Pentraxin-3 in hemodialysis patients: Relationship to comorbidities.

Hemodialysis (HD), despite being the most common treatment modality for endstage renal disease (ESRD), still carries a mortality rate higher than 20-50%/year resulting from various comorbidities. The aim of this study was to measure the plasma level of pentraxin-3 (PTX-3) in patients on maintenance HD and to assess its relationships to comorbidities such as malnutrition and associated comorbid diseases. This case-control study included 50 HD patients, 30 ESRD patients, and 30 healthy controls. HD patients were classified into different subgroups according to the Davies comorbidity index and malnutrition score. Plasma PTX-3 was analyzed by a sandwich ELISA technique. Plasma level of PTX-3 reached its highest levels in HD patients followed by ESRD patients as compared to healthy controls. Moreover, within the different subgroups, the highest levels and the highest odd ratio of PTX-3 were detected in the subgroups having the highest Davies comorbidity index or the highest malnutrition score as compared to the other subgroups. At a cutoff of 0.6 ng/mL, PTX-3 was able to discriminate HD patients with low Davies comorbidity index from those with both medium and high Davies comorbidity index with a diagnostic sensitivity of 92.5% and a diagnostic specificity of 70.0%. Meanwhile, the best cutoff of plasma PTX-3 for discriminating patients with mild malnutrition from severe and moderate malnutrition was 0.6 ng/mL with a diagnostic sensitivity of 90.9% and a diagnostic specificity of 41.2%. In conclusion, PTX-3 appears to be a clinically useful marker for the early identification of patients with renal failure on maintenance HD who are at substantially increased risk of morbidity. These patients may require care and aggressive follow-up in more specialized units and an early referral to a renal transplant center.

Adiponectin as a marker of complications in type I diabetes.

OBJECTIVE: To evaluate adiponectin levels in children and adolescents with type I diabetes, and their relationship to long term complications. DESIGN: Cross sectional. SETTING: Tertiary referral hospital, Cairo, Egypt. PARTICIPANTS: Thirty children and adolescents with type I diabetes mellitus, classified into complicated and non-complicated and compared to 10 healthy age and sex matched subjects as a control group. METHODS: All children underwent anthropometric measurements, neurological assessment, fundus examination, echocardiography and assays of HbA1c, creatinine, 24-hr urinary protein, and serum adiponectin. MAIN OUTCOME MEASURE: Relationship of serum adiponectin to complications of type I diabetes mellitus, and glucose control. RESULTS: Serum adiponectin was significantly elevated in complicated diabetes (10.3 ± 5.9 pg/dL) as compared to the controls (6.5 ± 3.7 pg/dL) (P<0.01), and correlated directly with HbA1c (P<0.05) and creatinine (P<0.001). Patients with nephropathy showed high values of adiponectin (15.7 ± 3.7 pg/dL). CONCLUSION: Elevated adiponectin level in children and adolescents with type I diabetes indicates poor glycemic control and development of complications, especially nephropathy.