Skip to main content
Erschienen in: International Urology and Nephrology 10/2015

01.10.2015 | Nephrology - Original Paper

Hematological parameters can predict the extent of coronary artery disease in patients with end-stage renal disease

verfasst von: Zeynep Bal, Ugur Bal, Kaan Okyay, Mustafa Yilmaz, Serhat Balcioglu, Ozge Turgay, Senem Hasirci, Alp Aydinalp, Aylin Yildirir, Siren Sezer, Haldun Muderrisoglu

Erschienen in: International Urology and Nephrology | Ausgabe 10/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Aside from traditional factors (e.g., diabetes, age, and hypertension), some hematological parameters, such as neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), and mean platelet volume (MPV), have increasingly been reported as measures of systemic inflammation and atherosclerosis in patients with end-stage renal disease (ESRD). This study aimed to determine whether there is an association between these hematological parameters and the extent of coronary artery disease (CAD) in patients with ESRD.

Methods

A total of 149 consecutive ESRD patients (66 % males) without established CAD were studied. NLR, RDW, and MPV values in all patients were calculated from the complete blood count before coronary angiography. Angiographic views were assessed by an experienced interventional cardiologist, and the extent of CAD was evaluated by the Gensini score. The patients were divided into quartiles of the Gensini score.

Results

Age, time on dialysis, calcium–phosphorus product, C-reactive protein levels, NLR, and MPV were significantly different among the groups (all p < 0.05). The Gensini score was correlated with age, time on dialysis (both p < 0.001), NLR (p = 0.004), and C-reactive protein levels (p = 0.034) and inversely correlated with left ventricular ejection fraction (p = 0.023). Multivariate regression analysis showed that age (p = 0.001), time on dialysis (p < 0.001), NLR (p = 0.001), and MPV (p = 0.005) were independent predictors of the extent of CAD.

