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1. CKD PATHOPHYSIOLOGY AND CLINICAL STUDIES

Author

Paola Achilli, Francesco Marino, Ioannis Karatzas, Steven Fishbane, Alessandro Domenico Quercia, Yu Du, Richard R. Furman, Katarzyna Maresz, Jack F.M. Wetzels, Gerard A. Rongen, Hyun Yul Rhew, Ogo Egbuna, Mariano Rodriguez, Leena Patel, Kiyoto Koibuchi, Anna-Ewa O Kulik, M Weiswasser, Ken Sakai, Antoine Bouquegneau, Myles Wolf, Ilona Kurnatowska, Chantal Loirat, Alberto Ortiz, Stéphane Poitevin, Tilo Hanowski, Elvira Fernández, Abdul Rashid Qureshi, Françoise Dignat-George, Christophe Legendre, Juan Jesus Carrero, Jeffrey Kaupke, Maurizio Postorino, Pablo E. Pergola, Jaco Botha, Bernhard K Kraemer, Mariusz Kusztal, Camille L. Bedrosian, Ada Braun, Marion Sallée, Katarzyna Jankowska, Marcus E. Kleber, Magdalena Kaczmarska, Georg Schlieper, Yeon Soon Jung, Giuseppe Enia, Rosaria Lupica, Beatriz Martínez Fernández, Taro Hoshino, Peter Boor, Mai Ots-Rosenberg, Maria Pina P Madonna, Ayako Tsuchiya, Cesare Guarena, Usama Elewa, Rika Miura, Graciela E. Delgado, Winfried Maerz, Jacek C Szepietowski, Yoshifumi Ubara, Alan G. Jardine, Thiane Gama-Axelsson, Kaoru Tabei, Vincenzo Cantaluppi, Franco Brescia, Carmine Zoccali, Yao Yu, Akihiro Tsuda, Viatcheslav Rakov, Yasemin G Kurt, Sergio Dellepiane, Mahmut Ilker Yilmaz, Winnie Sohn, Bengt Lindholm, Claudia Carmone, Rabab Mohamed Elbehidy, Ye Na Kim, Bertrand Gondouin, Hark Rim, Larry Greenbaum, Dimitrios Arvanitis, Cristina Masini, Michael Chen, Laetitia Dou, Vincenzo Panichi, Leszek Bieniaszewski, Etienne Cavalier, Federica Genovese, Hikmet Tekce, Giovanni Camussi, Mahmut I Yilmaz, Tacyano Tavares Leite, Stéphane Burtey, Yoshiteru Ohno, Atsushi Aikawa, Peter Braunhofer, Johan Vande Walle, Irina Mititiuc, Olivier Devuyst, Amit Sharma, Stefan Degenhardt, Glenn M. Chertow, Henrik S. Rasmussen, Rannveig Skrunes, Dimitra Nastou, E. Marie Freel, Zbigniew Heleniak, Mahmut Gok, Heike Kielstein, Jesús Egido, Steven Zeig, Patrick B. Mark, David Arroyo, Katarzyna Kunicka, Dimosthenis Vlassopoulos, Paweł Poznański, Bruce Spinowitz, Gian Domenico D Fabbri, Jaap Deinum, Yasmine Draz, Marina Foramitti, K. Lysaja, Marian Klinger, Iris Fuhrmann, Cees Vermeer, A. Villari, Piotr Skrzypczyk, Hubert Scharnagl, Emily P. McQuarrie, Giuseppina Pettinato, Kentaro Tanaka, Bożena Werner, Yasuhisa Sakurai, MałGorzata Sojka, Bolesław Rutkowski, Cric Study Investigators, Song Rong, Adrian Covic, Lisa M. Bernard, Carlo Massimetti, Candice Bezerra Torres De Melo, Davide Medica, Jose M. Valdivielso, Martin Flamant, Markus Ketteler, Morten A. Karsdal, Shay Shemesh, Domenico Santoro, Aoi Nabata, Bhupinder Singh, Jean-Marie Krzesinski, Emmanuelle Vidal-Petiot, Tanja B. Grammer, Sandro Feriozzi, Fabio Malberti, Camilla Tøndel, Tayfun Eyileten, Nikolaos Manolios, K K