali Mendi
- 1 Department of Cardiology, Türkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Baris Afsar
- 2 Department of Nephrology, Konya Numune Hospital, Konya, Turkey
| | - Fatih Oksuz
- 1 Department of Cardiology, Türkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Osman Turak
- 1 Department of Cardiology, Türkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Cagri Yayla
- 1 Department of Cardiology, Türkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Firat Ozcan
- 1 Department of Cardiology, Türkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Richard J Johnson
- 3 Division of Renal Diseases and Hypertension, University of Colorado, Denver, CO, USA
| | - Mehmet Kanbay
- 4 Department of Medicine, Division of Nephrology, Koç University School of Medicine, Istanbul, Turkey
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18
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Serum uric acid as a surrogate marker of favorable response to bevacizumab treatment in patients with metastatic colon cancer. Clin Transl Oncol 2016; 18:1082-1087. [PMID: 26781472 DOI: 10.1007/s12094-016-1485-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/07/2016] [Indexed: 12/20/2022]
Abstract
Bevacizumab is a monoclonal antibody which is a vascular endothelial growth factor inhibitor. It obscures vascularization of tumor tissue and damages intratumoral microcirculation. The damaged intratumoral microcirculation leads to tissue hypoxia and results in increase of uric acid level. The main aim of our study was to investigate the relationship between uric acid change and response to bevacizumab therapy. This study included a total of 158 patients with metastatic colorectal cancer who had received bevacizumab therapy. The number of male patients was 100 (63.3 %) while female patients number was 58 (37.7 %). The median age was 61 (29-83). There was relationship between increase of uric acid level of third month uric acid level and stable disease (p < 0.001). There was a significant overall survival increased in the group with increased uric acid level (p < 0.001). The decline of CEA level was related to uric acid level (p < 0.022). In conclusion, this study is the first showing significant increases of serum uric acid in patients with metastatic colorectal cancer who favorably responded to chemotherapy with bevacizumab. But further studies are justified to test whether monitoring uric acid levels might predict clinical outcomes of patients with metastatic colorectal cancer.
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19
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Milane A, Khazen G, Zeineddine N, Amro M, Masri L, Ghassibe-Sabbagh M, Youhanna S, Salloum AK, Haber M, Platt DE, Cazier JB, Othman R, Kabbani S, Sbeite H, Chami Y, Chammas E, el Bayeh H, Gauguier D, Abchee AB, Zalloua P, Barbari A. Association of coronary artery disease and chronic kidney disease in Lebanese population. Int J Clin Exp Med 2015; 8:15866-15877. [PMID: 26629090 PMCID: PMC4658979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/14/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND More evidence is emerging on the strong association between chronic kidney disease (CKD) and cardiovascular disease. We assessed the relationship between coronary artery disease (CAD) and renal dysfunction level (RDL) in a group of Lebanese patients. METHODS A total of 1268 patients undergoing cardiac catheterization were sequentially enrolled in a multicenter cross sectional study. Angiograms were reviewed and CAD severity scores (CADSS) were determined. Estimated glomerular filtration rate (eGFR) was calculated and clinical and laboratory data were obtained. CKD was defined as eGFR < 60 ml/min. Logistic regression model was performed using multivariate analysis including all traditional risk factors associated with both diseases. ANOVA and the Tukeytestswere used to compare subgroups of patients and to assess the impact of each disease on the severity of the other. RESULTS Among the 82% patients who exhibited variable degrees of CAD, 20.6% had an eGFR < 60 ml/min. Logistic regression analysis revealed a bidirectional independent association between CAD and CKD with an OR = 2.01 (P < 0.01) and an OR = 1.99 (P < 0.01) for CAD and CKD frequencies, respectively. We observed a steady increase in the CADSS mean as eGFR declined and a progressive reduction in renal function with the worsening of CAD (P < 0.05). This correlation remained highly significant despite considerable inter-patient variability and was at its highest at the most advanced stages of both diseases. CONCLUSIONS Our results show a strong, independent and graded bidirectional relationship between CAD severity and RDL. We propose to add CAD to the list of risk factors for the development and progression of CKD.
