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Güçlü K, Tur K, Şahin S, Güçlü A. Independent correlation between ischemia modified albumin and parathormone in hemodialysis patients. ITALIAN JOURNAL OF MEDICINE 2023. [DOI: 10.4081/itjm.2022.1560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction. Hemodialysis patients are the group which oxidative stress is found more exacerbated. Ischemia modified albumin (IMA) is a new and sensitive marker for ischemia and oxidative stress. At current study we evaluated relation between IMA and biochemical parameters in hemodialysis patients.
Materials and Methods. Thirty-four patients on maintenance hemodialysis were included. Pre-hemodialysis and post-hemodialysis blood samples were taken. Serum IMA and biochemistry parameters were measured.
Results. There was a positive correlation between alkaline phosphatase (ALP) and IMA (r=0,268, p<0,05), CRP and IMA (r=0,452, p=0,007), parathormone and IMA (r=0,436, p=0,010), There was a negative correlation between albumin and IMA (r=-0,338, p=0,05). Multiple regression analysis was run to predict IMA levels from parathormone, CRP and creatinine the model statistically significantly predicted relation p<0,05, R=0,506, out of four two variables added statistically significant to the prediction, PTH (p=0,006), CRP (p=0,029). In multiregression analysis, IMA was found to be associated with PTH and CRP independent of creatinine value.
Conclusions. We showed for the first time that PTH is associated with IMA in hemodialysis patients, independent of the level of renal function.
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Güçlü K, Tur K, Şahin S, Güçlü A. Independent correlation between ischemia modified albumin and parathormone in hemodialysis patients. ITALIAN JOURNAL OF MEDICINE 2023. [DOI: 10.4081/itjm.2023.1560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Introduction. Hemodialysis patients are the group which oxidative stress is found more exacerbated. Ischemia modified albumin (IMA) is a new and sensitive marker for ischemia and oxidative stress. At current study we evaluated relation between IMA and biochemical parameters in hemodialysis patients.
Materials and Methods. Thirty-four patients on maintenance hemodialysis were included. Pre-hemodialysis and post-hemodialysis blood samples were taken. Serum IMA and biochemistry parameters were measured.
Results. There was a positive correlation between alkaline phosphatase (ALP) and IMA (r=0,268, p<0,05), CRP and IMA (r=0,452, p=0,007), parathormone and IMA (r=0,436, p=0,010), There was a negative correlation between albumin and IMA (r=-0,338, p=0,05). Multiple regression analysis was run to predict IMA levels from parathormone, CRP and creatinine the model statistically significantly predicted relation p<0,05, R=0,506, out of four two variables added statistically significant to the prediction, PTH (p=0,006), CRP (p=0,029). In multiregression analysis, IMA was found to be associated with PTH and CRP independent of creatinine value.
Conclusions. We showed for the first time that PTH is associated with IMA in hemodialysis patients, independent of the level of renal function.
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Gan W, Guan Q, Hu X, Zeng X, Shao D, Xu L, Xiao W, Mao H, Chen W. The association between platelet-lymphocyte ratio and the risk of all-cause mortality in chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol 2022; 54:2959-2967. [PMID: 35581444 DOI: 10.1007/s11255-022-03234-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 04/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) patients have high levels of inflammatory mediators. These inflammatory mediators contribute to the increased risk of cardiovascular events and all-cause mortality. Platelet-lymphocyte ratio (PLR) has recently been recognized as a novel inflammatory marker and has been shown to be associated with the prognosis in CKD patients. However, the quality of these studies varies and their results are controversial. The purpose of this meta-analysis was to investigate the relationship between PLR and all-cause mortality in CKD patients. METHODS A systematic literature search of PubMed, EMBASE, CENTRAL and ISI Web of Science was conducted. The databases were searched from their inception dates up to the latest issue (31 October 2021). Two reviewers independently searched the databases and screened studies. Data were extracted using a standardized collection form. Meta-analysis was performed to compare PLR values between CKD and non-CKD patients, and to investigate the association between PLR and all-cause mortality in CKD patients. This meta-analysis is reported in adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS A total of 11 studies involving 4244 participants were selected. The pooled data indicated that PLR values were significantly higher in CKD patients than non-CKD controls (weighted mean difference = 21.6, 95% CI 17.39-25.81, p < 0.01), and PLR is associated with an increased risk of all-cause mortality in CKD patients (hazard ratio = 2.49, 95% CI 1.78-3.49, p < 0.01). CONCLUSIONS Patients with CKD have higher PLR values compared to non-CKD patients. Meanwhile, PLR values were highly associated with all-cause mortality in CKD patients. PLR is a valid predictor as a clinically accessible indicator for patients with CKD.
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Affiliation(s)
- Wenyuan Gan
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Qingyu Guan
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China.,Medical School, Jianghan University, Wuhan, 430056, Hubei, China
| | - Xiaosong Hu
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Xingruo Zeng
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Danni Shao
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Li Xu
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Wei Xiao
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Huihui Mao
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China
| | - Wenli Chen
- Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China.
