Oxidative Balance Score and the Risk of End-Stage Renal Disease and Cardiovascular Disease

2017 ◽  
Vol 45 (4) ◽  
pp. 338-345 ◽  
Author(s):  
Titilayo O. Ilori ◽  
Xiao Wang ◽  
Morong Huang ◽  
Orlando M. Gutierrez ◽  
K.M. Venkat Narayan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cox Proportional Hazards ◽  
Oxidative Balance ◽  
Crude Model ◽  
Oxidative Balance Score ◽  
Stage Renal Disease ◽  
End Stage ◽  
Adjusted Model

Background: Oxidative balance score (OBS) is a composite measure of oxidative stress-related exposures. The aim of this study was to investigate the association between OBS, end-stage renal disease (ESRD), and cardiovascular disease (CVD). Methods: Using data from the Chronic Renal Insufficiency Cohort, we calculated the main exposure OBS by summing up 12 apriori-defined pro- and antioxidant factors obtained from the diet history questionnaire and lifestyle assessment. We divided OBS into quartiles (Q1-Q4), with Q1 (predominance of pro-oxidants) as the reference. We analyzed OBS quartiles as an ordinal variable. Crude and adjusted hazards ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models for time to ESRD and CVD. Results: Compared to Q1, Q4 (high antioxidant) was associated with ESRD in the crude model (HR 1.35, 95% CI 1.08-1.69) and adjusting for age, sex, and race (HR 1.36, 95% CI 1.09-1.71) but not in the fully adjusted model (HR 1.12, 95% CI 0.84-1.51). HR of ESRD increased as the OBS quartiles increased in the crude model (ptrend < 0.05) but not in the fully adjusted model (ptrend = 0.30). Compared to Q1, Q4 was associated with CVD in the crude (HR 1.33, 95% CI 1.06-1.68) but not adjusted models. The HR of CVD increased with an increase in OBS quartiles in the crude model (ptrend < 0.05). Conclusion: The reverse association between OBS and progression to ESRD suggests that perhaps the effect of oxidative balance-related exposure is different in the setting of established chronic kidney disease.

scholarly journals Obesity, End-stage Renal Disease, and Survival in an Elderly Cohort With Cardiovascular Disease

Obesity ◽  
2009 ◽  
Vol 17 (12) ◽  
pp. 2216-2222 ◽  
Author(s):  
Janice P. Lea ◽  
Daryl O. Crenshaw ◽  
Stephen J. Onufrak ◽  
Britt B. Newsome ◽  
William M. McClellan
Keyword(s):  
Cardiovascular Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Elderly Cohort ◽  
Stage Renal Disease ◽  
End Stage

Cardiovascular Disease as a Late Complication of End-Stage Renal Disease in Children

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 123-126 ◽  
Author(s):  
Jaap Groothoff ◽  
Mariken Gruppen ◽  
Eric De Groot ◽  
Martin Offringa
Keyword(s):  
Cardiovascular Disease ◽  
Aortic Valve ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Arterial Wall ◽  
Aortic Valve Calcification ◽  
Cross Sectional ◽  
Valve Calcification ◽  
Stage Renal Disease ◽  
End Stage

♦ Objective To analyze the late cardiovascular outcome of end-stage renal disease (ESRD) in children. ♦ Design A nation-wide long-term follow-up study. Determinants of outcomes and causes of death were retrospectively assessed. Patients underwent assessment of overall health state, B- and M-mode ultrasound of the carotid arteries, and echocardiography for cross-sectional analysis. ♦ Results We analyzed the medical course of all 249 adult Dutch patients with ESRD onset between 1972 and 1992 at age 0 – 14 years, and who were born before 1979. Of the 187 living patients, 140 participated in the cross-sectional part of the study. The standardized mortality rate was 31.0. Overall 5-, 10-, and 20-year survival after ESRD onset was 87%, 82%, and 78%, respectively. Cardiovascular disease accounted for most deaths (41%). In the whole group, left ventricular hypertrophy (LVH), aortic valve calcification, and arterial wall stiffening were highly prevalent. LVH was associated with hypertension at time of assessment. Aortic valve calcification was strongly associated with a long total duration of peritoneal dialysis (β = 0.33, p < 0.001). Arterial wall pathology was not associated with current treatment modality. ♦ Conclusions As in adults, cardiovascular disease is the most important cause of death in children with ESRD. Stricter reduction of volume overload, prevention of high serum calcium–phosphate product, and more vigorous treatment of hypertension are important targets to improve cardiovascular survival in children with ESRD.

Assessing Plasma Total Homocysteine in Patients with End-Stage Renal Disease

2007 ◽  
Vol 27 (5) ◽  
pp. 476-488 ◽  
Author(s):  
Bradley L. Urquhart ◽  
Andrew A. House
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Elevated Plasma ◽  
Plasma Thcy ◽  
Total Homocysteine ◽  
Stage Renal Disease ◽  
End Stage ◽  
Plasma Total Homocysteine

Elevated plasma total homocysteine (tHcy) is a risk factor for cardiovascular disease; however, in light of several recent randomized trials, the issue of causality has been cast into doubt. Patients with end-stage renal disease are particularly interesting as they consistently have elevated tHcy and their leading causes of morbidity and mortality are related to cardiovascular disease. In the present article, we review the early evidence for the homocysteine theory of atherosclerosis, homocysteine metabolism, mechanisms of toxicity, and pertinent available clinical investigations. Where appropriate, the sparse evidence of homocysteine in peritoneal dialysis is reviewed. We conclude by addressing the difficulties associated with lowering plasma tHcy in patients with end-stage renal disease and suggest some novel methods for lowering tHcy in this resistant population. Finally, to address the issue of causality, we recommend that clinicians and scientists await the results of the FAVORIT trial before abandoning homocysteine as a modifiable risk factor for cardiovascular disease, as this study has recruited patients from a population with consistently elevated plasma tHcy who are known to respond to vitamin therapy.

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