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Affiliation(s)
| | | | | | - Mazen Amro
- School of Medicine, Lebanese UniversityBeirut, Lebanon
| | - Leila Masri
- School of Medicine, Lebanese UniversityBeirut, Lebanon
| | | | | | | | - Marc Haber
- The Wellcome Trust Centre for Human Genetics, University of OxfordOxford, UK
| | - Daniel E Platt
- Bioinformatics and Pattern Discovery, IBM T. J. Watson Research CentreNew York, NY, USA
| | | | - Raed Othman
- Division of Cardiology, Department of Internal Medicine, Rafik Hariri University HospitalBeirut, Lebanon
| | - Samer Kabbani
- Division of Cardiology, Department of Internal Medicine, Rafik Hariri University HospitalBeirut, Lebanon
| | - Hana Sbeite
- Division of Cardiology, Department of Internal Medicine, Rafik Hariri University HospitalBeirut, Lebanon
| | | | - Elie Chammas
- School of Medicine, Lebanese UniversityBeirut, Lebanon
| | | | - Dominique Gauguier
- INSERM UMRS1138, Cordeliers Research Centre, 15 rue de l’Ecole de Médecine75006 Paris, France
| | - Antoine B Abchee
- Division of Cardiology, Department of Internal Medicine, American University of BeirutBeirut, Lebanon
| | - Pierre Zalloua
- Lebanese American UniversityBeirut, Lebanon
- Harvard School of Public HealthBoston, MA 02215, USA
| | - Antoine Barbari
- School of Medicine, Lebanese UniversityBeirut, Lebanon
- Division of Nephrology, Department of Internal Medicine, Rafik Hariri University HospitalBeirut, Lebanon
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20
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Gul CB, Yildiz A, Ersoy A, Kahvecioglu S, Asiltas B, Yildirim F, Ermurat S, Sag S, Oruc A, Gullulu S, Gullulu M. Correlation between arterial stiffness and inflammatory markers in autosomal dominant polycystic kidney disease patients with preserved renal function. Int Urol Nephrol 2015; 47:1187-94. [PMID: 26047596 DOI: 10.1007/s11255-015-1022-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 05/27/2015] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the association between arterial stiffness and inflammatory markers including C-reactive protein (CRP), pentraxin 3 (PTX3) and neutrophil-to-lymphocyte ratio (NLR) in autosomal dominant polycystic kidney disease (ADPKD) patients with preserved renal function. METHODS A total of 52 ADPKD patients [mean (SD) age 38.2 (12.8) years, 69.2 % were females] with preserved renal function and 25 healthy volunteers [mean (SD) age 35.5 (6.5) years, 48.0 % were females] were included. Data on patient characteristics, blood biochemistry, inflammatory markers [PTX3 (pg/mL), CRP (mg/dL) and NLR] and arterial stiffness [large artery elasticity index (LAEI) (mL/mmHg × 10) and small artery elasticity index (SAEI) (mL/mmHg × 100)] were recorded in patient and control groups. Correlation between inflammatory markers and arterial stiffness parameters was analysed in patients. RESULTS Overall, 42.3 % of ADPKD patients were hypertensive and 44.4 % were receiving renin-angiotensin-aldosterone system (RAAS) blockade therapy. Median levels for PTX3 [442.0 (20.0-4140.0) pg/mL vs. 220.5 (14.7-393.0) pg/mL, p < 0.001] and SAEI [4.90 (1.60-11.80) mL/mmHg × 100 vs. 6.45 (2.80-15.70) mL/mmHg × 10, p = 0.013] were significantly higher in ADPKD patients than in controls. PTX3 and CRP were not correlated with arterial elasticity, while NLR was significantly correlated with LAEI negatively (Rho = -0.278, p = 0.042). CONCLUSION In conclusion, our findings revealed increased PTX3 levels and reduced SAEI in patients as compared with controls, while no correlation between inflammatory markers studied and the small artery elasticity.