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Zhang J, Lu X, Wang S, Li H. Neutrophil-to-Lymphocyte Ratio and Erythropoietin Resistance among Maintenance Hemodialysis Patients. Blood Purif 2021; 51:708-713. [PMID: 34649238 DOI: 10.1159/000519644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are recent prognostic biomarkers associated with inflammation. Increased erythropoiesis resistance index (ERI) may predict the risk of all-cause and cardiovascular mortality in hemodialysis (HD) patients. However, the roles of NLR and PLR in erythropoietin (EPO) responsiveness remain unclear in HD patients. This study aims to investigate the relationship between NLR and PLR and EPO responsiveness in maintenance HD patients. METHODS A total of 299 HD patients were included in this survey. Laboratory data and demographic details were collected. EPO responsiveness was evaluated by ERI. Pearson correlation analysis and logistic regressions were conducted to evaluate the factors that may be associated with EPO responsiveness. RESULTS The EPO responsiveness was positively related to ferritin and negatively related to serum albumin, lymphocytes, and hemoglobin. A multivariate linear regression revealed that only NLR (standardized β = 0.13, p = 0.024) but not PLR (standardized β = 0.107, p = 0.063) was correlated with a higher ERI. CONCLUSION A higher NLR level was shown to be a cheaper method to predict worse EPO responsiveness in HD patients.
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Affiliation(s)
- Jialing Zhang
- Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China,
| | - Xiangxue Lu
- Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shixiang Wang
- Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Han Li
- Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Xue X, Lu CL, Cheng H, Jin XY, Liu XH, Yang M, Xu WC, Liu Q, Yuan J, Liu JP, Wang XQ. Factor analysis of Traditional Chinese Medicine syndromes and clinical characteristics of patients with secondary hyperparathyroidism maintained by hemodialysis: A cross-sectional study. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.101373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Marques P, de Vries F, Dekkers OM, Korbonits M, Biermasz NR, Pereira AM. Serum Inflammation-based Scores in Endocrine Tumors. J Clin Endocrinol Metab 2021; 106:e3796-e3819. [PMID: 33837783 PMCID: PMC8475227 DOI: 10.1210/clinem/dgab238] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Indexed: 12/13/2022]
Abstract
CONTEXT Serum inflammation-based scores reflect systemic inflammatory response and/or patients' nutritional status, and may predict clinical outcomes in cancer. While these are well-described and increasingly used in different cancers, their clinical usefulness in the management of patients with endocrine tumors is less known. EVIDENCE ACQUISITION A comprehensive PubMed search was performed using the terms "endocrine tumor," "inflammation," "serum inflammation-based score," "inflammatory-based score," "inflammatory response-related scoring," "systemic inflammatory response markers," "neutrophil-to-lymphocyte ratio," "neutrophil-to-platelet ratio," "lymphocyte-to-monocyte ratio," "Glasgow prognostic score," "neutrophil-platelet score," "Systemic Immune-Inflammation Index," and "Prognostic Nutrition Index" in clinical studies. EVIDENCE SYNTHESIS The neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio are the ones most extensively investigated in patients with endocrine tumors. Other scores have also been considered in some studies. Several studies focused in finding whether serum inflammatory biomarkers may stratify the endocrine tumor patients' risk and detect those at risk for developing more aggressive and/or refractory disease, particularly after endocrine surgery. CONCLUSIONS In this review, we summarize the current knowledge on the different serum inflammation-based scores and their usefulness in predicting the phenotype, clinical aggressiveness, and disease outcomes and prognosis in patients with endocrine tumors. The value of such serum inflammation-based scores in the management of patients with endocrine tumors has been emerging over the last decade. However, further research is necessary to establish useful markers and their cut-offs for routine clinical practice for individual diseases.
