Patients with end-stage renal disease are prone to inflammation and inflammation is related to erythropoietin-stimulating agent hyporesponsiveness and mortality in this population. Statins have been demonstrated to reduce cardiovascular mortality in selected populations of end-stage renal disease patients. These drugs have pleiotrophic effects such as anti-inflammation. In this retrospective analysis, we determined whether the use of statins improves inflammation and inflammation-related anemia in a cohort of hemodialysis patients. Data were analyzed from Fresenius Medical Care Dialysis Clinics in Turkey between 2005 and 2007. Seventy prevalent hemodialysis patients who were on statins at the start of the study and have been on statins during follow-up (statin users) and 1293 patients who were not on statin at the start of the study and had never been prescribed any lipid-modifying drugs during follow-up (statin nonusers) were included in the study. High-sensitive C-reactive protein levels were significantly decreased in statin users (1.50±1.49 vs. 1.33±1.11 mg/L, P=0.05) compared with nonusers (1.93±3.22 vs. 2.05±2.77 mg/L). Hemoglobin levels and the rate of erythropoietin-stimulating agent users were similar. However, the prescribed erythropoietin-stimulating agent dose (31.6±27.5 vs. 47.3±45.2 U/kg/week, P<0.05) and the erythropoietin response index (2.90±2.73 vs. 4.51±4.48 U/kg/week/Hb, P=0.001) were lower in statin users compared with statin nonusers. On stepwise multiple regression analysis, gender, high-sensitive C-reactive protein, duration of hemodialysis, serum ferritin, and statin use were independent determinants of the erythropoietin responsiveness index. Our results suggest that statin treatment leads to lower inflammation and improves hematopoiesis in hemodialysis patients.
Chronic hepatitis C virus (HCV) infection is a common infectious agent in chronic hemodialysis (HD) patients. In this prospective case-control study, we aimed to investigate the influence of chronic HCV infection on erythropoietin (EPO) and iron requirement in HD patients.49 HD patients (24 male, 25 female, mean age 47 +/- 15 years) were included. The mean time spent on dialysis was 39 +/- 38 months, and follow-up time was 1 year for this study. Biochemical analyses and complete blood counts together with iron status of the patients (transferrin saturation and serum ferritin levels) were measured monthly. Highly sensitive C-reactive protein (hs-CRP) levels were measured within 3-month intervals. Endogenous EPO levels were measured by enzyme-linked immunoassay 2 weeks after cessation of EPO treatment.Eleven of the HD patients (22%) were anti-HCV(+). There was no difference in age, sex, time on dialysis, distribution of primary renal diseases, predialytic BUN, Kt/V, albumin and i-PTH levels between HCV(+) and (-) patients. Anti-HCV-positive patients required significantly lower weekly doses of EPO (87 +/- 25 IU/kg vs 129 +/- 11 IU/kg, p = 0.042) and iron (16.8 +/- 12.2 mg vs 32.6 +/- 16.1 mg, p = 0.02) replacement than anti-HCV(-) group; hs-CRP levels were similar between study groups. Serum endogenous EPO levels were significantly higher in HCV(+) patients than HCV(-) HD patients (9.43 +/- 6.47 mU/ml vs 3.59 +/- 2.08 mU/ml, p = 0.008).Anti-HCV(+) HD patients had higher serum EPO levels and required less EPO and iron replacement as compared to anti-HCV(-) patients. Because of the changes in iron metabolism, iron treatment should be carefully administered in HD patients with HCV.
Objective: The aim of the study was determine whether there were an important differences in levels of Ca (calcium),Mg (magnesium), P (phosphorus), cholesterol, HDL-cholesterol, triglyceride, and plasma PTH (parathyroid hormone) between hemodialysis and healthy groups, besides whether there were any correlations between elements, lipid profiles and PTH in all groups. Material and methods: The study included 47 hemodialysis patients who were dialyzed with a range of 2-16 years. This group called as a ÂÂHemodialyis groupÂÂ. Blood samples were taken before (pre-hemodialysis) and after (post-hemodialysis) hemodialysis session. ÂÂControl groupÂÂ included 23 healthy volunteers. Results: PTH (p = 0.01), Mg (p = 0.001) levels were lower and HDLcholesterol (p = 0.001) levels were higher in group of control than prehemodialysis. Levels of PTH (p = 0.05) were higher in post-hemodialysis than the control group. Mg (p = 0.001) and P (p = 0.01) levels were significantly higher and cholesterol, triglyceride (p = 0.05), HDL-cholesterol (p = 0.001) levels were lower in pre-hemodialysis patients than post-hemodialysis patients. In patients pre- and post-hemodialysis, a positive correlation between P and Cholesterol (respectively r = 0.553, r = 0.679, p = 0.001) were determined. In pre-hemodialysis patients, correlation between Ca and triglyceride were negative (r = -0.392, p = 0, 05). In control group, correlation between PTH andMg were (r = 0.509, p = 0.05) statistically significant. Conclusions: Our findings indicated that the levels of Mg, P, cholesterol, HDL-cholesterol and triglyceride altered during dialysis session. PTH levels showed significant differences when we compared the groups of control and pre-, post-hemodialysis. Moreover, the correlation between P and cholesterol levels in hemodialysis groups demonstrated that there were association between P and cholesterol. Further extensive studies are necessary to clarify the effect of P levels on lipid parameters.