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Affiliation(s)
- Cuma Bulent Gul
- Department of Nephrology, Sevket Yılmaz Training and Research Hospital, Bursa, Turkey,
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21
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Abstract
OBJECTIVE To investigate the associations between plasma levels of pentraxins 3 (PTX3) and C reactive protein (CRP) and the severity of coronary artery lesions. DESIGN AND METHODS 60 patients with coronary heart disease (CHD) who underwent coronary angiography (CAG) in our hospital were included. Plasma was collected during CAG. The coronary Gensini score was used to evaluate the severity of coronary artery lesions. Associations between Gensini scores and plasma levels of PTX3 and CRP were analysed. Patients with estimated glomerular filtration rate <60 mL/min/1.73 m(2) were included in the chronic renal dysfunction subgroup. RESULTS A linear correlation was observed between PTX3 and the Gensini score (r=0.513, p<0.001). One-way analysis of variance showed that PTX3 levels were significantly higher in patients with Gensini scores >90 compared with patients with scores of 46-90 or <45 (0-45:4.8±0.8, 46-90:6.7±1.2, >90:7.7±2.0, p<0.001). Stepwise multiple linear regression showed that PTX3 levels were significantly associated with Gensini score in patients with chronic renal dysfunction (p=0.012), while no significant association was found for CRP. CONCLUSIONS PTX3 levers were positively associated with the severity of coronary artery lesions. PTX3 is closely associated with the severity of coronary artery stenosis in patients with chronic renal dysfunction.
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Affiliation(s)
- Hua Liu
- Department of Cardiology, Shanghai Chest Hospital, Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Shaofeng Guan
- Department of Cardiology, Shanghai Chest Hospital, Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Weiyi Fang
- Department of Cardiology, Shanghai Chest Hospital, Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Fang Yuan
- Department of Cardiology, Shanghai Chest Hospital, Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Min Zhang
- Department of Cardiology, Shanghai Chest Hospital, Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Xinkai Qu
- Department of Cardiology, Shanghai Chest Hospital, Affiliated to Shanghai Jiao Tong University, Shanghai, China
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22
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George M, Shanmugam E, Srivatsan V, Vasanth K, Ramraj B, Rajaram M, Jena A, Sridhar A, Chaudhury M, Kaliappan I. Value of pentraxin-3 and galectin-3 in acute coronary syndrome: a short-term prospective cohort study. Ther Adv Cardiovasc Dis 2015; 9:275-84. [PMID: 25814534 DOI: 10.1177/1753944715578405] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Acute coronary syndrome (ACS) continues to be a leading cause of morbidity and mortality worldwide. Galectin-3 and pentraxin-3 are two prognostic biomarkers that have been studied in heart failure (HF). However, there are limited data on these biomarkers in the ACS population. The objective of the study was to determine the variables that are most affected by high concentrations of pentraxin-3 and galectin-3, and the influence they have on outcomes of all-cause mortality in patients with ACS. METHODS We included a total of 160 patients [ST elevation myocardial infarction (STEMI),n = 64; non STEMI/unstable angina (NSTEMI/UA), n = 38; and control subjects with chronic stable angina (CSA)/microvascular angina (MVA) n = 58]. Plasma pentraxin-3 and galectin-3 levels were assessed from these patients at the time of hospital admission. Major adverse cardiovascular events including all-cause mortality, rehospitalizations and coronary artery bypass graft surgery (CABG) were assessed at 6 months. RESULTS The median concentration of pentraxin-3 and galectin-3 were significantly higher in STEMI than in NSTEMI patients (p < 0.005) or controls (p < 0.005). Greater numbers of deaths (4 versus 0) were observed in STEMI patients with higher levels of these biomarkers. In addition, ACS patients with high levels of pentraxin-3 and galectin-3 had lower left ventricular ejection fraction (LVEF) (p < 0.005), and a moderate correlation was observed between LVEF and pentraxin-3 levels (r = -0.45, p < 0.005). Patients with higher galectin-3 levels were also observed to have a lower estimated glomerular fraction rate (eGFR), and a moderate correlation was observed between them (r = -0.34, p < 0.005). CONCLUSION Pentraxin-3 and galectin-3 hold much promise in the ACS population as prognostic biomarkers.
