Oxidative stress and other risk factors for white matter lesions in chronic hemodialysis patients

Abstract Background Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients. Methods This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients’ medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. Results A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). Conclusions This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.

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Evaluation of Assays for Measurement of Serum (Anti)oxidants in Hemodialysis Patients

BioMed Research International ◽

10.1155/2014/843157 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Tatjana Ruskovska ◽

Eugene H. J. M. Jansen ◽

Risto Antarorov

Keyword(s):

Oxidative Stress ◽

Statistical Significance ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Total Serum ◽

Antioxidant Assays ◽

Hemodialysis Session ◽

Anti Oxidant ◽

Oxidant Status ◽

Healthy Persons

Background. Various biomarkers and assays have been used for assessment of (anti)oxidant status in hemodialysis patients, including those intended for measurement of serum total (anti)oxidants, most often as a part of panel biomarkers.Methods. Serum (anti)oxidant status was measured in 32 chronically hemodialyzed patients and in 47 healthy persons, using two oxidations and three antioxidant assays.Results. The patients before the hemodialysis session have had higher values of total oxidants in comparison to the healthy persons, with a further increase during the hemodialysis. These findings were confirmed with both oxidation assays, but they differ in the percentage of increase and the statistical significance. All three antioxidant assays showed significantly higher values of the total serum antioxidants in the patients before the hemodialysis session in comparison to the healthy persons, and their significant decrease during the hemodialysis. However, the assays differ in the percentage of decrease, its statistical significance, and the correlations with uric acid.Conclusion. The variability of results of total (anti)oxidants which are obtained using different assays should be taken into account when interpreting data from clinical studies of oxidative stress, especially in complex pathologies such as chronic hemodialysis.

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The Prevalence and Severity of White Matter Lesions, Their Relationship with Age, Ethnicity, Gender, and Cardiovascular Disease Risk Factors: The ARIC Study

Neuroepidemiology ◽

10.1159/000368814 ◽

1997 ◽

Vol 16 (3) ◽

pp. 149-162 ◽

Cited By ~ 258

Author(s):

Duanping Liao ◽

Lawton Cooper ◽

Jianwen Cai ◽

James Toole ◽

Nick Bryan ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

White Matter ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

White Matter Lesions ◽

Cardiovascular Disease Risk Factors ◽

Aric Study

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Cognitive features of white matter lesions accompanied by different risk factors of cerebrovascular diseases

Advances in Clinical and Experimental Medicine ◽

10.17219/acem/110324 ◽

2019 ◽

Vol 28 (12) ◽

pp. 1705-1710

Author(s):

Yafei Shangguan ◽

Tao Xiong ◽

Changwei Jiang ◽

Wei Chen ◽

Yan Zhang ◽

...

Keyword(s):

Risk Factors ◽

White Matter ◽

White Matter Lesions ◽

Cerebrovascular Diseases

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The study on analysis of risk factors for severity of white matter lesions and its correlation with cerebral microbleeds in the elderly with lacunar infarction

Medicine ◽

10.1097/md.0000000000018865 ◽

2020 ◽

Vol 99 (4) ◽

pp. e18865

Author(s):

Yu-Ni Zhou ◽

Hao-Yuan Gao ◽

Fang-Fang Zhao ◽

Ying-Chun Liang ◽

Yuan Gao ◽

...

Keyword(s):

Risk Factors ◽

White Matter ◽

White Matter Lesions ◽

The Elderly ◽

Cerebral Microbleeds ◽

Lacunar Infarction

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Pomegranate juice improves cardiometabolic risk factors, biomarkers of oxidative stress and inflammation in hemodialysis patients: a randomized crossover trial

Journal of the Science of Food and Agriculture ◽

10.1002/jsfa.10096 ◽

2019 ◽

Vol 100 (2) ◽

pp. 846-854 ◽

Cited By ~ 7

Author(s):

Reza Barati Boldaji ◽

Masoumeh Akhlaghi ◽

Mohammad Mahdi Sagheb ◽

Zahra Esmaeilinezhad

Keyword(s):

Oxidative Stress ◽

Risk Factors ◽

Cardiometabolic Risk ◽

Crossover Trial ◽

Hemodialysis Patients ◽

Cardiometabolic Risk Factors ◽

Pomegranate Juice ◽

Randomized Crossover Trial ◽

Biomarkers Of Oxidative Stress

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Associations of Cardiovascular and All-Cause Mortality with Metabolic Syndrome in Hemodialysis Patients: A Prospective Single-Center Study

Medicina ◽

10.3390/medicina55100694 ◽

2019 ◽

Vol 55 (10) ◽

pp. 694

Author(s):

Zorica Dimitrijevic ◽

Andriana Jovanovic ◽

Mina Cvetkovic ◽

Tamara Vrecic ◽

Emina Kostic ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Metabolic Disorders ◽

Cardiometabolic Risk ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Single Center Study ◽

All Cause Mortality

Background and objectives: Metabolic syndrome (MetS) is a cluster of risk factors, such as abdominal obesity, insulin resistance, dyslipidemia and hypertension, that together increase the risk of cardiovascular disease. Chronic hemodialysis (HD) patients have multiple comorbidities and many metabolic disorders, causing the frequent occurrence of metabolic syndrome. The goal of this study was to assess the prevalence of MetS in HD patients, and its association with all-cause and cardiovascular (CV) mortality. Patients and methods: A total of 138 HD patients were included in this prospective study. We analyzed demographic, anthropometric and biochemical data. Outcome measures were all-cause and CV mortality during the three-year follow-up. Results: MetS was diagnosed in 57.24% of enrolled patients. During the 36 months of follow-up, 33 patients died. MetS patients showed a significantly higher mortality rate than non-MetS (30.4% versus 16.36%, p < 0.001). The association of different MetS components with cardiovascular mortality reached significance when a minimum of three components were present (1.81 (95% confidence interval CI = 1.21–2.33)), with a grouped increase in effect size for subjects with four or five MetS components. Subjects with MetS exhibited nearly twice as high risk for all-cause (hazard ratio HR = 1.99 (95%CI) = 1.42–2.97) and 2.5 times for CV (HR = 2.51 (95%CI) = 1.25–3.83) mortality compared with those without MetS, after adjustment for age, gender, and cardiovascular disease. Conclusions: The study demonstrates that MetS is widespread in HD patients. In future, the focus must be on an active screening approach, and treatment of cardiometabolic risk factors, aiming to reduce mortality.

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