Conclusions

Aside from the well-known traditional factors, NLR and MPV are independent predictors of the extent of CAD in patients with ESRD.
Literatur
1.
Zurück zum Zitat Foley RN, Parfrey PS, Sarnak MJ (1998) Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32:112–119CrossRef Foley RN, Parfrey PS, Sarnak MJ (1998) Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32:112–119CrossRef
2.
Zurück zum Zitat Parfrey PS, Foley RN, Harnett JD, Kent GM, Murray DC, Barre PE (1996) Outcome and risk factors for left ventricular disorders in chronic uremia. Nephrol Dial Transplant 11:1277–1285CrossRefPubMed Parfrey PS, Foley RN, Harnett JD, Kent GM, Murray DC, Barre PE (1996) Outcome and risk factors for left ventricular disorders in chronic uremia. Nephrol Dial Transplant 11:1277–1285CrossRefPubMed
3.
Zurück zum Zitat Muntner P, He J, Astor BC, Folsom AR, Coresh J (2005) Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the atherosclerosis risk in communities study. J Am Soc Nephrol 16:529–538CrossRefPubMed Muntner P, He J, Astor BC, Folsom AR, Coresh J (2005) Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the atherosclerosis risk in communities study. J Am Soc Nephrol 16:529–538CrossRefPubMed
4.
Zurück zum Zitat Himmelfarb J, Stenvinkel P, Ikizler TA, Hakim RM (2002) The elephant in uraemia: oxidant stress as a unifying concept of cardiovascular disease in uremia. Kidney Int 62:1524–1538CrossRefPubMed Himmelfarb J, Stenvinkel P, Ikizler TA, Hakim RM (2002) The elephant in uraemia: oxidant stress as a unifying concept of cardiovascular disease in uremia. Kidney Int 62:1524–1538CrossRefPubMed
5.
Zurück zum Zitat Carrero JJ, Stenvinkel P (2010) Inflammation in end-stage renal disease—what have we learned in 10 years? Semin Dial 23:498–509CrossRefPubMed Carrero JJ, Stenvinkel P (2010) Inflammation in end-stage renal disease—what have we learned in 10 years? Semin Dial 23:498–509CrossRefPubMed
6.
Zurück zum Zitat Wang AY, Lam CW, Chan IH, Wang M, Lui SF, Sanderson JE (2009) Long-term mortality and cardiovascular risk stratification of peritoneal dialysis patients using a combination of inflammation and calcification markers. Nephrol Dial Transplant 24:3826–3833CrossRefPubMed Wang AY, Lam CW, Chan IH, Wang M, Lui SF, Sanderson JE (2009) Long-term mortality and cardiovascular risk stratification of peritoneal dialysis patients using a combination of inflammation and calcification markers. Nephrol Dial Transplant 24:3826–3833CrossRefPubMed
7.
Zurück zum Zitat Carrero JJ, Park SH, Axelsson J, Lindholm B, Stenvinkel P (2009) Cytokines, atherogenesis, and hypercatabolism in chronic kidney disease: a dreadful triad. Semin Dial 22:381–386CrossRefPubMed Carrero JJ, Park SH, Axelsson J, Lindholm B, Stenvinkel P (2009) Cytokines, atherogenesis, and hypercatabolism in chronic kidney disease: a dreadful triad. Semin Dial 22:381–386CrossRefPubMed
8.
Zurück zum Zitat Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS (2008) Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 102:653–657CrossRefPubMed Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS (2008) Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 102:653–657CrossRefPubMed
9.
Zurück zum Zitat Park BJ, Shim JY, Lee HR, Lee JH, Jung DH, Kim HB, Na HY, Lee YJ (2011) Relationship of neutrophil–lymphocyte ratio with arterial stiffness and coronary calcium score. Clin Chim Acta 412:925–929CrossRefPubMed Park BJ, Shim JY, Lee HR, Lee JH, Jung DH, Kim HB, Na HY, Lee YJ (2011) Relationship of neutrophil–lymphocyte ratio with arterial stiffness and coronary calcium score. Clin Chim Acta 412:925–929CrossRefPubMed
10.
Zurück zum Zitat Bhutta H, Agha R, Wong J, Tang TY, Wilson YG, Walsh SR (2011) Neutrophil lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a cross-sectional study. Vasc Endovascular Surg 45:227–231CrossRefPubMed Bhutta H, Agha R, Wong J, Tang TY, Wilson YG, Walsh SR (2011) Neutrophil lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a cross-sectional study. Vasc Endovascular Surg 45:227–231CrossRefPubMed
11.
Zurück zum Zitat Ekici B, Erkan AF, Alhan A, Sayın I, Aylı M, Töre HF (2013) Is mean platelet volume associated with the angiographic severity of coronary artery disease? Kardiol Pol 71:832–838CrossRefPubMed Ekici B, Erkan AF, Alhan A, Sayın I, Aylı M, Töre HF (2013) Is mean platelet volume associated with the angiographic severity of coronary artery disease? Kardiol Pol 71:832–838CrossRefPubMed
12.
Zurück zum Zitat Abalı G, Akpınar O, Söylemez N (2014) Correlation of the coronary severity scores and mean platelet volume in diabetes mellitus. Adv Ther 31:140–148CrossRefPubMed Abalı G, Akpınar O, Söylemez N (2014) Correlation of the coronary severity scores and mean platelet volume in diabetes mellitus. Adv Ther 31:140–148CrossRefPubMed
13.
Zurück zum Zitat Mayer FJ, Hoke M, Schillinger M, Minar E, Arbesú I, Koppensteiner R, Mannhalter C (2014) Mean platelet volume predicts outcome in patients with asymptomatic carotid artery disease. Eur J Clin Invest 44:22–28CrossRefPubMed Mayer FJ, Hoke M, Schillinger M, Minar E, Arbesú I, Koppensteiner R, Mannhalter C (2014) Mean platelet volume predicts outcome in patients with asymptomatic carotid artery disease. Eur J Clin Invest 44:22–28CrossRefPubMed
14.
Zurück zum Zitat Ma FL, Li S, Li XL et al (2013) Correlation of red cell distribution width with the severity of coronary artery disease: a large Chinese cohort study from a single center. Chin Med J (Engl) 126:1053–1057 Ma FL, Li S, Li XL et al (2013) Correlation of red cell distribution width with the severity of coronary artery disease: a large Chinese cohort study from a single center. Chin Med J (Engl) 126:1053–1057
16.
Zurück zum Zitat Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Task Böhm M, Members Force (2013) ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 34:2159–2219CrossRefPubMed Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Task Böhm M, Members Force (2013) ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 34:2159–2219CrossRefPubMed
17.