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Affiliation(s)
- Pedro Marques
- Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors Leiden (CETL), Leiden University Medical Center, Leiden, The Netherlands
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
- Correspondence: Pedro Marques, Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors Leiden (CETL), Leiden University Medical Center. Albinusdreef 2, 2333 ZA Leiden, The Netherlands. E-mail:
| | - Friso de Vries
- Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors Leiden (CETL), Leiden University Medical Center, Leiden, The Netherlands
| | - Olaf M Dekkers
- Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors Leiden (CETL), Leiden University Medical Center, Leiden, The Netherlands
| | - Márta Korbonits
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Nienke R Biermasz
- Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors Leiden (CETL), Leiden University Medical Center, Leiden, The Netherlands
| | - Alberto M Pereira
- Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors Leiden (CETL), Leiden University Medical Center, Leiden, The Netherlands
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Alakuş H, Göksu M. Does Parathyroidectomy Affect the Neutrophil/Lymphocyte Ratio, a Systemic Inflammatory Marker? Cureus 2021; 13:e13708. [PMID: 33833922 PMCID: PMC8019483 DOI: 10.7759/cureus.13708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction Primary hyperparathyroidism (PHPT) is an endocrinological disorder associated with increased systemic inflammation. This study aimed to examine the changes in the neutrophil/lymphocyte ratio (NLR), serum parathormone, serum corrected calcium, serum phosphate, and white blood cell (WBC) count in patients with PHPT before and after parathyroidectomy. Methods A total of 37 patients who underwent successful parathyroidectomy for PHPT were included in the study. NLR, serum parathormone, serum corrected calcium, serum phosphate, and WBC count were compared before parathyroidectomy and at the sixth postoperative month. Results The difference in the NLR, serum parathormone, serum corrected calcium, and serum phosphate values before and after parathyroidectomy was statistically significant (p=0.019, p<0.001, p<0.001, and p<0.001, respectively), but there was no significant difference in the WBC count (p=0.314). The correlation analysis performed before parathyroidectomy revealed a significant positive correlation between NLR and serum parathormone (r=0.519, p=0.001), serum corrected calcium (r=0.390, p=0.017) and WBC count (r=0.531, p=0.001), and a significant negative correlation between NLR and serum phosphate (r=-0.331). Conclusion In patients with PHPT, successful parathyroidectomy results in a decrease in NLR. Increased systemic inflammation in patients with PHPT can be reduced following parathyroidectomy.
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Affiliation(s)
- Hüseyin Alakuş
- Department of Surgical Oncology, Adiyaman University Faculty of Medicine, Adiyaman, TUR
| | - Mustafa Göksu
- Department of General Surgery, Adiyaman University Faculty of Medicine, Adiyaman, TUR
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Yang Y, Da J, Jiang Y, Yuan J, Zha Y. Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study. BMC Nephrol 2021; 22:44. [PMID: 33514340 PMCID: PMC7847059 DOI: 10.1186/s12882-021-02241-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/13/2021] [Indexed: 12/25/2022] Open
Abstract
Background Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH < 150 pg/mL; middle-PTH group, PTH 150-300 pg/mL; high-PTH group, PTH > 300 pg/mL. Results During a median follow-up of 29.5 (interquartile range 16–49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014–2.663, P = 0.044]. Conclusions Low PTH levels are independently associated with peritonitis in incident PD patients.
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Affiliation(s)
- Yuqi Yang
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jingjing Da
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yi Jiang
- NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China.,Information section, Provincial People's Hospital, Guiyang, China
| | - Jing Yuan
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yan Zha
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China. .,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China.
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Genetic Variants Associated with Chronic Kidney Disease in a Spanish Population. Sci Rep 2020; 10:144. [PMID: 31924810 PMCID: PMC6954113 DOI: 10.1038/s41598-019-56695-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022] Open
Abstract
Chronic kidney disease (CKD) patients have many affected physiological pathways. Variations in the genes regulating these pathways might affect the incidence and predisposition to this disease. A total of 722 Spanish adults, including 548 patients and 174 controls, were genotyped to better understand the effects of genetic risk loci on the susceptibility to CKD. We analyzed 38 single nucleotide polymorphisms (SNPs) in candidate genes associated with the inflammatory response (interleukins IL-1A, IL-4, IL-6, IL-10, TNF-α, ICAM-1), fibrogenesis (TGFB1), homocysteine synthesis (MTHFR), DNA repair (OGG1, MUTYH, XRCC1, ERCC2, ERCC4), renin-angiotensin-aldosterone system (CYP11B2, AGT), phase-II metabolism (GSTP1, GSTO1, GSTO2), antioxidant capacity (SOD1, SOD2, CAT, GPX1, GPX3, GPX4), and some other genes previously reported to be associated with CKD (GLO1, SLC7A9, SHROOM3, UMOD, VEGFA, MGP, KL). The results showed associations of GPX1, GSTO1, GSTO2, UMOD, and MGP with CKD. Additionally, associations with CKD related pathologies, such as hypertension (GPX4, CYP11B2, ERCC4), cardiovascular disease, diabetes and cancer predisposition (ERCC2) were also observed. Different genes showed association with biochemical parameters characteristic for CKD, such as creatinine (GPX1, GSTO1, GSTO2, KL, MGP), glomerular filtration rate (GPX1, GSTO1, KL, ICAM-1, MGP), hemoglobin (ERCC2, SHROOM3), resistance index erythropoietin (SOD2, VEGFA, MTHFR, KL), albumin (SOD1, GSTO2, ERCC2, SOD2), phosphorus (IL-4, ERCC4 SOD1, GPX4, GPX1), parathyroid hormone (IL-1A, IL-6, SHROOM3, UMOD, ICAM-1), C-reactive protein (SOD2, TGFB1,GSTP1, XRCC1), and ferritin (SOD2, GSTP1, SLC7A9, GPX4). To our knowledge, this is the second comprehensive study carried out in Spanish patients linking genetic polymorphisms and CKD.
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