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Affiliation(s)
- Melvin George
- Department of Cardiology, SRM Medical College Hospital & Research Centre, Kattankulathur, Kancheepuram, Chennai, Tamil Nadu 603203, India
| | - Elangovan Shanmugam
- Department of Cardiology, SRM Medical College Hospital & Research Centre, Chennai, India
| | - Varsha Srivatsan
- Department of Cardiology, SRM Medical College Hospital & Research Centre, Chennai, India
| | | | - Balaji Ramraj
- Department of Community Medicine, SRM Medical College Hospital & Research Centre, Chennai, India
| | - Muthukumar Rajaram
- Department of Cardiology, SRM Medical College Hospital & Research Centre, Chennai, India
| | - Amrita Jena
- Department of Cardiology, SRM Medical College Hospital & Research Centre, Chennai, India
| | - Aruna Sridhar
- Department of Cardiology, SRM Medical College Hospital & Research Centre, Chennai, India
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23
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Kanbay A, Inonu H, Solak Y, Erden A, Uslu E, Yuksel SA, Ozturk MA, McFann K, Johnson RJ, Kanbay M. Uric acid as a potential mediator of cardiovascular morbidity in obstructive sleep apnea syndrome. Eur J Intern Med 2014; 25:471-6. [PMID: 24793835 DOI: 10.1016/j.ejim.2014.04.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 04/04/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Obstructive sleep apnea (OSA) is now considered as an independent risk factor for cardiovascular (CV) disease. Although uric acid is increasingly being implicated in CV morbidity and mortality, no study attempted to determine independent role of uric acid in CV morbidity of OSA patients. We aimed to assess the role of serum uric acid as a potential mechanism of CV morbidity in a nonselected cohort of OSA patients. METHODS This was a cohort study in which patients who had undergone a formal sleep study for diagnosis of OSA were recruited. Included patients were grouped according to apnea-hypopnea index (AHI) as mild, moderate and severe OSA. Patients with AHI<5 served as control group. Patients were interrogated as to cardiovascular morbid conditions which included prior history and an established diagnosis of coronary artery disease, cerebrovascular accident, congestive heart failure due to coronary artery disease and arrhythmias. RESULTS 436 OSA patients included (72 controls, 97 with mild, 75 with moderate, and 192 with severe OSA). The severe group also had higher serum uric acid level compared with the control and other OSA groups. Linear regression showed that the Ln uric acid was positively associated with Ln AHI score. In unadjusted logistic regression, severe OSA was associated with higher odds of a cardiovascular event, OR=2.81 (1.307-6.041), p=0.0081 while the other categories of sleep apnea were not. However, severe OSA was no longer significant after adjusting for age, gender, diabetes mellitus status, hypertension status, BMI, and smoking, OR=1.882 (0.826-4.287), p=0.1322. Uric acid was significantly higher in those who had a cardiovascular event even in the mild, moderate and severe OSA groups. CONCLUSION Hyperuricemia is strongly associated with cardiovascular disease in OSA patients. This strong relationship persists even after controlling for well-known traditional risk factors for cardiovascular disease.
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Affiliation(s)
- Asiye Kanbay
- Department of Pulmonary Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey.
| | - Handan Inonu
- Department of Pulmonary Medicine, Gazi Osmanpasa University School of Medicine, Tokat, Turkey
| | - Yalcin Solak
- Nephrology Clinic, Karaman State Hospital, Karaman, Turkey
| | - Abdulsamet Erden
- Department of Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Emine Uslu
- Department of Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Sevgi Arik Yuksel
- Department of Neurology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Mehmet Akif Ozturk
- Division of Rheumatology, Department of Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Kim McFann
- Division of Renal Diseases and Hypertension, University of CO, Denver, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of CO, Denver, USA
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
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Miao Y, Liao JK. Potential serum biomarkers in the pathophysiological processes of stroke. Expert Rev Neurother 2014; 14:173-85. [PMID: 24417214 DOI: 10.1586/14737175.2014.875471] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Stroke is a leading cause of death and serious long-term disability. Ischemic stroke is the major subtype of stroke. Currently, its diagnosis is mainly dependent upon clinical symptoms and neuroimaging techniques. Despite these clinical and imaging modalities, often strokes are not recognized after initial onset. As early intervention of medical or surgical therapy is often associated with improved outcomes, there is an urgent need to improve the speed and accuracy of stroke diagnosis. Stroke is a complex pathophysiological process involving; energy failure, imbalance of ion homeostasis, acidosis, intracellular calcium overload, neuronal excitotoxicity, free radical-mediated lipid oxidation, inflammatory cell infiltration, and glial cell activation. These events ultimately lead to neuronal apoptotic cell death or necrosis. In this review, we have summarized the serum biomarkers according to the pathophysiological processes of stroke, which have been intensively studied in clinical trials of stroke over the past five years, and also used Medline's 'related article' option to identify further articles. We focused on the potential biomarkers pertaining to vascular injury, metabolic changes, oxidative injury, and inflammation, and newly studied biomarkers, and discussed how these biomarkers could be used for the diagnosis or determining the prognosis of stroke.
