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Article: Hyperleptinaemia and chronic inflammation after peritonitis predicts poor nutritional status and mortality in patients on peritoneal dialysis

TitleHyperleptinaemia and chronic inflammation after peritonitis predicts poor nutritional status and mortality in patients on peritoneal dialysis
Authors
KeywordsHyperleptinaemia
Inflammation
Malnutrition
Peritonitis
Issue Date2007
PublisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/
Citation
Nephrology Dialysis Transplantation, 2007, v. 22 n. 5, p. 1445-1450 How to Cite?
AbstractBackground. The serum leptin level is elevated in patients undergoing peritoneal dialysis (PD) and associated with a loss of lean body mass. The nutritional status of PD patients may further be worsened following peritonitis. We investigated the association between hyperleptinaemia, inflammation and malnourishment in PD-related peritonitis. Methods. We conducted a prospective study on PD patients who developed peritonitis. Blood samples were obtained as baseline (D0) before the onset of peritonitis, and once peritonitis developed, leptin, adiponectin (ADPN) and other inflammatory markers were collected, on day 1 (D1), day 7 (D7) and day 42 (D42) of peritonitis. Patients were followed-up for any censor event or 1 year after peritonitis. Results. Forty-two patients with a mean age of 62.9 ± 13.2 years were recruited. Fourteen (33.3%) were diabetic. The serum leptin levels increased significantly from baseline to day 1 and 7, but fell back to the premorbid state at day 42. In contrast, the ADPN level decreased from a baseline value of 15.60 ± 10.4 μg/ml to 13.01 ± 8.1 μg/ml on day 1 (P = 0.01) but rose to 14.39 ± 8.9 μg/ml on day 7 (P = 0.28) and 13.87 ± 7.9 μg/ml on day 42 (P = 0.21). High-sensitivity C-reactive protein (hs-CRP) increased significantly from baseline to day 1, 7 and even at day 42. The lean body mass (LBM) and nutritional markers decreased significantly after peritonitis. For patients with high hs-CRP (>3.0 mg/l) at day 42, there was a higher mortality rate than for those with lower hs-CRP (<3.0 mg/l, P = 0.02), even if they were in clinical remission of peritonitis. Conclusions. Our study confirmed an increase in serum leptin during acute peritonitis and a prolonged course of systemic inflammation after apparent clinical remission of peritonitis. These factors related to the persistent chronic inflammation may contribute to the development of malnourishment and poor survival rate. © The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/77916
ISSN
2015 Impact Factor: 4.085
2015 SCImago Journal Rankings: 1.780
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, MFen_HK
dc.contributor.authorLeung, JCKen_HK
dc.contributor.authorLo, WKen_HK
dc.contributor.authorTam, Sen_HK
dc.contributor.authorChong, MCen_HK
dc.contributor.authorLui, SLen_HK
dc.contributor.authorTse, KCen_HK
dc.contributor.authorChan, TMen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2010-09-06T07:37:10Z-
dc.date.available2010-09-06T07:37:10Z-
dc.date.issued2007en_HK
dc.identifier.citationNephrology Dialysis Transplantation, 2007, v. 22 n. 5, p. 1445-1450en_HK
dc.identifier.issn0931-0509en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77916-
dc.description.abstractBackground. The serum leptin level is elevated in patients undergoing peritoneal dialysis (PD) and associated with a loss of lean body mass. The nutritional status of PD patients may further be worsened following peritonitis. We investigated the association between hyperleptinaemia, inflammation and malnourishment in PD-related peritonitis. Methods. We conducted a prospective study on PD patients who developed peritonitis. Blood samples were obtained as baseline (D0) before the onset of peritonitis, and once peritonitis developed, leptin, adiponectin (ADPN) and other inflammatory markers were collected, on day 1 (D1), day 7 (D7) and day 42 (D42) of peritonitis. Patients were followed-up for any censor event or 1 year after peritonitis. Results. Forty-two patients with a mean age of 62.9 ± 13.2 years were recruited. Fourteen (33.3%) were diabetic. The serum leptin levels increased significantly from baseline to day 1 and 7, but fell back to the premorbid state at day 42. In contrast, the ADPN level decreased from a baseline value of 15.60 ± 10.4 μg/ml to 13.01 ± 8.1 μg/ml on day 1 (P = 0.01) but rose to 14.39 ± 8.9 μg/ml on day 7 (P = 0.28) and 13.87 ± 7.9 μg/ml on day 42 (P = 0.21). High-sensitivity C-reactive protein (hs-CRP) increased significantly from baseline to day 1, 7 and even at day 42. The lean body mass (LBM) and nutritional markers decreased significantly after peritonitis. For patients with high hs-CRP (>3.0 mg/l) at day 42, there was a higher mortality rate than for those with lower hs-CRP (<3.0 mg/l, P = 0.02), even if they were in clinical remission of peritonitis. Conclusions. Our study confirmed an increase in serum leptin during acute peritonitis and a prolonged course of systemic inflammation after apparent clinical remission of peritonitis. These factors related to the persistent chronic inflammation may contribute to the development of malnourishment and poor survival rate. © The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/en_HK
dc.relation.ispartofNephrology Dialysis Transplantationen_HK
dc.rightsNephrology, Dialysis, Transplantation. Copyright © Oxford University Press.en_HK
dc.subjectHyperleptinaemiaen_HK
dc.subjectInflammationen_HK
dc.subjectMalnutritionen_HK
dc.subjectPeritonitisen_HK
dc.subject.meshAdiponectin - blooden_HK
dc.subject.meshAgeden_HK
dc.subject.meshC-Reactive Protein - metabolismen_HK
dc.subject.meshChronic Diseaseen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInflammation - blood - etiologyen_HK
dc.subject.meshInterleukin-6 - blooden_HK
dc.subject.meshKidney Failure, Chronic - mortality - therapyen_HK
dc.subject.meshLeptin - blooden_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPeritoneal Dialysisen_HK
dc.subject.meshPeritonitis - blood - complicationsen_HK
dc.subject.meshPredictive Value of Testsen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshProtein-Energy Malnutrition - diagnosis - etiologyen_HK
dc.subject.meshTumor Necrosis Factor-alpha - blooden_HK
dc.titleHyperleptinaemia and chronic inflammation after peritonitis predicts poor nutritional status and mortality in patients on peritoneal dialysisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0931-0509&volume=32&spage=1445&epage=1450&date=2007&atitle=Hyperleptinaemia+and+chronic+inflammation+after+peritonitis+predicts+poor+nutritional+status+and+mortality+in+patients+on+peritoneal+dialysisen_HK
dc.identifier.emailLeung, JCK: jckleung@hku.hken_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityLeung, JCK=rp00448en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/ndt/gfl788en_HK
dc.identifier.pmid17277343-
dc.identifier.scopuseid_2-s2.0-34447548972en_HK
dc.identifier.hkuros132113en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34447548972&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume22en_HK
dc.identifier.issue5en_HK
dc.identifier.spage1445en_HK
dc.identifier.epage1450en_HK
dc.identifier.isiWOS:000246124100025-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLam, MF=35300050600en_HK
dc.identifier.scopusauthoridLeung, JCK=7202180349en_HK
dc.identifier.scopusauthoridLo, WK=7201502414en_HK
dc.identifier.scopusauthoridTam, S=7202037323en_HK
dc.identifier.scopusauthoridChong, MC=34967887300en_HK
dc.identifier.scopusauthoridLui, SL=7102379130en_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.citeulike1271975-

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