Larsen, Camillo Porta, Junichi Hoshino, Filippo Benedetto, Jesper N. Bech, Larry A. Greenbaum, Rolfdieter Krause, Dimitrie Siriopol, Catherine Delmas-Frenette, Hideaki Shima, Reginaldo Filho, Katarzyna Kilis-Pstrusinska, Stuart M. Sprague, Akifumi Kushiyama, Kiyonori Ito, Katsunori Saito, Ludomir Stefańczyk, Mari Aoe, Juliette Hadchouel, Juergen Floege, Jürgen Floege, Lara Cavalcante Vaz Cunha, Fernanda Macedo de Oliveira Neves, Honami Mori, Mutlu Saglam, Giovanni Tripepi, Yasemin Gulcan Kurt, Mohamed A El-Shahawy, Ewa Aleksandrowicz, Kristin Jäger, Graziella Caridi, Pierre Delanaye, Moriatsu Miyagi, Desmond Padhi, Mai Sugahara, Kiryong Park, Mait Raag, Renata de Almeida Leitão, Thomas D. Wooldridge, Keiji Hirai, Gianluca Trifirò, Elzbieta Prus-Wojtowicz, Naoki Sawa, Murat Karaman, Alexandre Braga Libório, François Vrtovsnik, Ewa Świerblewska, Yuichirou Ueda, Eiji Ishimura, Yusuf Oguz, Masayo Ogawa, Geoffrey A. Block, Frank H Mose, Ho Sik Shin, Yahsou Delmas, Magdalena Okarska-Napierała, Toshiyuki Aoki, Richard Amdur, Hilmi Umut Unal, Stéphan Troyanov, Tammo Lesch, Amal A Alshal, Edward Chong, Ülle Pechter, Alison Taylor, Katsuhito Mori, Mehmet Kanbay, Akinobu Ochi, Claire Cerini, Naobumi Mise, Susumu Ookawara, Joris H. Robben, Hakki Cetinkaya, Anna Masajtis-Zagajewska, Davide Bolignano, Hilmi Umut Ünal, Mitsuru Ichii, Kensuke Hamada, Naoya Sugiyama, Sebahattin Sari, Gianluca Leonardi, Abdulgaffar Vural, Noémie Jourde-Chiche, Sankar D. Navaneethan, N. Dimkovic, Franziska Knöfel, Marios Papasotiriou, Peter Mt Deen, Fadi Fakhouri, Dimitrios Hadjiyannakos, Erling B. Pedersen, Luigi Biancone, Vassilis Filiopoulos, N. Marx, Masayoshi Mori, Zbigniew Zdrojewski, Giovanni F.M. Strippoli, Yoshio Kaku, Masatomo Chikamori, Angels Betriu, Michele Buemi, Kenmei Takaichi, William T. Smith, Izumi Sugimoto, A. Savvaidis, Daijo Inaguma, Giuseppe Costantino, John F Kincaid, Laura Cosmai, Radosław Pietrzak, Roberto Sabbatini, Michał Nowicki, Stephen R. Ash, Kenichi Ishizawa, Masaaki Inaba, Daniela Leonardis, Piotr Grzelak, Jonas Axelsson, Robert A. Fenton, Massimiliano Migliori, Junichiro Yamamoto, Diana J Leeming, Giovanna Parlongo, Philip T. Lavin, Buket Kin Tekce, Dominic S. Raj, James Cotton, David J. Cohen, Shinya Nakatani, Sangeon Gwoo, Shigeko Hara, Frank Schiepe, Philip Awadalla, Gulali Aktas, Massimo Gai, Maria Roszkowska-Blaim, Neil S. Sheerin, Lei Nan, K: Hess, Haruhisa Miyazawa, Silvia Lucisano, Grahame J Elder, François Madore, Helena Ziółkowska, Cai-Li Wang, Einar Svarstad, Giuseppina Lorenzano, Maria Teresa T Muratore, Alex Yang, Graziella D'Arrigo, Doaa Mohammed Youssef, Janni M Jensen, Marta Gracia, Suetonia C. Palmer, Valeria Cernaro, Borja Quiroga, Anton E. Daul, Francesca Mallamaci, Philippe Brunet, Tomoko Honda, Gerjan Navis, Izumi Yoshida, Domenico Trimboli, and Anjay Rastogi

