Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients

Hoon Young Choi, Jung Eun Lee, SeungHyeok Han, TaeHyun Yoo, Beom Seok Kim, Hyeong Cheon Park, Shin-Wook Kang, Kyu Hun Choi, Sung Kyu Ha, Ho Yung Lee, Dae Suk Han

Research output: Contribution to journalArticle

28 Citations (Scopus)

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 languageEnglish
Pages (from-to)1266-1271
Number of pages6
JournalNephrology Dialysis Transplantation
Volume25
Issue number4
DOIs
Publication statusPublished - 2010 Apr 1

Fingerprint

Peritoneal Dialysis
Vasodilation
Inflammation
Intercellular Adhesion Molecule-1
Proteins
Nutritional Status
C-Reactive Protein
Doppler Ultrasonography
Mortality
Chronic Kidney Failure
Dialysis
Albumins
Interleukin-6
Cardiovascular Diseases
Body Weight
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Choi, Hoon Young ; Lee, Jung Eun ; Han, SeungHyeok ; Yoo, TaeHyun ; Kim, Beom Seok ; Park, Hyeong Cheon ; Kang, Shin-Wook ; Choi, Kyu Hun ; Ha, Sung Kyu ; Lee, Ho Yung ; Han, Dae Suk. / Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients. In: Nephrology Dialysis Transplantation. 2010 ; Vol. 25, No. 4. pp. 1266-1271.
@article{eb28834a5e274ebfac7a266cf6d2655c,
title = "Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients",
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.",
author = "Choi, {Hoon Young} and Lee, {Jung Eun} and SeungHyeok Han and TaeHyun Yoo and Kim, {Beom Seok} and Park, {Hyeong Cheon} and Shin-Wook Kang and Choi, {Kyu Hun} and Ha, {Sung Kyu} and Lee, {Ho Yung} and Han, {Dae Suk}",
year = "2010",
month = "4",
day = "1",
doi = "10.1093/ndt/gfp598",
language = "English",
volume = "25",
pages = "1266--1271",
journal = "Nephrology Dialysis Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",
number = "4",

}

Association of inflammation and protein-energy wasting with endothelial dysfunction in peritoneal dialysis patients. / Choi, Hoon Young; Lee, Jung Eun; Han, SeungHyeok; Yoo, TaeHyun; 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 journalArticle

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, SeungHyeok

AU - Yoo, TaeHyun

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

VL - 25

SP - 1266

EP - 1271

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

SN - 0931-0509

IS - 4

ER -