Meric Oruc1, Selda Mercan2, Selim Bakan3, Sennur Kose4, Baris Ikitimur5, Sinan Trabulus6, Mehmet Riza Altiparmak6. 1. Department of Nephrology, Kartal Dr Lutfi Kirdar City Hospital, 34865, Istanbul, Turkey. mericozd@yahoo.com. 2. Department of Science, Institute of Forensic Sciences and Legal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. 3. Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey. 4. Department of Nephrology, Istanbul Education and Research Hospital, Istanbul, Turkey. 5. Department of Cardiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey. 6. Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Abstract
PURPOSE: Abnormalities of trace elements have previously been linked to inflammatory processes in hemodialysis (HD) patients. We aimed to establish the trace element status of maintenance HD patients, to investigate the relationship between coronary artery calcification scores (CACs) and whole blood levels of trace elements. METHODS: Patients undergoing HD in three times a week for > 6 months and age-and sex-matched controls were included from October 2015 to June 2016. Data were collected from patient files. All subjects' whole blood levels of trace elements were measured by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). CACs for patients were assessed by multi-detector computed tomography. RESULTS: The 35 patients (male, 60%) with a mean age of 45.7 ± 10.4 years and 35 controls were included. HD patients showed significantly lower levels of selenium and uranium and higher cadmium (Cd), cobalt, lithium, manganese, nickel, lead, platinum, tin, strontium, and thallium levels compared to controls. Coronary artery calcification (CAC) was present in 21 patients (60%), and median CACs were 14.2 (IQR 0-149). Patients with CACs > median were significantly older, had a higher prevalence of hypertension and lower ALP levels than patients with CACs ≤ median. No significant differences in whole blood levels of trace elements were found between patients with CACs > median and patients with CACs ≤ median. A near significance was noted in median whole blood levels of Cd between these groups (P = 0.096). According to multivariate analysis, age was the only independent determinant for CAC development. CONCLUSION: Age is independently associated with coronary vascular calcification. High Cd levels might play a role in CAC development in HD patients.
PURPOSE: Abnormalities of trace elements have previously been linked to inflammatory processes in hemodialysis (HD) patients. We aimed to establish the trace element status of maintenance HD patients, to investigate the relationship between coronary artery calcification scores (CACs) and whole blood levels of trace elements. METHODS: Patients undergoing HD in three times a week for > 6 months and age-and sex-matched controls were included from October 2015 to June 2016. Data were collected from patient files. All subjects' whole blood levels of trace elements were measured by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). CACs for patients were assessed by multi-detector computed tomography. RESULTS: The 35 patients (male, 60%) with a mean age of 45.7 ± 10.4 years and 35 controls were included. HD patients showed significantly lower levels of selenium and uranium and higher cadmium (Cd), cobalt, lithium, manganese, nickel, lead, platinum, tin, strontium, and thallium levels compared to controls. Coronary artery calcification (CAC) was present in 21 patients (60%), and median CACs were 14.2 (IQR 0-149). Patients with CACs > median were significantly older, had a higher prevalence of hypertension and lower ALP levels than patients with CACs ≤ median. No significant differences in whole blood levels of trace elements were found between patients with CACs > median and patients with CACs ≤ median. A near significance was noted in median whole blood levels of Cd between these groups (P = 0.096). According to multivariate analysis, age was the only independent determinant for CAC development. CONCLUSION: Age is independently associated with coronary vascular calcification. High Cd levels might play a role in CAC development in HD patients.
Authors: Marcello Tonelli; Natasha Wiebe; Aminu Bello; Catherine J Field; John S Gill; Brenda R Hemmelgarn; Daniel T Holmes; Kailash Jindal; Scott W Klarenbach; Braden J Manns; Ravi Thadhani; David Kinniburgh Journal: Clin J Am Soc Nephrol Date: 2018-03-29 Impact factor: 8.237
Authors: Marit D Solbu; Geir Mjøen; Patrick B Mark; Hallvard Holdaas; Bengt Fellström; Roland E Schmieder; Faiez Zannad; William G Herrington; Alan G Jardine Journal: Nephrol Dial Transplant Date: 2018-01-01 Impact factor: 5.992
Authors: Marcello Tonelli; Natasha Wiebe; Brenda Hemmelgarn; Scott Klarenbach; Catherine Field; Braden Manns; Ravi Thadhani; John Gill Journal: BMC Med Date: 2009-05-19 Impact factor: 8.775