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Article: Inflammation, residual kidney function, and cardiac hypertrophy are interrelated and combine adversely to enhance mortality and cardiovascular death risk of peritoneal dialysis patients

TitleInflammation, residual kidney function, and cardiac hypertrophy are interrelated and combine adversely to enhance mortality and cardiovascular death risk of peritoneal dialysis patients
Authors
Issue Date2004
PublisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.org
Citation
Journal Of The American Society Of Nephrology, 2004, v. 15 n. 8, p. 2186-2194 How to Cite?
AbstractC-reactive protein (CRP), the prototype marker of inflammation, and cardiac hypertrophy are important prognostic indicators in dialysis patients. Residual renal function (RRF) has also been shown to influence survival of peritoneal dialysis (PD) patients. This study examined the relations between inflammation, RRF, and left ventricular hypertrophy (LVH) and determined whether inflammation, RRF, and LVH combine adversely to predict the outcomes of PD patients. A prospective observational study was performed in 231 chronic PD patients. Left ventricular mass index (LVMi), residual glomerular filtration rate (GFR), CRP, hemoglobin, serum albumin, and BP were determined at study baseline and related to outcomes. On univariate analysis, age (P = 0.002), dialysis duration (P = 0.004), coronary artery disease (P < 0.001), pulse pressure (P < 0.001), hemoglobin (P < 0.001), serum albumin (P = 0.032), log-CRP (P < 0.001), and GFR (P < 0.001) were significantly associated with log-LVMi. Log-CRP was positively correlated with pulse pressure (R = 0.218, P = 0.001) and negatively correlated with GFR (R = -0.272, P < 0.001). Multivariate analysis showed that log-CRP (P = 0.008) and RRF (P = 0.003) remained associated with log-LVMi independent of hemoglobin, serum albumin, arterial pulse pressure, and coronary artery disease. After follow-up for 30 ± 14 mo, 34.2% patients had died. CRP, RRF, and LVMi each were significantly predictive of all-cause mortality and cardiovascular death. Kaplan-Meier analysis showed a significant increase in all-cause (P < 0.0001) and cardiovascular mortality (P < 0.0001) as the number of risk factors, namely CRP ≥50th percentile, no RRF, and LVMi≥ 50th percentile increased with the 2-yr all-cause mortality and cardiovascular death reaching as high as 61% and 46%, respectively, for patients who had all three risk factors. Compared with patients with none of the three risk factors, those with all three risk factors had an adjusted hazards ratio of 6.94 (P < 0.001) and 5.43 (P = 0.001) for all-cause mortality and cardiovascular mortality, respectively. In conclusion, inflammation, RRF, and LVH are interrelated and combine adversely to increase mortality and cardiovascular death risk of PD patients.
Persistent Identifierhttp://hdl.handle.net/10722/163120
ISSN
2015 Impact Factor: 8.491
2015 SCImago Journal Rankings: 4.699
References

 

DC FieldValueLanguage
dc.contributor.authorWang, AYMen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorWoo, Jen_US
dc.contributor.authorLam, CWKen_US
dc.contributor.authorLui, SFen_US
dc.contributor.authorLi, PKTen_US
dc.contributor.authorSanderson, JEen_US
dc.date.accessioned2012-09-05T05:27:52Z-
dc.date.available2012-09-05T05:27:52Z-
dc.date.issued2004en_US
dc.identifier.citationJournal Of The American Society Of Nephrology, 2004, v. 15 n. 8, p. 2186-2194en_US
dc.identifier.issn1046-6673en_US
dc.identifier.urihttp://hdl.handle.net/10722/163120-
dc.description.abstractC-reactive protein (CRP), the prototype marker of inflammation, and cardiac hypertrophy are important prognostic indicators in dialysis patients. Residual renal function (RRF) has also been shown to influence survival of peritoneal dialysis (PD) patients. This study examined the relations between inflammation, RRF, and left ventricular hypertrophy (LVH) and determined whether inflammation, RRF, and LVH combine adversely to predict the outcomes of PD patients. A prospective observational study was performed in 231 chronic PD patients. Left ventricular mass index (LVMi), residual glomerular filtration rate (GFR), CRP, hemoglobin, serum albumin, and BP were determined at study baseline and related to outcomes. On univariate analysis, age (P = 0.002), dialysis duration (P = 0.004), coronary artery disease (P < 0.001), pulse pressure (P < 0.001), hemoglobin (P < 0.001), serum albumin (P = 0.032), log-CRP (P < 0.001), and GFR (P < 0.001) were significantly associated with log-LVMi. Log-CRP was positively correlated with pulse pressure (R = 0.218, P = 0.001) and negatively correlated with GFR (R = -0.272, P < 0.001). Multivariate analysis showed that log-CRP (P = 0.008) and RRF (P = 0.003) remained associated with log-LVMi independent of hemoglobin, serum albumin, arterial pulse pressure, and coronary artery disease. After follow-up for 30 ± 14 mo, 34.2% patients had died. CRP, RRF, and LVMi each were significantly predictive of all-cause mortality and cardiovascular death. Kaplan-Meier analysis showed a significant increase in all-cause (P < 0.0001) and cardiovascular mortality (P < 0.0001) as the number of risk factors, namely CRP ≥50th percentile, no RRF, and LVMi≥ 50th percentile increased with the 2-yr all-cause mortality and cardiovascular death reaching as high as 61% and 46%, respectively, for patients who had all three risk factors. Compared with patients with none of the three risk factors, those with all three risk factors had an adjusted hazards ratio of 6.94 (P < 0.001) and 5.43 (P = 0.001) for all-cause mortality and cardiovascular mortality, respectively. In conclusion, inflammation, RRF, and LVH are interrelated and combine adversely to increase mortality and cardiovascular death risk of PD patients.en_US
dc.languageengen_US
dc.publisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.orgen_US
dc.relation.ispartofJournal of the American Society of Nephrologyen_US
dc.subject.meshAgeden_US
dc.subject.meshCardiovascular Diseases - Mortalityen_US
dc.subject.meshCause Of Deathen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshHypertrophy, Left Ventricular - Mortalityen_US
dc.subject.meshKidney - Physiologyen_US
dc.subject.meshKidney Failure, Chronic - Mortality - Therapyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPeritoneal Dialysis - Statistics & Numerical Dataen_US
dc.subject.meshPeritonitis - Mortalityen_US
dc.subject.meshPrognosisen_US
dc.subject.meshProportional Hazards Modelsen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSurvival Analysisen_US
dc.titleInflammation, residual kidney function, and cardiac hypertrophy are interrelated and combine adversely to enhance mortality and cardiovascular death risk of peritoneal dialysis patientsen_US
dc.typeArticleen_US
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_US
dc.identifier.authorityWang, M=rp00281en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1097/01.ASN.0000135053.98172.D6en_US
dc.identifier.pmid15284304-
dc.identifier.scopuseid_2-s2.0-3543140656en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-3543140656&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume15en_US
dc.identifier.issue8en_US
dc.identifier.spage2186en_US
dc.identifier.epage2194en_US
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWang, AYM=13606226000en_US
dc.identifier.scopusauthoridWang, M=7406690398en_US
dc.identifier.scopusauthoridWoo, J=36040369400en_US
dc.identifier.scopusauthoridLam, CWK=8531362100en_US
dc.identifier.scopusauthoridLui, SF=7102379144en_US
dc.identifier.scopusauthoridLi, PKT=25928016800en_US
dc.identifier.scopusauthoridSanderson, JE=7202371250en_US

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