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Affiliation(s)
- Yanying Miao
- Department of Medicine, University of Chicago, Section of Cardiology, Chicago, IL 60637, USA
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25
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Lindblad YT, Axelsson J, Balzano R, Vavilis G, Chromek M, Celsi G, Bárány P. Left ventricular diastolic dysfunction by tissue Doppler echocardiography in pediatric chronic kidney disease. Pediatr Nephrol 2013; 28:2003-13. [PMID: 23740035 DOI: 10.1007/s00467-013-2504-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 04/15/2013] [Accepted: 04/15/2013] [Indexed: 01/20/2023]
Abstract
BACKGROUND Myocardial dysfunction is common in chronic kidney disease (CKD) and related to poor outcomes. New non-invasive methods to assess cardiac function have been introduced, but comparative studies evaluating their clinical usefulness in pediatric CKD are lacking. We studied left ventricular (LV) function in pediatric CKD and renal transplant patients, comparing conventional pulse-wave Doppler echocardiography (cPWD) with newer tissue Doppler imaging (TDI) and relating the results to known cardiovascular risk factors. METHODS The study included 34 children/adolescents with CKD stages 2-5, 44 renal transplant patients and 19 patients with a normal renal function. The mean age was 11.4 (range 0.8-18.8) years. RESULTS Both patient groups had significantly lower LV diastolic function than those with a normal renal function. The most sensitive determinants were TDI E'/A' and cPWD E/TDI E' ratios. In a stepwise linear regression analysis, high blood pressure, young age and the presence of albuminuria all independently predicted LV diastolic function. CONCLUSIONS Our study confirms the high prevalence of LV diastolic dysfunction in pediatric CKD patients and following renal transplantation, where TDI appears to be more sensitive than cPWD in assessing early myocardial dysfunction. Our results also underline the importance of preventive measures, such as rigorous blood pressure control, in pediatric CKD.
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Affiliation(s)
- Ylva Tranæus Lindblad
- Division of Pediatrics, Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
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Solak Y, Akilli H, Kayrak M, Aribas A, Gaipov A, Turk S, Perez-Pozo SE, Covic A, McFann K, Johnson RJ, Kanbay M. Uric acid level and erectile dysfunction in patients with coronary artery disease. J Sex Med 2013; 11:165-72. [PMID: 24433559 DOI: 10.1111/jsm.12332] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a frequent complaint of elderly subjects and is closely associated with endothelial dysfunction and cardiovascular disease (CVD). Uric acid is also associated with endothelial dysfunction, oxidative stress, and CVD, raising the hypothesis that an increased serum uric acid might predict ED in patients who are at risk for coronary artery disease (CAD). AIM This study aims to evaluate the association of serum uric acid levels with presence and severity of ED in patients presenting with chest pain of presumed cardiac origin. METHODS This is a cross-sectional study of 312 adult male patients with suspected CAD who underwent exercise stress test (EST) for workup of chest pain and completed a sexual health inventory for men survey form to determine the presence and severity of ED. Routine serum biochemistry (and uric acid levels) were measured. Logistic regression analysis was used to assess risk factors for ED. MAIN OUTCOME MEASURES The short version of the International Index of Erectile Function questionnaire diagnosed ED (cutoff score ≤ 21). Serum uric acid levels were determined. Patients with chest pain of suspected cardiac origin underwent an EST. RESULTS One hundred forty-nine of 312 (47.7%) male subjects had ED by survey criteria. Patients with ED were older and had more frequent CAD, hypertension, diabetes and impaired renal function, and also had significantly higher levels of uric acid, fibrinogen, glucose, C-reactive protein, triglycerides compared with patients without ED. Uric acid levels were associated with ED by univariate analysis (odds ratio = 1.36, P = 0.002); however, this association was not observed in multivariate analysis adjusted for estimated glomerular filtration rate. CONCLUSION Subjects presenting with chest pain of presumed cardiac origin are more likely to have ED if they have elevated uric acid levels.