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Medicine, business, Intensive care medicine, Pathophysiology
Published
2014
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2. IGF-1 and Survival in ESRD

Author

Abdul Rashid Qureshi, Peter Stenvinkel, Peter Bárány, Ting Jia, Thiane Gama Axelsson, Olof Heimbürger, and Bengt Lindholm

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Epidemiology, Cross-sectional study, medicine.medical_treatment, Down-Regulation, Nutritional Status, Kaplan-Meier Estimate, Critical Care and Intensive Care Medicine, Renal Dialysis, Risk Factors, Diabetes mellitus, Internal medicine, medicine, Humans, Longitudinal Studies, Insulin-Like Growth Factor I, Dialysis, Aged, Proportional Hazards Models, Sweden, Bone mineral, Transplantation, Chi-Square Distribution, Proportional hazards model, business.industry, Hazard ratio, Original Articles, Middle Aged, medicine.disease, Confidence interval, Cross-Sectional Studies, Treatment Outcome, Endocrinology, Nephrology, Multivariate Analysis, Cohort, Body Composition, Kidney Failure, Chronic, Female, Bone Remodeling, business, Biomarkers
Abstract

Summary Background and objectives IGF-1 deficiency links to malnutrition in CKD patients; however, it is not clear to what extent it associates with survival among these patients. Design, setting, participants, & measurements Serum IGF-1 and other biochemical, clinical (subjective global assessment), and densitometric (dual energy x-ray absorptiometry) markers of nutritional status and mineral and bone metabolism were measured in a cohort of 365 Swedish clinically stable CKD stage 5 patients (median age of 53 years) initiating dialysis between 1994 and 2009; in 207 patients, measurements were also taken after 1 year of dialysis. Deaths were registered during a median follow-up of 5 years. Associations of mortality with baseline IGF-1 and changes of IGF-1 after 1 year of dialysis were evaluated by Cox models. Results At baseline, IGF-1 concentrations associated negatively with age, diabetes mellitus, cardiovascular disease, poor nutritional status, IL-6, and osteoprotegerin and positively with body fat mass, bone mineral density, serum phosphate, calcium, and fibroblast growth factor-23. At 1 year, IGF-1 had increased by 33%. In multivariate regression, low age, diabetes mellitus, and high serum phosphate and calcium associated with IGF-1 at baseline, and in a mixed model, these factors, together with high fat body mass, associated with changes of IGF-1 during the first 1 year of dialysis. Adjusting for calendar year of inclusion, age, sex, diabetes mellitus, cardiovascular disease, IL-6, and poor nutritional status, a 1 SD higher level of IGF-1 at baseline associated with lower mortality risk (hazard ratio, 0.57; 95% confidence interval, 0.32 to 0.98). Persistently low or decreasing IGF-1 levels during the first 1 year on dialysis predicted worse survival (adjusted hazard ratio, 2.19; 95% confidence interval, 1.06 to 4.50). Conclusion In incident dialysis patients, low serum IGF-1 associates with body composition and markers of mineral and bone metabolism, and it predicts increased mortality risk.

Published
2014
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3. Serum Albumin as Predictor of Nutritional Status in Patients with ESRD

Author

Abdul Rashid Qureshi, Peter Stenvinkel, Peter Bárány, Bengt Lindholm, Thiane Gama-Axelsson, and Olof Heimbürger

Subjects
Male, Epidemiology, Cross-sectional study, Critical Care and Intensive Care Medicine, Gastroenterology, chemistry.chemical_compound, Absorptiometry, Photon, Risk Factors, Prevalence, Hand Strength, biology, Incidence, Age Factors, Middle Aged, Nutrition Disorders, Skinfold Thickness, Cardiovascular Diseases, Nephrology, Creatinine, Predictive value of tests, Biomarker (medicine), Female, medicine.symptom, Adult, medicine.medical_specialty, Serum albumin, Nutritional Status, Serum Albumin, Human, Risk Assessment, Sex Factors, Predictive Value of Tests, Diabetes mellitus, Internal medicine, Diabetes Mellitus, medicine, Albuminuria, Humans, Serum Albumin, Aged, Inflammation, Sweden, Transplantation, business.industry, Original Articles, Anthropometry, medicine.disease, Cross-Sectional Studies, Logistic Models, Nutrition Assessment, Endocrinology, chemistry, Multivariate Analysis, biology.protein, Kidney Failure, Chronic, business, Biomarkers
Abstract

Serum albumin is a widely used biomarker of nutritional status in patients with CKD; however, its usefulness is debated. This study investigated serum albumin and its correlation with several markers of nutritional status in incident and prevalent dialysis patients.In a cross sectional study, serum albumin (bromocresol purple), and other biochemical (serum creatinine), clinical (subjective global assessment [SGA]), anthropometric (handgrip strength, skinfold thicknesses), and densitometric (dual energy x-ray absorptiometry) markers of nutritional status were assessed in 458 incident (61% male; mean age 54 +/- 13 years; GFR, 6.6 +/-2.3 ml/min per 1.73 m(2); recruited 1994–2010) and 383 prevalent (56% male; mean age 62 +/- 14 years; recruited 1989–2004) dialysis patients.In incident patients: serum albumin was correlated with sex (beta = -0.13; P = 0.02), diabetes mellitus (beta = -0.18; P = 0.004), and urinary albumin excretion (beta = -0.42; P = 0.001) but less so with poor nutritional status (SGA score1; beta = -0.19; P = 0.001). In prevalent patients, serum albumin was correlated with age (beta = -0.14; P = 0.05), high-sensitivity C-reactive protein (beta = -0.34; P = 0.001), diabetes mellitus (beta = -0.11; P = 0.04), and SGA score1 (beta = -0.14; P = 0.003). In predicting nutritional status assessed by SGA and other markers, adding serum albumin to models that included age, sex, diabetes, and cardiovascular disease did not significantly increase explanatory power.In incident and prevalent dialysis patients,serum albumin correlates poorly with several markers of nutritional status. Thus, its value as a reliable marker of nutritional status in patients with ESRD is limited. In addition, the following inconsistencies between the main text and Tables 1 and 3 are also corrected as follows. (1) In Table 1, the GFR initially written as 6 +/- 3 ml/min per 1.73(2) should be corrected to 6.6 +/- 2.3 ml/min per 1.73(2). (2) On line 11 of page 1448, under the Clinical Correlates of Serum Albumin Concentration section describing the multiple regression models (Table 3), the P value was initially written as“serum albumin was associated with age (beta = -0.14; P = 0.05).” The P value should be corrected to have the same value as that given in Table 3 (beta = -0.14; P = 0.005. [corrected].

Published
2012
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