Patients with end-stage renal disease, including those treated with peritoneal dialysis, have a high risk for death, particularly from cardiovascular causes. Plasma fatty acid (FA) composition is used as an indicator of disease risk, because its alteration has been related to metabolic disease and cardiovascular disease. For this purpose, we have measured plasma FA composition in continuous ambulatory peritoneal dialysis (CAPD) patients and compared them with those of healthy subjects. This study was performed on 51 (21 M, 30 F) CAPD patients at least 6 months under dialysis, aged 20–75 years (mean 47.81 ± 11.8 years) and 45 (25 M, 20 F) healthy control subjects aged 20–60 years (mean 38.62 ± 12.9 years). Plasma 10-cis-pentadecanoic acid, 10-cis-heptadecanoic acid, heneicosanoic acid, tricosanoic acid, nervonic acid, saturated fatty acid, and monounsaturated FA levels and delta 9 desaturase activity were significantly higher whereas linoleic acid, linolenic acid, 11,14-eicosedienoic acid, arachidonic acid, docosahexaenoic acid, and omega-3 FA levels were significantly lower in the CAPD group than those in the healthy group. Our results show that there are FA abnormalities and especially a depletion in essential FA levels and a high level of omega-6/omega-3 ratio in CAPD patients, the underlying mechanism of which is not known and needs to be investigated. Therefore, we believe that essential FA supplementation should be encouraged for CAPD patients.
Journal Article Prevalence of anti-HCV among haemodialysis patients in Turkey: a multicentre study Get access T. Akpolat, T. Akpolat Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar N. Arik, N. Arik Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar M. Günaydin, M. Günaydin Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar C. Utaş, C. Utaş Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar K. Dilek, K. Dilek Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar Ş. Çaglar, Ş. Çaglar Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar F. Candan, F. Candan Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar G. Süleymanlar, G. Süleymanlar Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar S. Paydaş, S. Paydaş Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar S. Şen, S. Şen Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar ... Show more S. Kürşat, S. Kürşat Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar M. Yeksan, M. Yeksan Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar E. Akoglu, E. Akoglu Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar M. Boran, M. Boran Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar T. Arinsoy, T. Arinsoy Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar S. Bozfakioglu, S. Bozfakioglu Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar T. Çamsari, T. Çamsari Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar Z. Tonbul, Z. Tonbul Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar A. Vural, A. Vural Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar R. Ataman R. Ataman Ondokuz Mayis University School of MedicineSamsun, Turkey (organizing centre) Search for other works by this author on: Oxford Academic PubMed Google Scholar Nephrology Dialysis Transplantation, Volume 10, Issue 4, April 1995, Pages 479–480, https://doi.org/10.1093/ndt/10.4.479 Published: 01 April 1995
The aim of the present study was to determine changing in serum iron (Fe), copper (Cu) and ferritin levels in hemodialysis patients and to indicate whether there were any correlations between elements and ferritin levels. The study was carried out on 47 hemodialysis patient with the mean age 50.26±16.36 yr who were dialyzed with a range of 2-16 years. This group called as "Hemodialysis group". Blood samples were taken before (pre-hemodialysis) and after (post-hemodialysis) the hemodialysis session. "Control group" included 23 healthy volunteers with the mean age 39.52±11.54 yr. The findings demonstrated that there were no significant differences between the all groups according to data of serum Fe levels. However, serum Cu levels were higher in pre-hemodialysis than the control group (p<0.05) and serum ferritin levels were higher in group pre and post-hemodialysis than the control group (p<0.001). In pre-hemodialysis a significant positive correlations between ferritin and Fe (r=0.373, p<0.05), Fe and Cu (r=0.410, p<0.01) were determined. Findings obtained from the study deliberate that alterations in the levels of Cu may be important for the hemodialysis patients. In addition to correlation between Fe and Cu suggests that there is association between these elements. Further studies are necessary to clarify the association between Fe and Cu.
Cardiovascular diseases and endothelial disfunction are major causes of mortality in patients with end stage renal disease (ESRD). Treatment strategies like continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) have different effects on different parameters. Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide (NO) synthase inhibitor and it has been reported to be a novel marker for the progression of chronic kidney disease (CKD). Homocysteine is believed to cause atherogenesis and thrombogenesis via endothelial damage, vascular smooth muscle proliferation and coagulation abnormalities. In previous studies, conflicting findings have been reported about the effect of HD and CAPD on oxidant and antioxidant systems. In this study, we aimed to investigate ADMA, homocysteine and C- reactive protein (CRP) levels in patients with ESRD having HD and CAPD treatment and healthy individuals. This study was performed on 44 (23M, 21F) CAPD patients, 26 (13M, 13F) HD patients and 29 (15M, 14F) age and sex matched healthy control subjects. The lipid profile, ADMA, homocysteine, arginine and CRP levels were measured. Serum ADMA, homocysteine and CRP levels of the ESRD patients were significantly higher, whereas serum arginine levels were significantly lower in both HD and CAPD patients compared to control subjects. No differences were found between serum ADMA, homocysteine and CRP levels of the CAPD and HD patients. Our results suggest that ADMA, homocysteine and CRP levels were increased in HD and CAPD patients compared to the control subjects. These findings suggest that ESRD patients are prone to inflammation, oxidative stress and endothelial dysfunction. We conclude that endothelial dysfunction, inflammation and oxidative stress are increased in dialysis patients and ADMA concentrations are not affected by the modality of dialysis treatment.
