ABSTRACT
BACKGROUND: Cardiovascular diseases are important factors in mortality and morbidity of dialysis patients. Cardiovascular risk assessment is important in order to arrange the treatment strategies. The aim of the study was to investigate the relationship between carotid atherosclerosis and various CVD risk factors in dialysis patients. METHODS: 22 HD and 54 PD patients were included in the study. Carotid artery intima media thickness (IMT) and plaque score (PS) were obtained by B-mode ultrasonography for each participant. Uric acid, albumin, bilirubin, lipid profile, apolipoprotein A-l (apo A-l), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], high-sensitivity CRP (hs-CRP), homocysteine (Hcy), vitamin A, vitamin E, sialic acid (SA) and thiobarbituric acid-reactive substances (TBARS) were determined. The differences of the cardiovascular risk factors between the patients according to the treatment modality and the comparison of the risk factors as indicators of IMT and PS were investigated. RESULTS: There was no significant difference in IMT and PS between the two groups. SA, TBARS, hs-CRP, total, HDL- and LDL-cholesterol, white blood cell (WBC) and erythrocyte sedimentation rate (ESR) levels were significantly higher; albumin levels were significantly lower in PD group. In multiple regression analysis, only bilirubin for IMT and SA for PS were independent predictors. CONCLUSIONS: SA can be a superior marker to hs-CRP in PD patients; however, hs-CRP seems to be a more valuable marker than SA in HD patients according to the correlation analysis. This study provides information and opportunity for comparison of relatively new cardiovascular risk markers in hemodialysis and peritoneal dialysis patients using carotid atherosclerosis as an objective assessment criterion.
Subject(s)
Cardiovascular Diseases/etiology , Carotid Artery Diseases/complications , Peritoneal Dialysis/adverse effects , Renal Dialysis/adverse effects , Adult , C-Reactive Protein/analysis , Cardiovascular Diseases/blood , Carotid Artery Diseases/blood , Carotid Artery Diseases/diagnostic imaging , Female , Homocysteine/blood , Humans , Kidney Diseases/blood , Kidney Diseases/complications , Kidney Diseases/diagnostic imaging , Kidney Diseases/therapy , Male , Middle Aged , N-Acetylneuraminic Acid/blood , Risk Factors , Thiobarbituric Acid Reactive Substances/analysis , Tunica Intima/anatomy & histology , Tunica Intima/diagnostic imaging , UltrasonographyABSTRACT
BACKGROUND: Carnitine loss through dialysis membranes is shown to be related to the lack of carnitine in long-term haemodialysis patients. It has been previously reported that haemodialysis patients might have benefited from carnitine supplementation. METHODS: A total of 21 chronic haemodialysis patients maintaining carnitine supplementation and 21 controls (haemodialysis patients not receiving carnitine) were included in the study. L-carnitine was used intravenously three times a week after each haemodialysis session, at a 20 mg/kg dose. C-reactive protein (CRP), lipid profile, transferrin, total protein and albumin levels were determined at baseline after 3 and 6 months of treatment, and compared with the control group. RESULTS: CRP levels were significantly decreased in carnitine group in contrast to the increase in the control group. Transferrin, total protein and albumin levels and body mass index (BMI) of the patients rose in the carnitine group. CONCLUSIONS: There was a significant benefit of L-carnitine on CRP, transferrin, total protein and albumin levels of the haemodialysis patients.
Subject(s)
Carnitine/administration & dosage , Inflammation Mediators/blood , Nutritional Status , Renal Dialysis , Biomarkers/blood , Blood Proteins/metabolism , C-Reactive Protein/biosynthesis , C-Reactive Protein/metabolism , Carnitine/blood , Carnitine/physiology , Female , Humans , Incidence , Infusions, Intravenous , Lipids/blood , Male , Middle Aged , Serum Albumin/metabolism , Transferrin/metabolismABSTRACT
Glycerol-induced acute renal failure is an experimental model for myoglobinuric nephropathy. Amifostine is a cytoprotective agent which scavenges the free radicals. Since there is enhanced production of reactive oxygen metabolites in glycerol-induced acute renal failure, we wanted to examine whether amifostine has a protective role against vascular reactivity and histological changes in kidneys isolated from glycerol-pretreated rabbits. Perfusion pressure was recorded from kidneys obtained from rabbits injected with glycerol 3 hr before the experiments and from glycerol-pretreated and non-pretreated rabbits injected with amifostine 30 min. before the experiments. Acetylcholine-induced (10(-8)-10(-5) M) vasodilatation was tested following the construction of submaximal vasoconstriction by phenylephrine. Histological investigation was performed using light microscope. Acetylcholine-induced vasodilatation was found to be significantly decreased in glycerol, glycerol+amifostine and amifostine groups compared to controls at all concentrations. Reduction in acetylcholine-induced vasodilation was more prominent in amifostine group compared to amifostine+glycerol group. There was histological renal damage in all experimental groups and this damage was more pronounced in glycerol+amifostine group. In conclusion, contrary to expectation, amifostine per se led to histological damage and potentiated the histological damage caused by glycerol and produced a decrease in acetylcholine-induced vasodilatation. The mechanisms by which amifostine exerts its effects are not known.
