Effect of Erythropoietin-stimulating Agent on Uremic Inflammation

Overview

Journal J Inflamm (Lond)

Publisher Biomed Central

Date 2012 May 16

PMID 22583484

Citations 6

Authors

Yuri Tanaka

Nobuhiko Joki

Hiroki Hase

Masaki Iwasaki

Masato Ikeda

Ryoichi Ando

Toshio Shinoda

Daijo Inaguma

Toshifumi Sakaguchi

Yasuhiro Komatsu

Fumihiko Koiwa

Toshihiko Yamaka

Takashi Shigematsu

Affiliations

Soon will be listed here.

Abstract

Background: The goal of the present study was to explore the effect of medications that are commonly prescribed for CKD patients on uremic state.

Methods: This was a cross-sectional study. From January 2006 to October 2009, 1,623 patients with end-stage kidney disease (ESKD) commenced hemodialysis (HD) at the 9 participating hospitals. The criteria for exclusion from the database were 1) serum C-reactive protein (CRP) > 3 mg/dL, 2) WBC count > 9,000/mm3 or <4,000/mm3, and 3) patients with cancer, immune complex disease, or vasculitis. A total of 900 patients were entered into the final database. We explored the association of serum CRP just before the first HD session with clinical characteristics, laboratory data, and medications for CKD in the predialysis period.

Results: On univariate analysis, age, CTR, eGFR, and WBC were significantly correlated with CRP. Systolic and diastolic blood pressure, serum albumin, LDL-C, HDL-C, Hb, Cr, and Ca were inversely associated with CRP. Use of erythropoietin-stimulating agents (ESA) using (r = -0.111, p = 0.0015), renin-angiotensin-aldosterone system inhibitors (r = -0.083, p = 0.0154), and calcium channel blockers (r = -0.1, p = 0.0039) was also negatively correlated with CRP. However, only use of ESA showed a significant negative correlation with CRP that was independent of other clinical factors and CKD medications on multiple regression analysis.

Conclusion: ESA may strongly reduce uremic inflammation in addition to improving anemia. To confirm this potential effect, a large-scale longitudinal study would be required.

Citing Articles

Erythropoietin for the prevention of postoperative neurocognitive disorder in older adult patients undergoing total joint arthroplasty: a randomized controlled study.

Kim E, Park K, Choi S, Ju H, Kim T, Kim J BMC Anesthesiol. 2024; 24(1):418.

PMID: 39548414 PMC: 11566623. DOI: 10.1186/s12871-024-02770-9.

Saccharated ferric oxide attenuates haematopoietic response induced by epoetin beta pegol in patients undergoing haemodialysis.

Iwasaki T, Fujimori A, Nakanishi T, Okada S, Hanawa N, Hasuike Y BMC Nephrol. 2021; 22(1):124.

PMID: 33832448 PMC: 8034147. DOI: 10.1186/s12882-021-02320-2.

Biological variation of procalcitonin levels in hemodialysis patients.

Kubo S, Iwasaki M, Horie M, Matsukane A, Hayashi T, Tanaka Y Clin Exp Nephrol. 2018; 23(3):402-408.

PMID: 30196520 DOI: 10.1007/s10157-018-1639-2.

Impact of Continuous Erythropoietin Receptor Activator on Selected Biomarkers of Cardiovascular Disease and Left Ventricle Structure and Function in Chronic Kidney Disease.

Bartnicki P, Rysz J, Franczyk B, Baj Z, Majewska E Oxid Med Cell Longev. 2016; 2016:9879615.

PMID: 27034745 PMC: 4789516. DOI: 10.1155/2016/9879615.

Association between Plaque Score of the Carotid Artery and the Severity of Sleep Apnea Syndrome in Patients with Chronic Kidney Disease.

Hasegawa D, Tanaka A, Inaguma D, Ito E, Kamegai N, Kato A Cardiorenal Med. 2016; 6(2):159-68.

PMID: 26989401 PMC: 4789906. DOI: 10.1159/000443748.

References

Kon Koh K, Ahn J, Han S, Kim D, Jin D, Kim H . Pleiotropic effects of angiotensin II receptor blocker in hypertensive patients. J Am Coll Cardiol. 2003; 42(5):905-10. DOI: 10.1016/s0735-1097(03)00846-5. View

Wanner C, Krane V, Marz W, Olschewski M, Mann J, Ruf G . Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med. 2005; 353(3):238-48. DOI: 10.1056/NEJMoa043545. View

. K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis. 2005; 45(4 Suppl 3):S1-153. View

Yao Q, Pecoits-Filho R, Lindholm B, Stenvinkel P . Traditional and non-traditional risk factors as contributors to atherosclerotic cardiovascular disease in end-stage renal disease. Scand J Urol Nephrol. 2005; 38(5):405-16. DOI: 10.1080/00365590410031715. View

