| 1. |
|
|
| 2. |
- Kato, S, et al.
(författare)
-
DNA hypermethylation and inflammatory markers in incident Japanese dialysis patients
- 2012
-
Ingår i: Nephron extra. - : S. Karger AG. - 1664-5529. ; 2:1, s. 159-68
-
Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background/Aims:</i></b> Inflammation is an established mortality risk factor in chronic kidney disease (CKD) patients. Although a previous report showed that uremic Caucasian patients with inflammation had signs of global DNA hypermethylation, it is still unknown whether DNA hypermethylation is linked to inflammatory markers including a marker of bacterial infections in Japanese CKD patients. <b><i>Methods:</i></b> In 44 consecutive incident dialysis patients (26 males, mean age 59 ± 12 years) without clinical signs of infection, global DNA methylation was evaluated in peripheral blood DNA using the <i>Hpa</i>II<i>/Msp</i>I ratio by the luminometric methylation assay method. A lower ratio of <i>Hpa</i>II<i>/Msp</i>I indicates global DNA hypermethylation. Procalcitonin (PCT), a marker of inflammation due to bacterial infections, was measured using an immunochromatographic assay. <b><i>Results:</i></b> The patients were divided into hyper- and hypomethylation groups based on the median value of the <i>Hpa</i>II<i>/Msp</i>I ratio 0.31 (range 0.29–0.37). Whereas patients in the hypermethylation group had higher ferritin levels [133.0 (51.5–247.3) vs. 59.5 (40.0–119.0) ng/ml; p = 0.046], there were no significant differences in age, gender, diabetes, smoking, anemia or serum albumin levels. However, the <i>Hpa</i>II<i>/Msp</i>I ratio showed significant negative correlations with PCT (ρ = –0.32, p = 0.035) and ferritin (ρ = –0.33, p = 0.027) in Spearman’s rank test. In a multiple linear regression analysis, PCT and ferritin were associated with a lower <i>Hpa</i>II<i>/Msp</i>I ratio (R<sup>2</sup> = 0.24, p = 0.013). <b><i>Conclusion:</i></b> In this study, global DNA hypermethylation was associated with ferritin and, most likely, PCT, suggesting that inflammation induced by subclinical bacterial infection promoted DNA methylation.
|
|
| 3. |
- Kato, S, et al.
(författare)
-
High Ferritin Level and Malnutrition Predict High Risk of Infection-Related Hospitalization in Incident Dialysis Patients: A Japanese Prospective Cohort Study
- 2016
-
Ingår i: Blood purification. - : S. Karger AG. - 1421-9735 .- 0253-5068. ; 42:1, s. 56-63
-
Tidskriftsartikel (refereegranskat)abstract
- <b><i>Aims:</i></b> The aim of the study was to clarify the relationship between serum ferritin and infectious risks. <b><i>Methods:</i></b> We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. <b><i>Results:</i></b> Kaplan-Meier analysis revealed that the period without infections requiring hospitalization was significantly shorter in ferritin > median (82.0 ng/ml) group than in the ferritin < median group (log-rank test 4.44, p = 0.035). High ferritin was associated with significantly increased relative risk of hospitalization for infection (Cox hazard model 1.52, 95% CI 1.06-2.17). The number of hospitalization days was gradually longer in patients with high ferritin levels and malnutrition. <b><i>Conclusion:</i></b> Although serum ferritin levels were low, and doses of iron administered to dialysis patients in Japan are generally lower than in Western countries, an elevated ferritin level was associated with increased risk of infection, particularly in patients with poor nutritional status.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Kato, S, et al.
(författare)
-
Inter-leg systolic blood pressure difference predicts cardiovascular events and mortality in incident hemodialysis patients
- 2020
-
Ingår i: The International journal of artificial organs. - : SAGE Publications. - 1724-6040 .- 0391-3988. ; 43:4, s. 217-224
-
Tidskriftsartikel (refereegranskat)abstract
- High inter-arm blood pressure difference, a marker of vascular disease, may be difficult to assess in hemodialysis patients with arm arteriovenous fistulae. We investigated if high inter-leg systolic blood pressure difference associates with cardiovascular events and increased mortality in hemodialysis patients.Methods:Among 118 incident Japanese dialysis patients, bilateral leg blood pressure, arm blood pressure, brachial–ankle pulse wave velocity, and ankle–brachial index were measured, and the relative risk associated with inter-leg systolic blood pressure difference and other indices of vascular status was analyzed.Results:During follow-up (median, 46 months), 18 deaths and 75 cardiovascular events occurred in 38 patients. Kaplan–Meier curves showed that higher inter-leg systolic blood pressure difference was associated with overall (log-rank 9.35, p = 0.002) and cardiovascular (log-rank 5.81, p = 0.02) mortality. The period from the start of dialysis therapy to the first cardiovascular event was shorter as inter-leg systolic blood pressure difference increased (log-rank 23.7, p < 0.0001). In Cox hazard models, inter-leg systolic blood pressure difference greater than median independently predicted deaths (relative risk, 3.8; 95% confidence interval, 1.3–13.9) and cardiovascular events (relative risk, 3.9; 95% confidence interval, 1.9–9.21) after adjustments for age, sex, nutritional status, and diabetes, whereas other indices were not related to the risks. For well-nourished, moderately malnourished, and severely malnourished patients, the cumulative number of cardiovascular events in the high–inter-leg systolic blood pressure difference patients were 4.96, 31.44, and 55.18 events per 100 patient-years.Conclusions:Higher inter-leg systolic blood pressure difference associated with increased risk of mortality and cardiovascular events suggesting that wider application of inter-leg systolic blood pressure difference measurements may be warranted in hemodialysis patients.
|
|
| 8. |
|
|
| 9. |
- Kato, S, et al.
(författare)
-
Telomere Attrition and Elongation after Chronic Dialysis Initiation in Patients with End-Stage Renal Disease
- 2016
-
Ingår i: Blood purification. - : S. Karger AG. - 1421-9735 .- 0253-5068. ; 41:1-3, s. 25-33
-
Tidskriftsartikel (refereegranskat)abstract
- <b><i>Aims:</i></b> To analyze changes in telomere length (TL) after dialysis initiation. <b><i>Methods:</i></b> In 59 Japanese incident dialysis patients, associations between TL in peripheral blood leukocytes, inflammatory biomarkers and nutritional status at baseline and changes in TL during 1 year of dialysis, were investigated. <b><i>Results:</i></b> Whereas relative TL decreased by 8.6% (median 14.4%), TL elongation occurred in 16 patients (27%). Change in TL (ΔTL), defined as TL at 1 year minus TL at baseline, was associated with baseline TL (ρ = -0.70, p < 0.0001) and leukocyte count (ρ = 0.26, p = 0.044). In a logistic regression model, baseline TL (p < 0.0001) and leukocyte count (p = 0.047) were associated with ΔTL. <b><i>Conclusions:</i></b> TL shortening was observed in most incident dialysis patients. In 16 of the 59 patients, TL elongation occurred, possibly reflecting a more robust biological aging in patients whose naïve leukocytes may have undergone less proliferation to replace lost leukocytes.
|
|
