Introduction
Subjects and methods
Haemodialysis patients (N = 150) | Control subjects (N = 30) | |
---|---|---|
Age (years) | 62 (59–64) | 53 (49–57) |
Gender (male/female) | 92/58 | 21/9 |
Body mass index (kg/m2) | 26.1 (25.2–26.9) | 26.5 (24.8–28.3) |
Obesity (BMI ≥ 30 kg/m2) (n/ %) | 28/18.7 | 9/30.0 |
Primary cause of CKD (n/ %) | ||
Diabetes
| 42/28.0 | NA |
Hypertension
| 17/11.3 | NA |
Nephrolithiasis
| 8/5.3 | NA |
Autosomal dominant polycystic kidney disease (ADPKD)
| 10/6.7 | NA |
Ischaemic nephropathy
| 2/1.3 | NA |
Glomerulonephritis
| 24/16.0 | NA |
Interstitial nephritis
| 13/8.5 | NA |
Other or unknown
| 34/22.7 | NA |
Time on dialysis (months) | 48 (41–56) | NA |
Kt/V (per HD session)^
| 1.05 (1.01–1.08) | NA |
Urea reduction ratio (%) | 64.8 (63.3–66.2) | NA |
Comorbidity (%) | ||
Hypertension
| 136/90.7 | 0 |
Diabetes
| 55/36.7 | 0 |
Coronary artery disease
| 83/55.3 | 0 |
Stroke
| 12/8.0 | 0 |
Past kidney transplantation
| 11/7.3 | 0 |
Pharmacotherapy (n/%) | ||
Antihypertensive
| 136/90.7 | 0 |
No. of antihypertensive drugs (n) | 2.0 (1.8–2.2) | 0 |
Oral anti-diabetic
| 19/34.5* | 0 |
Insulin
| 36/65.5* | 0 |
Anti-platelet
| 77/51.3 | 0 |
Statins
| 60/40.0 | 0 |
Fibrates
| 0 | 0 |
Oral phosphorous binders
| 129/86.0 | 0 |
Carbonate calcium dose (g/day) | 3.8 (3.4–4.3) | 0 |
Sevelamer hydrochloride
| 4/2.6 | 0 |
Cinacalcet
| 17/11.3 | 0 |
Cinacalcet dose (mg/day) | 79 (60–98) | |
Alfacalcidol
| 31/20.7 | 0 |
Measurements
Statistical analysis
Results
Study group characteristics
Haemodialysis patients [N= | Control subjects [N = 30] |
p
| |
---|---|---|---|
Haemoglobin (g/dL)^
| 10.8 (10.6–11.0) | 13.8 (11.2–14.9) | <0.01 |
Total cholesterol (mg/dL) | 169 (160–178) | 198 (183–214) | <0.05 |
LDL cholesterol (mg/dL) | 90 (84–95) | 131 (117–146) | <0.05 |
HDL cholesterol (mg/dL) | 28 (26–29) | 57 (50–64) | <0.01 |
Triglycerides (mg/dL) | 169 (160–178) | 114 (95–133) | <0.05 |
Calcium (mg/dL)^
| 8.57 (8.44–8.70) | ND | – |
Phosphorous (mg/dL)^
| 5.77 (5.52–6.02) | ND | – |
Parathyroid hormone (pg/mL) | 449 (380–519) | ND | – |
hsCRP (mg/L)*
| 4.82 (2.33–11.60) | 1.71 (0.87–3.19) | <0.05 |
Interleukin 6 (pg/mL)*
| 6.20 (1.01–10.32) | 1.34 (0.99–1.97) | <0.05 |
Tumour necrosis factor-α (pg/mL)*
| 5.94 (2.93–11.80) | 1.61 (1.31–1.85) | <0.01 |
Bacterial lipopolysaccharides (ng/mL) | 27.7 (22.1–36.9) | 28.1 (16.6–57.6) | 0.72 |
d-lactates (µg/mL)*
| 1.47 (0.94–2.34) | 1.55 (1.35–1.77) | 0.63 |
Zonulin (ng/mL) | 11.6 (10.9–12.3) | 6.8 (5.8–7.8) | <0.01 |
Haptoglobin (µg/mL)*
| 1.37 (0.82–2.03) | 1.39 (0.98–1.72) | 0.87 |
Subgroups analysis
Zonulin (ng/mL) | ANOVA/ Kruskal–Wallis | |||
---|---|---|---|---|
Low tertile <9.8 | Medium tertile | High tertile >13.1 | ||
Haemoglobin (g/dL) | 10.6 (10.3–10.9) | 10.8 (10.5–11.2) | 10.9 (10.5–11.3) |
p = 0.43 |
Total cholesterol (mg/dL) | 169 (155–183) | 161 (146–176) | 177 (161–193) |
p = 0.32 |
LDL cholesterol (mg/dL) | 89 (80–99) | 85 (75–94) | 95 (84–106) |