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Affiliation(s)
- Yalcin Solak
- Nephrology Unit, Department of Internal Medicine, Karaman State Hospital, Karaman, Turkey
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Abstract
The inexorable increase in the prevalence of obesity is a global health concern, which will result in a concomitant escalation in health-care costs. Obesity-related metabolic syndrome affects approximately 25% of adults and is associated with cardiovascular and renal disease. The heart and kidneys are physiologically interdependent, and the pathological effects of obesity can lead to cardiorenal syndrome and, ultimately, kidney and heart failure. Weight loss can prevent or ameliorate obesity-related cardiorenal syndrome, but long-term maintenance of a healthy weight has been difficult to achieve through lifestyle changes or pharmacotherapy. Bariatric surgery offers both sustained weight loss and favourable metabolic changes, including dramatic improvements in glycaemic control and symptoms of type 2 diabetes mellitus. Procedures such as Roux-en-Y gastric bypass offer immediate multisystemic benefits, including bile flow alteration, reduced gastric size, anatomical gut rearrangement and altered flow of nutrients, vagal manipulation and enteric hormone modulation. In patients with cardiorenal syndrome, bariatric surgery also offers renoprotection and cardioprotection, and attenuates both kidney and heart failure by improving organ perfusion and reversing metabolic dysfunction. However, further research is required to understand how bariatric surgery acts on the cardiorenal axis, and its pioneering role in novel treatments and interventions for cardiorenal disease.
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28
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Kaya MG. Hyperuricemia and cardiovascular disease: is this relationship independent of the etiology of hyperuricemia? Cardiology 2013; 125:201-3. [PMID: 23796915 DOI: 10.1159/000351697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 04/24/2013] [Indexed: 11/19/2022]
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Biology of Human Pentraxin 3 (PTX3) in Acute and Chronic Kidney Disease. J Clin Immunol 2013; 33:881-90. [DOI: 10.1007/s10875-013-9879-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/18/2013] [Indexed: 12/13/2022]
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Balla S, Nusair MB, Alpert MA. Risk factors for atherosclerosis in patients with chronic kidney disease: recognition and management. Curr Opin Pharmacol 2013; 13:192-9. [PMID: 23291030 DOI: 10.1016/j.coph.2012.12.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 11/29/2012] [Accepted: 12/08/2012] [Indexed: 10/27/2022]
Abstract
Heart disease is the most common cause of death in patients with chronic kidney disease (CKD), particularly in those receiving dialysis. Atherosclerosic cardiovascular (CV) disease (CVD) accounts for a large number of these deaths. Atherosclerosis is accelerated in patients with CKD due predominantly to the high prevalence of traditional CVD risk factors in the CKD population. CKD aggravates pre-existent traditional risk factors such as hypertension and dyslipidemia due to secondary renal parenchymal hypertension and secondary dyslipidemia. In addition, a variety of non-traditional risk factors that occur commonly in CKD patients contribute to CV risk. Recent studies suggest that CKD itself may be an independent risk factor for CVD, particularly coronary heart disease (CHD). Many therapies aimed at CV risk factor modification that have been successful in reducing CV risk in the general population are less effective or ineffective in favorably modifying CV risk in CKD.
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Affiliation(s)
- Sudarshan Balla
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO, USA
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Lech M, Rommele C, Anders HJ. Pentraxins in nephrology: C-reactive protein, serum amyloid P and pentraxin-3. Nephrol Dial Transplant 2012; 28:803-11. [PMID: 23243042 DOI: 10.1093/ndt/gfs448] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Every clinician uses C-reactive protein (CRP) levels as a biomarker for systemic inflammation in acute disorders. Nephrologists also consider CRP levels as a predictor for overall mortality in patients with chronic kidney disease or end-stage renal disease. But what is the biological function of CRP? CRP is a member of the family of pentraxins, which are small pentameric innate immunity effector proteins. Pentraxins are absent or weakly expressed during homeostasis. However, the pro-inflammatory cytokines interleukin (IL)-1, IL-6 and tumour necrosis factor induce CRP and serum amyloid P (SAP) in hepatocytes, whereas the long pentraxins, such as pentraxin (PTX)-3, are produced in peripheral tissues and monocytic phagocytes. Pentraxins opsonize pathogens or other particles such as dead cells, for their phagocytic clearance or induce pathogen killing in extracellular compartments. In this review, we discuss the immunoregulatory properties of the different members of the pentraxin family. We discuss the evolving evidence demonstrating their roles in acute and chronic forms of kidney disease and the significance of SAP and PTX3 as additional biomarkers of innate immune activation and systemic inflammation.
