Low cholesterol along with inflammation predicts morbidity and mortality in hemodialysis patients
| Autor: | Kyriaki Stamatelou, Aliki Bleta, Margarita Zoga, Chrysoula Nicolaou, Alexandra Fatourou, George Tsirpanlis, Fotini Boufidou, George Triantafyllis, Christiana Petrihou, Stylianos Chatzipanagiotou |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Population Kaplan-Meier Estimate Gastroenterology High cholesterol chemistry.chemical_compound Predictive Value of Tests Renal Dialysis Internal medicine medicine Humans education Cause of death Aged Inflammation education.field_of_study biology medicine.diagnostic_test Cholesterol business.industry Proportional hazards model Interleukin-6 C-reactive protein Hematology Middle Aged medicine.disease Surgery Interleukin-10 Hospitalization C-Reactive Protein chemistry Nephrology biology.protein Kidney Failure Chronic Female Hemodialysis Morbidity business Lipid profile Follow-Up Studies |
| Zdroj: | Hemodialysis international. International Symposium on Home Hemodialysis. 13(2) |
| ISSN: | 1492-7535 |
| Popis: | Low and not high cholesterol seems to predict high mortality in hemodialysis (HD) patients. The confirmation of this reverse epidemiology as well as its possible interconnection with the increased inflammatory activity observed in this population is being explored in the present study. A group of 136 HD patients was prospectively studied for 2 years, and cardiovascular disease (CVD) as well as all-cause mortality and morbidity were recorded. Baseline lipid profile, inflammatory status, and patients' characteristics were studied as potential survival and hospitalization predictors. During the 24-month follow-up, 21 deaths (52.4% due to CVD) and 38 hospitalizations (55.3% due to CVD) were recorded. In multivariate Cox regression analysis, decreased interleukin-10 (IL-10) and decreased total serum cholesterol (TChol) were the only independent predictors of CVD mortality while C-reactive protein and decreased TChol predicted all-cause mortality. Interleukin-10 at baseline was 11.29 +/- 21.49 vs. 5.51 +/- 4.57 pg/mL (P0.018) and TChol 167.37 +/- 47.84 vs.122.04 +/- 26.48 mg/dL (P0.000) in survivors vs. nonsurvivors from CVD, while C-reactive protein at baseline was 9.37 +/- 11.54 vs. 23.15 +/- 18.76 mg/L (P0.000) and TChol 169.26 +/- 46.42 vs. 133.26 +/- 46.33 mg/dL (P0.003) in survivors vs. nonsurvivors from any cause of death. Using the same method of statistical analysis, IL-6 and decreased soluble gp130 (sgp130)--an antagonist of IL-6 action--were found to be the only independent prognostic factors for hospitalization due to CVD while decreased soluble gp130 remained the sole predictor of hospitalization due to any cause. In conclusion, reverse epidemiology regarding cholesterol is confirmed in the present study. Furthermore, inflammatory activity also predicts, independently of or in conjunction with low-cholesterol, CVD and all-cause morbidity and mortality in HD patients. |
| Databáze: | OpenAIRE |
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