p = 0.35 |
HDL cholesterol (mg/dL) | 28 (26–30) | 28 (26–31) | 27 (24–30) |
p = 0.72 |
Triglycerides (mg/dL) | 158 (134–182) | 158 (120–196) | 162 (134–190) |
p = 0.97 |
hsCRP (mg/L)*
| 3.96 (1.58–10.32) | 4.04 (2.20–8.78) | 5.76 (3.58–13.20)^ |
p = 0.07 |
Interleukin 6 (pg/mL)*
| 6.39 (1.01–9.66) | 4.08 (0.78–9.70) | 8.35 (1.28–11.31) |
p = 0.12 |
Tumour necrosis factor-α (pg/mL)*
| 4.41 (2.36–8.26) | 7.07 (3.12–15.60)^ | 7.01 (3.16–11.80)^ |
p = 0.04 |
Bacterial lipopolysaccharides (ng/mL)*
| 26.9 (22.2–37.0) | 28.5 (21.8–35.6) | 27.0 (22.9–37.3) |
p = 0.98 |
d-Lactates (µg/mL)*
| 1.77 (0.96–2.62) | 1.29 (0.91–2.21) | 1.42 (0.98–2.30) |
p = 0.23 |
Haptoglobin (µg/mL)*
| 1.37 (0.74–1.91) | 1.27 (0.84–2.36) | 1.64 (0.91–2.30) |
p = 0.54 |
Bacterial lipopolysaccharides (ng/mL) | ||||
---|---|---|---|---|
Low tertile <24.1 | Medium tertile | High tertile >32.6 | ||
Haemoglobin (g/dL) | 10.6 (10.3–10.9) | 10.9 (10.6–11.2) | 10.9 (10.4–11.3) |
p = 0.47 |
Total cholesterol (mg/dL) | 171 (153–188) | 176 (163–191) | 159 (146–173) |
p = 0.26 |
LDL cholesterol (mg/dL) | 87 (76–97) | 95 (86–104) | 87 (77–98) |
p = 0.41 |
HDL cholesterol (mg/dL) | 27 (25–29) | 29 (26–31) | 27 (25–30) |
p = 0.65 |
Triglycerides (mg/dL) | 178 (137–219) | 153 (129–177) | 146 (123–170) |
p = 0.29 |
hsCRP (mg/L)*
| 3.73 (1.80–11.04) | 4.84 (3.42–9.08) | 5.48 (2.58–15.92) |
p = 0.21 |
Interleukin 6 (pg/mL) | 3.48 (0.78–8.38) | 6.29 (1.20–9.52) | 9.11 (1.09–11.80)#
|
p = 0.02 |
Tumour necrosis factor-α (pg/mL)*
| 4.94 (2.31–10.10) | 6.46 (3.06–12.30) | 8.26 (3.15–12.90) |
p = 0.35 |
d-Lactates (µg/mL)*
| 1.65 (0.97–2.38) | 1.33 (0.95–2.34) | 1.47 (0.94–2.21) |
p = 0.70 |
Haptoglobin (µg/mL)*
| 1.43 (0.84–2.36) | 1.33 (0.83–2.30) | 1.37 (0.73–1.92) |
p = 0.63 |
Zonulin (ng/mL) | 10.8 (9.7–11.9) | 12.2 (11.2–13.2) | 11.8 (10.1–13.4) |
p = 0.24 |
d-Lactates (µg/mL) | ||||
---|---|---|---|---|
Low tertile <1.14 | Medium tertile | High tertile >2.0 | ||
Haemoglobin (g/dL) | 10.7 (10.4–11.1) | 10.7 (10.4–11.1) | 10.9 (10.5–11.2) |
p = 0.80 |
Total cholesterol (mg/dL) | 165 (153–177) | 170 (153–186) | 173 (156–189) |
p = 0.76 |
LDL cholesterol (mg/dL) | 89 (80–98) | 85 (76–95) | 94 (83–106) |
p = 0.44 |
HDL cholesterol (mg/dL) | 28 (25–30) | 28 (25–30) | 27 (25–30) |
p = 0.98 |
Triglycerides (mg/dL) | 150 (126–174) | 172 (137–208) | 156 (124–187) |
p = 0.57 |
hsCRP (mg/L)*
| 4.84 (2.58–12.60) | 5.20 (2.61–10.32) | 3.87 (2.15–11.04) |
p = 0.70 |
Interleukin 6 (pg/mL)*
| 2.78 (0.86–9.66) | 6.54 (0.68–10.33) | 8.27 (1.95–10.80)^ |
p = 0.04 |
Tumour necrosis factor-α (pg/mL)*
| 6.33 (3.15–15.63) | 7.07 (2.48–12.20) | 4.68 (2.59–10.20) |
p = 0.15 |
Bacterial lipopolysaccharides (ng/mL)*
| 27.5 (21.4–37.6) | 27.7 (23.3–36.6) | 28.0 (21.3–34.4) |
p = 0.88 |
Haptoglobin (µg/mL)*
| 1.00 (0.71–1.73) | 1.64 (1.03–2.33)^ | 1.39 (0.89–2.38)^ |
p = 0.02 |
Zonulin (ng/mL) | 11.4 (10.4–12.3) | 12.7 (11.1–14.4) | 10.7 (9.6–11.8) |
p = 0.12 |