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Affiliation(s)
- Maciej Lech
- Medizinische Klinik und Poliklinik IV, Campus Innenstadt, University of Munich-LMU, Ziemssenstr 1 D-80336, Munich, Germany
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Knoflach M, Kiechl S, Mantovani A, Cuccovillo I, Bottazzi B, Xu Q, Xiao Q, Gasperi A, Mayr A, Kehrer M, Willeit J, Wick G. Pentraxin-3 as a marker of advanced atherosclerosis results from the Bruneck, ARMY and ARFY Studies. PLoS One 2012; 7:e31474. [PMID: 22319633 PMCID: PMC3272046 DOI: 10.1371/journal.pone.0031474] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 01/09/2012] [Indexed: 12/03/2022] Open
Abstract
Objective Pentraxins like C-reactive protein are key components of the innate immune system. Recently, pentraxin-3 (PTX3) has been proposed to be a specific marker of vascular inflammation, yet its association with atherosclerosis is still unclear. Methods and Results PTX3 serum levels were measured in three independent studies of 132 young men (ARMY Study), 205 young women (ARFY Study) and 562 individuals 55 to 94 years old (Bruneck Study). In contrast to C-reactive protein, PTX3 showed little relationships with classic vascular risk factors and pro-inflammatory conditions. In the population based Bruneck Study, PTX3 level was independently associated with prevalent cardiovascular diseases (multivariable odds ratio [95%CI] 3.09 [1.65–5.79]; P<0.001). Moreover, PTX3 level correlated with the severity of carotid and femoral atherosclerosis and was highest in individuals with multiple vascular territories affected. In contrast, there was no association with elevated intima-media thickness, a precursor lesion of atherosclerosis, in any of the three populations investigated. Conclusions Level of PTX3 is independently associated with atherosclerosis and manifest cardiovascular disease but not early vessel pathology. Unlike C-reactive protein, PTX3 is not a component of the classic acute phase response (systemic inflammation) but appears to be more specific for vascular inflammation.
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Affiliation(s)
- Michael Knoflach
- Department of Neurology, Medical University, Innsbruck, Austria.
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Duran M, Kalay N, Akpek M, Orscelik O, Elcik D, Ocak A, Inanc MT, Kasapkara HA, Oguzhan A, Eryol NK, Ergin A, Kaya MG. High Levels of Serum Uric Acid Predict Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome. Angiology 2011; 63:448-52. [DOI: 10.1177/0003319711426868] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We aimed to elucidate the relation between serum uric acid (SUA) level and severity of coronary artery disease (CAD) in nondiabetic, nonhypertensive patients (n = 246) with acute coronary syndrome (ACS). Severity of CAD was assessed by the Gensini score. One, 2, and 3 or more diseased vessels were identified in 87 (35.4%), 55 (22.4%), and 104 (42.2%) patients, respectively. Patients with hyperuricemia had higher Gensini score, high number of diseased vessels, critical lesions, and total occlusion. Serum uric acid level was significantly associated with number of diseased vessels. Serum uric acid was an independent risk factor for multivessel disease by univariate analysis. High levels of SUA associated with the severity of CAD in nondiabetic, nonhypertensive patients with ACS.
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Affiliation(s)
- Mustafa Duran
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Nihat Kalay
- Department of Cardiology, Erciyes University, Kayseri, Turkey
| | - Mahmut Akpek
- Department of Cardiology, Erciyes University, Kayseri, Turkey
| | - Ozcan Orscelik
- Department of Cardiology, Erciyes University, Kayseri, Turkey
| | - Deniz Elcik
- Department of Cardiology, Erciyes University, Kayseri, Turkey
| | - Ayse Ocak
- Department of Internal Medicine, Erciyes University, Kayseri, Turkey
| | | | | | | | - Namik K. Eryol
- Department of Cardiology, Erciyes University, Kayseri, Turkey
| | - Ali Ergin
- Department of Cardiology, Erciyes University, Kayseri, Turkey
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Mok Y, Lee SJ, Kim MS, Cui W, Moon YM, Jee SH. Serum uric acid and chronic kidney disease: the Severance cohort study. Nephrol Dial Transplant 2011; 27:1831-5. [DOI: 10.1093/ndt/gfr530] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Katsiki N, Elisaf M. Multifactorial treatment for improvement of renal function and cardiovascular risk: an ATTEMPT for patients with metabolic syndrome and chronic kidney disease. Curr Med Res Opin 2011; 27:1669-72. [PMID: 21718096 DOI: 10.1185/03007995.2011.596410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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