Abstract
Background. Cardiovascular disease is the main cause of mortality in end-stage renal disease (ESRD) patients. Recent studies have indicated that non-traditional risk factors such as endothelial dysfunction (ED), chronic inflammation and protein-energy wasting (PEW) may contribute significantly to the increased cardiovascular mortality among dialysis patients. To further ascertain this association, we carried out a cross-sectional assessment of nutritional status, inflammatory markers and endothelial dysfunction in peritoneal dialysis (PD) patients.Methods. We measured ED functionally by flow-mediated vasodilatation (FMD) using doppler ultrasonography and biochemically by soluble intercellular adhesion molecule-1 (sICAM-1) in 105 stable PD patients and 32 age-and sex-matched healthy controls. We also simultaneously measured inflammatory markers and performed a subjective global assessment (SGA) of their nutritional status using a seven-point scoring scale. Subjects were subgrouped according to their nutritional and inflammatory status.Results. In PD patients, FMD was markedly lower (9.9±4.8% vs. 16.4±4.8%, P<0.05), and sICAM-1 was significantly higher than those in controls. The malnourished patients had significantly lower FMD (8.4±4.6% vs. 10.8±4.7%, P<0.05) and higher sICAM-1 than the nourished patients. The inflamed group had significantly lower FMD (7.1±3.8 vs.11.1±4.6%, P<0.05) and higher sICAM-1 than the non-inflamed group. In all PD patients, lean body mass/body weight %, albumin and SGA correlated positively with FMD (r = +0.207, r = +0.224, r = +0.285, P<0.05). However, age, log high sensitivity C-reactive protein (hsCRP), log IL-6 and sICAM-1 were negatively correlated with FMD (r=-0.275, r =-0.361, r =-0.360, r =-0.271, P<0.05). A multiple regression analysis showed that log hsCRP was an independent factor affecting FMD. Endothelial function, demonstrated as FMD and sICAM-1 in the nourished PD patients without inflammation, was well preserved compared to other subgroups.Conclusion. Our data suggest that chronic inflammation and PEW are closely linked to ED in PD patients.
| Original language | English |
|---|---|
| Pages (from-to) | 1266-1271 |
| Number of pages | 6 |
| Journal | Nephrology Dialysis Transplantation |
| Volume | 25 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2010 Apr 1 |
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All Science Journal Classification (ASJC) codes
- Nephrology
- Transplantation
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Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients. / Choi, Hoon Young; Lee, Jung Eun; Han, Seung Hyeok; Yoo, Tae Hyun; Kim, Beom Seok; Park, Hyeong Cheon; Kang, Shin Wook; Choi, Kyu Hun; Ha, Sung Kyu; Lee, Ho Yung; Han, Dae Suk.
In: Nephrology Dialysis Transplantation, Vol. 25, No. 4, 01.04.2010, p. 1266-1271.Research output: Contribution to journal › Article
TY - JOUR
T1 - Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients
AU - Choi, Hoon Young
AU - Lee, Jung Eun
AU - Han, Seung Hyeok
AU - Yoo, Tae Hyun
AU - Kim, Beom Seok
AU - Park, Hyeong Cheon
AU - Kang, Shin Wook
AU - Choi, Kyu Hun
AU - Ha, Sung Kyu
AU - Lee, Ho Yung
AU - Han, Dae Suk
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Background. Cardiovascular disease is the main cause of mortality in end-stage renal disease (ESRD) patients. Recent studies have indicated that non-traditional risk factors such as endothelial dysfunction (ED), chronic inflammation and protein-energy wasting (PEW) may contribute significantly to the increased cardiovascular mortality among dialysis patients. To further ascertain this association, we carried out a cross-sectional assessment of nutritional status, inflammatory markers and endothelial dysfunction in peritoneal dialysis (PD) patients.Methods. We measured ED functionally by flow-mediated vasodilatation (FMD) using doppler ultrasonography and