1
|
Dual Roles of the Mineral Metabolism Disorders Biomarkers in Prevalent Hemodilysis Patients: In Renal Bone Disease and in Vascular Calcification. J Med Biochem 2019; 38:134-144. [PMID: 30867641 PMCID: PMC6411002 DOI: 10.2478/jomb-2018-0026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/16/2018] [Indexed: 12/21/2022] Open
Abstract
Background Vascular calcification (VC) is highly prevalent in dialysis (HD) patients, and its mechanism is multifactorial. Most likely that systemic or local inhibitory factor is overwhelmed by promoters of VC in these patients. VC increased arterial stiffness, and left ventricular hypertrophy. Thus, the present study aimed to investigate the association of VC and myocardial remodeling and to analyze their relationship with VC promoters (fibroblast growth factor 23-FGF23, Klotho, intact parathormon-iPTH, vitamin D) in 56 prevalent HD patients (median values: age 54 yrs, HD vintage 82 months). Methods Besides routine laboratory analyzes, serum levels of FGF 23, soluble Klotho, iPTH, 1,25-dihydroxyvitamin D3; pulse wave velocity (PWV); left ventricular (LV) mass by ultrasound; and VCs score by Adragao method were measured. Results VC was found in 60% and LV concentric or eccentric hypertrophy in 50% patients. Dialysis vintage (OR 1.025, 95%CI 1.007–1.044, p=0.006) FGF23 (OR 1.006, 95% CI 0.992–1.012, p=0.029) and serum magnesium (OR 0.000, 95%CI 0.000–0.214, p=0.04) were associated with VC. Changes in myocardial geometry was associated with male sex (beta=-0.273, 95% CI -23.967 1.513, p=0.027), iPTH (beta 0.029, 95%CI -0.059–0.001, p=0.027) and vitamin D treatment (beta 25.49, 95%CI 11.325–39.667, p=0.001). Also, patients with the more widespread VC had the highest LV remodeling categories. PWV was associated patient’s age, cholesterol, diastolic blood pressure, LV mass (positively) and serum calcium (negatively), indicating potential link with atherosclerotic risk. Conclusions Despite to different risk factors for VC and myocardial remodeling, obtained results could indicate that risk factors intertwine in long-term treatment of HD patients and therefore careful and continuous correction of mineral metabolism disorders is undoubtedly of the utmost importance.
Collapse
|
2
|
Zheng W, Mu J, Chu C, Hu J, Yan Y, Ma Q, Lv Y, Xu X, Wang K, Wang Y, Deng Y, Yan B, Yang R, Yang J, Ren Y, Yuan Z. Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age. J Am Soc Nephrol 2018; 29:2835-2846. [PMID: 30420422 DOI: 10.1681/asn.2018030263] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 10/10/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Although high BP is one of the most important factors affecting renal function, whether longitudinal BP trajectories in early life course are associated with renal function damage in later life is unclear. METHODS To investigate the correlation between BP trajectories from childhood to adulthood and renal function in middle age, we used group-based trajectory models to identify BP trajectories in 2430 individuals (aged 6-15 years old at baseline) participating in the ongoing Hanzhong Adolescent Hypertension Cohort. We tested the association between these trajectories and subclinical renal damage in middle age, adjusting for several covariates. RESULTS We identified four distinct systolic BP trajectories among 2430 subjects: low stable, moderate stable, high stable, and moderate increasing on the basis of systolic BP levels at baseline and during the 30-year follow-up period. The urinary albumin-to-creatinine ratio (uACR) was higher in moderate stable, high stable, and moderate increasing groups compared with the low stable group. A total of 228 individuals had subclinical renal disease by 2017. Compared with the low stable trajectory group, the other groups had increasingly greater odds of experiencing subclinical renal disease in middle age. These associations were not altered after adjustment for other covariates, except for in the moderate stable group. Analyzed results were similar for the mean arterial pressure and diastolic BP trajectory groups. CONCLUSIONS Higher BP trajectories were correlated with higher of uACR levels and risk of subclinical renal disease in middle age. Identifying long-term BP trajectories from early age may assist in predicting individuals' renal function in later life.
Collapse
Affiliation(s)
- Wenling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Jianjun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China;
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Jiawen Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yongbo Lv
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xianjing Xu
- Department of Cardiovascular Medicine, Henan Province People's Hospital, Zhengzhou, People's Republic of China
| | - Keke Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| | - Ying Deng
- Department of Cardiovascular Medicine, Hanzhong No. 405 Hospital, Hanzhong, People's Republic of China
| | - Bo Yan
- Department of Cardiovascular Medicine, Hanzhong Central Hospital, Hanzhong, People's Republic of China; and
| | - Ruihai Yang
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Jun Yang
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Yong Ren
- Institute of Cardiovascular Sciences, Hanzhong People's Hospital, Hanzhong, People's Republic of China
| | - Zuyi Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, People's Republic of China
| |
Collapse
|
3
|
Alpdemir M, Eryilmaz M, Alpdemir MF, Topçu G, Azak A, Yücel D. Comparison of Widely Used Biochemical Analytes in the Serum and Saliva Samples of Dialysis Patients. J Med Biochem 2018; 37:346-354. [PMID: 30598632 PMCID: PMC6298461 DOI: 10.1515/jomb-2017-0056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 12/05/2017] [Indexed: 11/15/2022] Open
Abstract
Background The aim of this study is to determine whether the saliva analysis is an alternative to routine biochemical and immunoassay analyses in patients undergoing perito - neal dialysis (PD) or hemodialysis (HD). Methods Study group consisted of 40 healthy control, 44 PD and 44 HD patients. Routine biochemical analytes, thyroid stimulating hormone (TSH), free T3, free T4, vitamin B12, ferritin and folic acid were measured. Results Compared to pre-HD, urea, creatinine, uric acid, potassium levels were lower in post-HD, and calcium, magnesium, vitamin B12 levels were higher in post-HD both in saliva and serum. Positive correlations between saliva and serum were found for TSH and ferritin in control; urea, LDH, K in PD; urea, creatinine, alkaline phosphatase in pre-HD, and gamma-glutamyl transferase, iron, TSH in post-HD. There was a negative correlation only for creatine kinase and Mg in pre-HD and calcium in post-HD. In all groups, a positive correlation was found for urea, creatinine and a negative correlation was found for magnesium. Conclusions Our study showed higher salivary urea and creatinine levels in patient groups, consistent with serum levels. Based on these results, salivary urea and creatinine levels may be useful in the evaluation of azotemia in dialysis patients.
Collapse
Affiliation(s)
- Medine Alpdemir
- Department of Clinical Biochemistry, Balıkesir State Hospital, Ministry of Health, Balikesir, Turkey
| | - Mehmet Eryilmaz
- Department of Clinical Biochemistry, Aydın Çine State Hospital, Ministry of Health,Aydin, Turkey
| | - Mehmet Fatih Alpdemir
- Department of Clinical Biochemistry, Balıkesir State Hospital, Ministry of Health, Balikesir, Turkey
| | - Güler Topçu
- Department of Clinical Biochemistry, Balıkesir State Hospital, Ministry of Health, Balikesir, Turkey
| | - Alper Azak
- Department of Nephrology, Balikesir State Hospital, Ministry of Health, Balikesir, Turkey
| | - Doğan Yücel
- Department of Clinical Biochemistry, Ankara Training and Research Hospital, Ministry of Health,Ankara, Turkey
| |
Collapse
|