Zurück zum Zitat Diagnosis and classification of diabetes mellitus (2014) American diabetes association. Diabetes Care 37:81–90CrossRef Diagnosis and classification of diabetes mellitus (2014) American diabetes association. Diabetes Care 37:81–90CrossRef
18.
Zurück zum Zitat Expert panel on detection, evaluation, and treatment of high blood cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) (2001) JAMA 285:2486–2497 Expert panel on detection, evaluation, and treatment of high blood cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) (2001) JAMA 285:2486–2497
19.
Zurück zum Zitat Gensini GG (1983) A more meaningful scoring system for determining the se-verity of coronary heart disease. Am J Cardiol 51:606CrossRefPubMed Gensini GG (1983) A more meaningful scoring system for determining the se-verity of coronary heart disease. Am J Cardiol 51:606CrossRefPubMed
20.
Zurück zum Zitat Zoccali C (2000) Cardiovascular risk in uraemic patients-is it fully explained by classical risk factors? Nephrol Dial Transplant 15:454–457CrossRefPubMed Zoccali C (2000) Cardiovascular risk in uraemic patients-is it fully explained by classical risk factors? Nephrol Dial Transplant 15:454–457CrossRefPubMed
21.
Zurück zum Zitat Longenecker JC, Coresh J, Powe NR, Levey AS, Fink NE, Martin A, Klag MJ (2002) Traditional cardiovascular disease risk factors in dialysis patients compared with the general population: the CHOICE study. J Am Soc Nephrol 13:1918–1927CrossRefPubMed Longenecker JC, Coresh J, Powe NR, Levey AS, Fink NE, Martin A, Klag MJ (2002) Traditional cardiovascular disease risk factors in dialysis patients compared with the general population: the CHOICE study. J Am Soc Nephrol 13:1918–1927CrossRefPubMed
22.
Zurück zum Zitat Raggi P, Boulay A, Chasan-Taber S, Amin N, Dillon M, Burke SK, Chertow GM (2002) Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease & cardiovascular disease? J Am Coll Cardiol 39:695–701CrossRefPubMed Raggi P, Boulay A, Chasan-Taber S, Amin N, Dillon M, Burke SK, Chertow GM (2002) Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease & cardiovascular disease? J Am Coll Cardiol 39:695–701CrossRefPubMed
23.
Zurück zum Zitat Lindner A, Charra B, Sherrard DJ, Scribner BH (1974) Accelerated atherosclerosis in prolonged maintenance hemodialysis. N Engl J Med 290:697–701CrossRefPubMed Lindner A, Charra B, Sherrard DJ, Scribner BH (1974) Accelerated atherosclerosis in prolonged maintenance hemodialysis. N Engl J Med 290:697–701CrossRefPubMed
24.
Zurück zum Zitat Block GA, Hulbert-Shearon TE, Levin NW, Port FK (1998) Association of serum phosphorus and serum calcium x phosphate with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis 31:607–617CrossRefPubMed Block GA, Hulbert-Shearon TE, Levin NW, Port FK (1998) Association of serum phosphorus and serum calcium x phosphate with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis 31:607–617CrossRefPubMed
25.
Zurück zum Zitat Wanner C, Zimmermann J, Schwelder S, Metzger T (2002) Inflammation and cardiovascular risk in dialysis patients. Kidney Int 80:99–102CrossRef Wanner C, Zimmermann J, Schwelder S, Metzger T (2002) Inflammation and cardiovascular risk in dialysis patients. Kidney Int 80:99–102CrossRef
26.
Zurück zum Zitat Kanbay M, Afsar B, Gusbeth-Tatomir P, Covic A (2010) Arterial stiffness in dialysis patients: where are we now? Int Urol Nephrol 42:741–752CrossRefPubMed Kanbay M, Afsar B, Gusbeth-Tatomir P, Covic A (2010) Arterial stiffness in dialysis patients: where are we now? Int Urol Nephrol 42:741–752CrossRefPubMed
27.
Zurück zum Zitat Giachelli CM (2004) Mechanisms of vascular calcification in uremia. Semin Nephrol 24:401–402CrossRefPubMed Giachelli CM (2004) Mechanisms of vascular calcification in uremia. Semin Nephrol 24:401–402CrossRefPubMed
28.
29.
Zurück zum Zitat Brancaccio D, Tetta C, Gallieni M, Panichi V (2002) Inflammation, CRP, calcium overload and a high calcium-phosphorus product: a “liaison dangereuse”. Nephrol Dial Transplant 17:201–203CrossRefPubMed Brancaccio D, Tetta C, Gallieni M, Panichi V (2002) Inflammation, CRP, calcium overload and a high calcium-phosphorus product: a “liaison dangereuse”. Nephrol Dial Transplant 17:201–203CrossRefPubMed
30.
Zurück zum Zitat Turkmen K, Ozcicek F, Ozcicek A, Akbas EM, Erdur FM, Tonbul HZ (2014) The relationship between neutrophil-to-lymphocyte ratio and vascular calcification in end-stage renal disease patients. Hemodial Int 18:47–53CrossRefPubMed Turkmen K, Ozcicek F, Ozcicek A, Akbas EM, Erdur FM, Tonbul HZ (2014) The relationship between neutrophil-to-lymphocyte ratio and vascular calcification in end-stage renal disease patients. Hemodial Int 18:47–53CrossRefPubMed
31.
Zurück zum Zitat Turkmen K, Guney I, Yerlikaya FH, Tonbul HZ (2012) The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail 34:155–159CrossRefPubMed Turkmen K, Guney I, Yerlikaya FH, Tonbul HZ (2012) The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail 34:155–159CrossRefPubMed
32.
Zurück zum Zitat Henning BF, Zidek W, Linder B, Tepel M (2002) Mean platelet volume and coronary heart disease in hemodialysis patients. Kidney Blood Pressure Res 25:103–108CrossRef Henning BF, Zidek W, Linder B, Tepel M (2002) Mean platelet volume and coronary heart disease in hemodialysis patients. Kidney Blood Pressure Res 25:103–108CrossRef
33.
Zurück zum Zitat Bath PM, Butterworth RJ (1996) Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 7:157–161CrossRefPubMed Bath PM, Butterworth RJ (1996) Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 7:157–161CrossRefPubMed
Metadaten
Titel
Hematological parameters can predict the extent of coronary artery disease in patients with end-stage renal disease
verfasst von
Zeynep Bal
Ugur Bal
Kaan Okyay
Mustafa Yilmaz
Serhat Balcioglu
Ozge Turgay
Senem Hasirci
Alp Aydinalp
Aylin Yildirir
Siren Sezer
Haldun Muderrisoglu
Publikationsdatum
01.10.2015
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 10/2015
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-015-1073-2

Weitere Artikel der Ausgabe 10/2015

International Urology and Nephrology 10/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.