Document Detail


Anti-inflammatory properties of high-density lipoprotein cholesterol in chronic hemodialysis patients: impact of intervention.
MedLine Citation:
PMID:  20833077     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Levels of high-density lipoprotein (HDL) cholesterol as well as its functional roles are suppressed in chronic kidney disease because of ongoing chronic microinflammatory state. We hypothesized that intervention aimed at reducing inflammation may improve the levels and activity of HDL cholesterol as well as survival of our patients.
METHODS: In this prospective follow-up study, we selected 67 patients (33 women, 34 men) on chronic hemodialysis (23.5 months [range, 10 to 34], aged 67.5 years [range, 39 to 90 years]). Targeted examination for asymptomatic infective foci or poor function of arterio-venous (AV)-fistula was carried out after a detailed initial clinical examination in all patients. Individual intervention was performed according to examination results. Blood was drawn for analysis of HDL cholesterol; interleukin-6, its soluble receptor, monocyte chemoattractant protein 1 (MCP-1), total iron binding capacity, and high sensitivity C-reactive protein at the beginning of the study and after 3 months. The patients were then closely followed up for 2 years during which the occurrence and cause of death was registered.
RESULTS: A significant decrease of inflammatory parameters (Interleukin-6: 4.9 vs. 1.1 pg/mL, P > .001 and MCP-1: 397 vs. 310 pg/mL, P = .02) and increase of HDL cholesterol (1.22 ± 0.55 vs. 1.33 ± 0.55; P = .003) was seen in the entire study population. No difference in survival was found between the different interventional groups. The 2-year death rate was 37%. On using Kaplan-Meier analysis, a significantly better survival in patients with increase of HDL cholesterol (77% vs. 50%; P = .013) and/or a decrease of MCP-1 (81% vs. 53%; P = .04) was found after 3 months of intervention.
CONCLUSIONS: It was concluded that individually aimed intervention may improve levels of HDL cholesterol and MCP-1. Changes in these 2 parameters can predict the 2-year survival rates of patients.
Authors:
Erik Mistrík; Vladimír Bláha; Sylvie Dusilová-Sulková; Ctirad Andrýs; Marta Kalousová; Lubos Sobotka
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-15
Journal Detail:
Title:  Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation     Volume:  20     ISSN:  1532-8503     ISO Abbreviation:  J Ren Nutr     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2011-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9112938     Medline TA:  J Ren Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  368-76     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Metabolic Care and Gerontology, University Hospital Hradec Králové, Charles University, Hradec Králové, Czech Republic. erosito@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon
Anti-Inflammatory Agents / blood*
Arteriovenous Shunt, Surgical
C-Reactive Protein / metabolism
Catheterization
Chemokine CCL2 / metabolism
Cholesterol, HDL / blood*
Cholesterol, LDL / blood
Female
Follow-Up Studies
Humans
Interleukin-6 / metabolism
Intervention Studies
Kidney Failure, Chronic / mortality*,  therapy*
Male
Middle Aged
Prospective Studies
Renal Dialysis
Survival Rate
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/CCL2 protein, human; 0/Chemokine CCL2; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Interleukin-6; 9007-41-4/C-Reactive Protein

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