Plasma microRNA-126-3p and neutrophil-to-lymphocyte ratio in patients with chronic kidney disease: relationships to ambulatory 24-h blood pressure

BACKGROUND: Sleep deprivation is strongly associated with cardiovascular disease (CVD) via sympathetic overstimulation and systemic inflammation in general population. However, the significance of poor sleep quality in chronic kidney disease (CKD) is still underexplored.METHODS: This study assessed the sleep quality of 39 with non-dialysis CKD (ND CKD) patients and 25 hemodialysis CKD (HD CKD) patients using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Poor sleeper was defined as individual with PSQI > 5.RESULTS: The prevalence of poor sleeper (30% vs. 60%, p=0.029) and the cummulative PSQI (ND CKD 4.5±4.4, HD CKD 8±6, p=0.038) are different between ND CKD and HD CKD groups. Among the ND CKD, there are association between short sleep duration (< 5 hours per day) with elevated diastolic blood pressure groups (r=0.421, p<0.05); habitual sleep efficiency with platelet-to-lymphocyte ratio (r= 0.532, p<0.0001); daytime dysfunction with increased hs-CRP (r=0.345, p=0.032) and neutrophil-to-lymphocyte ratio (r=0.320, p=0.046). In HD CKD group, a requirement to use sleep medication was associated with elevated highsensitivity C-reactive protein (hs-CRP) level (r=0.434, p=0.030) and decreased monocyte-to-lymphocyte ratio (r=- 0.410, p=0.042); daytime dysfunction was associated with serum hs-CRP (r=0.452, p=0.023).CONCLUSION: This study revealed that some features of poor sleep quality in CKD patients including low sleep efficiency, daytime dysfunction and requirement to use sleep medication were associated with increased diastolic blood pressure, hs-CRP and blood-count-based inflammatory predictors. Thus, this finding prompt to pay closer attention to sleep complaints in the management of CVD risk factors in CKD patients.KEYWORDS: sleep quality, chronic kidney disease, blood pressure, inflammation

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Markers of Atherosclerosis in Hypertensive Patients with Less Advanced Chronic Kidney Disease

Acta Medica Marisiensis ◽

10.2478/amma-2019-0022 ◽

2019 ◽

Vol 65 (3) ◽

pp. 91-96

Author(s):

Claudia Floriana Suciu ◽

Andreea Varga ◽

Corneliu Florin Buicu ◽

Ioan Tilea

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Aortic Arch ◽

Laboratory Data ◽

Hypertensive Heart Disease ◽

Neutrophil To Lymphocyte Ratio ◽

Advanced Chronic Kidney Disease ◽

Hypertensive Patients ◽

Lymphocyte Ratio ◽

Aortic Arch Calcification

AbstractObjective: Our study aimed to validate the neutrophil-to-lymphocyte ratio (NLR) as a marker for aortic arch calcification in hypertensive patients with less advanced chronic kidney disease (CKD).Methods: A number of forty-four hypertensive patients with chronic kidney disease (categories G3a and G3b – 2012 KDIGO nomenclature) were included in the study. Considering the presence of aortic arch calcification (AAC) on chest X-ray, the study population was divided into two groups: 27 patients AAC present and seventeen without aortic arch calcification. Laboratory data were collected for each patient and NLR was computed. Comorbidities were also recorded: stable coronary artery disease, lower extremity arterial disease and hypertensive heart disease.Results: A positive correlation between neutrophil-to-lymphocyte ratio and aortic arch calcification in hypertensive CKD patients was identified. Furthermore, advanced age, increased alkaline phosphatase and increased erythrocyte sedimentation rate had a positive association with aortic arch calcification. We found no statistical correlation between neutrophil-to-lymphocyte ratio and other laboratory features in both groups of patients.Conclusions: Neutrophil-to-lymphocyte ratio may be viewed as a potential risk factor for vascular calcification in patients with moderate chronic kidney disease; nevertheless, future extensive studies are necessary. In the management of hypertensive patients, general medicine might particularly benefit of this simple, readily available inflammatory marker.

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Neutrophil-to-lymphocyte ratio in relation to the risk of all-cause mortality and cardiovascular events in patients with chronic kidney disease: a systematic review and meta-analysis

Renal Failure ◽

10.1080/0886022x.2020.1832521 ◽

2020 ◽

Vol 42 (1) ◽

pp. 1059-1066

Author(s):

Wen-Man Zhao ◽

Shu-Man Tao ◽

Gui-Ling Liu

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Cardiovascular Events ◽

Meta Analysis ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

All Cause Mortality

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Association of High Blood Pressure with Elevated Oxidative Stress, Inflammatory Marker and Albuminuria in Chronic Kidney Disease Patients

Journal of Medicine ◽

10.3329/jom.v20i1.38815 ◽

2019 ◽

Vol 20 (1) ◽

pp. 12-18 ◽

Cited By ~ 1

Author(s):

Mochammad Thaha ◽

Ika N Kadariswantiningsih ◽

Maulana A Empitu

Keyword(s):

Oxidative Stress ◽

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Diastolic Blood Pressure ◽

Inflammatory Marker ◽

Reactive Oxygen Species Generation ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Lymphocyte To Monocyte Ratio

Background: Activation of renin-Angiotensin system in hypertension was believed to be major determinant in endothelial dysfunction, micro-inflammation, and reactive oxygen species generation. This study aimed to investigate the interaction of increased blood pressure with cardiovascular risk factors in chronic kidney disease (CKD). Materials & methods: The study was an observational study with cross-sectional design that consecutively enrolled CKD patients in Universitas Airlangga Hospital and two other hospitals in Surabaya, Indonesia. The resting blood pressure and kidney functions of the participants were examined. Malondialdehyde (MDA) and total antioxidant capacity (TAC) was measured in serum and used as oxidative stress markers. Serum hs-C-reactive protein (CRP), lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio were utilized as inflammatory markers, while urine albumin-to-creatinine ratio (ACR) was used as renal disease marker. The participants were grouped based on their systolic and diastolic blood pressure (SBP and DBP). The difference of marker levels between groups was tested using Mann-Whitney test. The correlation between SBP and DBP with inflammation, oxidative stress, and albuminuria was determined using Spearman’s test. Results: As many as 71 patients with CKD were enrolled in this study. As much as 37% of the participants had high SBP and 14% had high DBP. High SBP positively associated with MDA (P<0.05), hs-CRP (P<0.05), platelet-to-lymphocyte ratio (P<0.05), and ACR (P<0.0001) and negatively with lymphocyte-to-monocyte ratio (P<0.05) and TAC (P<0.0001). High DBP associated positively with ACR (P<0.05) and negatively with TAC (P<0.05). Conclusions: High systolic or diastolic blood pressure was significantly associated with inflammation, oxidative stress and albuminuria. Optimal blood pressure control may be one of strategies to prevent inflammation and oxidative stress among CKD patients. J MEDICINE JUL 2019; 20 (1) : 12-18

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