Gabay C, Kushner I . Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999; 340(6):448-54. DOI: 10.1056/NEJM199902113400607. View

Shimoishi K, Anraku M, Kitamura K, Tasaki Y, Taguchi K, Hashimoto M . An oral adsorbent, AST-120 protects against the progression of oxidative stress by reducing the accumulation of indoxyl sulfate in the systemic circulation in renal failure. Pharm Res. 2007; 24(7):1283-9. DOI: 10.1007/s11095-007-9248-x. View

Nakai S, Masakane I, Akiba T, Shigematsu T, Yamagata K, Watanabe Y . Overview of regular dialysis treatment in Japan as of 31 December 2006. Ther Apher Dial. 2009; 12(6):428-56. DOI: 10.1111/j.1744-9987.2008.00634.x. View

Ruilope L, Malacco E, Khder Y, Kandra A, Bonner G, Heintz D . Efficacy and tolerability of combination therapy with valsartan plus hydrochlorothiazide compared with amlodipine monotherapy in hypertensive patients with other cardiovascular risk factors: the VAST study. Clin Ther. 2005; 27(5):578-87. DOI: 10.1016/j.clinthera.2005.05.006. View

Mathieu C, van Etten E, Gysemans C, Decallonne B, Kato S, Laureys J . In vitro and in vivo analysis of the immune system of vitamin D receptor knockout mice. J Bone Miner Res. 2001; 16(11):2057-65. DOI: 10.1359/jbmr.2001.16.11.2057. View

10.

Nakai S, Suzuki K, Masakane I, Wada A, Itami N, Ogata S . Overview of regular dialysis treatment in Japan (as of 31 December 2008). Ther Apher Dial. 2010; 14(6):505-40. DOI: 10.1111/j.1744-9987.2010.00893.x. View

11.

Hase H, Tsunoda T, Tanaka Y, Takahashi Y, Imamura Y, Ishikawa H . Risk factors for de novo acute cardiac events in patients initiating hemodialysis with no previous cardiac symptom. Kidney Int. 2006; 70(6):1142-8. DOI: 10.1038/sj.ki.5001726. View

12.

Dohi Y, Ohashi M, Sugiyama M, Takase H, Sato K, Ueda R . Candesartan reduces oxidative stress and inflammation in patients with essential hypertension. Hypertens Res. 2003; 26(9):691-7. DOI: 10.1291/hypres.26.691. View

13.

Stenvinkel P, Heimburger O, Paultre F, Diczfalusy U, Wang T, Berglund L . Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney Int. 1999; 55(5):1899-911. DOI: 10.1046/j.1523-1755.1999.00422.x. View

14.

Joki N, Hase H, Tanaka Y, Takahashi Y, Saijyo T, Ishikawa H . Relationship between serum albumin level before initiating haemodialysis and angiographic severity of coronary atherosclerosis in end-stage renal disease patients. Nephrol Dial Transplant. 2006; 21(6):1633-9. DOI: 10.1093/ndt/gfl037. View

15.

Hung M, Cherng W, Cheng C, Yang N . Effect of antispastic agents (calcium antagonists and/or isosorbide dinitrate) on high-sensitivity C-reactive protein in patients with coronary vasospastic angina pectoris and no hemodynamically significant coronary artery disease. Am J Cardiol. 2004; 95(1):84-7. DOI: 10.1016/j.amjcard.2004.08.064. View

16.

Schieffer B, Bunte C, Witte J, Hoeper K, Boger R, Schwedhelm E . Comparative effects of AT1-antagonism and angiotensin-converting enzyme inhibition on markers of inflammation and platelet aggregation in patients with coronary artery disease. J Am Coll Cardiol. 2004; 44(2):362-8. DOI: 10.1016/j.jacc.2004.03.065. View

17.

Fellstrom B, Jardine A, Schmieder R, Holdaas H, Bannister K, Beutler J . Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med. 2009; 360(14):1395-407. DOI: 10.1056/NEJMoa0810177. View

18.

Fliser D, Buchholz K, Haller H . Antiinflammatory effects of angiotensin II subtype 1 receptor blockade in hypertensive patients with microinflammation. Circulation. 2004; 110(9):1103-7. DOI: 10.1161/01.CIR.0000140265.21608.8E. View

19.

Ronco C, McCullough P, Anker S, Anand I, Aspromonte N, Bagshaw S . Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J. 2009; 31(6):703-11. PMC: 2838681. DOI: 10.1093/eurheartj/ehp507. View

20.

Yasunari K, Maeda K, Watanabe T, Nakamura M, Yoshikawa J, Asada A . Comparative effects of valsartan versus amlodipine on left ventricular mass and reactive oxygen species formation by monocytes in hypertensive patients with left ventricular hypertrophy. J Am Coll Cardiol. 2004; 43(11):2116-23. DOI: 10.1016/j.jacc.2003.12.051. View