biochemically by soluble intercellular adhesion molecule-1 (sICAM-1) in 105 stable PD patients and 32 age-and sex-matched healthy controls. We also simultaneously measured inflammatory markers and performed a subjective global assessment (SGA) of their nutritional status using a seven-point scoring scale. Subjects were subgrouped according to their nutritional and inflammatory status.Results. In PD patients, FMD was markedly lower (9.9±4.8% vs. 16.4±4.8%, P<0.05), and sICAM-1 was significantly higher than those in controls. The malnourished patients had significantly lower FMD (8.4±4.6% vs. 10.8±4.7%, P<0.05) and higher sICAM-1 than the nourished patients. The inflamed group had significantly lower FMD (7.1±3.8 vs.11.1±4.6%, P<0.05) and higher sICAM-1 than the non-inflamed group. In all PD patients, lean body mass/body weight %, albumin and SGA correlated positively with FMD (r = +0.207, r = +0.224, r = +0.285, P<0.05). However, age, log high sensitivity C-reactive protein (hsCRP), log IL-6 and sICAM-1 were negatively correlated with FMD (r=-0.275, r =-0.361, r =-0.360, r =-0.271, P<0.05). A multiple regression analysis showed that log hsCRP was an independent factor affecting FMD. Endothelial function, demonstrated as FMD and sICAM-1 in the nourished PD patients without inflammation, was well preserved compared to other subgroups.Conclusion. Our data suggest that chronic inflammation and PEW are closely linked to ED in PD patients.
AB - Background. Cardiovascular disease is the main cause of mortality in end-stage renal disease (ESRD) patients. Recent studies have indicated that non-traditional risk factors such as endothelial dysfunction (ED), chronic inflammation and protein-energy wasting (PEW) may contribute significantly to the increased cardiovascular mortality among dialysis patients. To further ascertain this association, we carried out a cross-sectional assessment of nutritional status, inflammatory markers and endothelial dysfunction in peritoneal dialysis (PD) patients.Methods. We measured ED functionally by flow-mediated vasodilatation (FMD) using doppler ultrasonography and biochemically by soluble intercellular adhesion molecule-1 (sICAM-1) in 105 stable PD patients and 32 age-and sex-matched healthy controls. We also simultaneously measured inflammatory markers and performed a subjective global assessment (SGA) of their nutritional status using a seven-point scoring scale. Subjects were subgrouped according to their nutritional and inflammatory status.Results. In PD patients, FMD was markedly lower (9.9±4.8% vs. 16.4±4.8%, P<0.05), and sICAM-1 was significantly higher than those in controls. The malnourished patients had significantly lower FMD (8.4±4.6% vs. 10.8±4.7%, P<0.05) and higher sICAM-1 than the nourished patients. The inflamed group had significantly lower FMD (7.1±3.8 vs.11.1±4.6%, P<0.05) and higher sICAM-1 than the non-inflamed group. In all PD patients, lean body mass/body weight %, albumin and SGA correlated positively with FMD (r = +0.207, r = +0.224, r = +0.285, P<0.05). However, age, log high sensitivity C-reactive protein (hsCRP), log IL-6 and sICAM-1 were negatively correlated with FMD (r=-0.275, r =-0.361, r =-0.360, r =-0.271, P<0.05). A multiple regression analysis showed that log hsCRP was an independent factor affecting FMD. Endothelial function, demonstrated as FMD and sICAM-1 in the nourished PD patients without inflammation, was well preserved compared to other subgroups.Conclusion. Our data suggest that chronic inflammation and PEW are closely linked to ED in PD patients.
UR - http://www.scopus.com/inward/record.url?scp=77950248157&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77950248157&partnerID=8YFLogxK
U2 - 10.1093/ndt/gfp598
DO - 10.1093/ndt/gfp598
M3 - Article
C2 - 19926717
AN - SCOPUS:77950248157
VL - 25
SP - 1266
EP - 1271
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
SN - 0931-0509
IS - 4
ER -