Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis

Hernán Trimarchi,1 Alexis Muryan,2 María-Soledad Raña,1 Pedro Paggi,2 Fernando Lombi,1 Mariano Forrester,1 Vanesa Pomeranz,1 Alejandra Karl,1 Mirta Alonso,2 Pablo Young,3 Mariana Dicugno2 1Department of Nephrology, 2Department of Biochemistry, 3Department of Internal...

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Main Authors: Trimarchi H, Muryan A, Raña MS, Paggi P, Lombi F, Forrester M, Pomeranz V, Karl A, Alonso M, Young P, Dicugno M
Format: Article
Language:English
Published: Dove Medical Press 2013-06-01
Series:International Journal of Nephrology and Renovascular Disease
Online Access:http://www.dovepress.com/proteinuria-and-its-relation-to-diverse-biomarkers-and-body-mass-index-a13508
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author Trimarchi H
Muryan A
Raña MS
Paggi P
Lombi F
Forrester M
Pomeranz V
Karl A
Alonso M
Young P
Dicugno M
author_facet Trimarchi H
Muryan A
Raña MS
Paggi P
Lombi F
Forrester M
Pomeranz V
Karl A
Alonso M
Young P
Dicugno M
author_sort Trimarchi H
collection DOAJ
description Hern&aacute;n Trimarchi,1 Alexis Muryan,2 Mar&iacute;a-Soledad Ra&ntilde;a,1 Pedro Paggi,2 Fernando Lombi,1 Mariano Forrester,1 Vanesa Pomeranz,1 Alejandra Karl,1 Mirta Alonso,2 Pablo Young,3 Mariana Dicugno2 1Department of Nephrology, 2Department of Biochemistry, 3Department of Internal Medicine Services, Hospital Brit&aacute;nico de Buenos Aires, Buenos Aires, Argentina Background: Certain adipokines exert direct effects on proteinuria, a cardiovascular risk factor ignored in hemodialysis. We measured different adipokines according to body mass index (BMI) in relation to proteinuria. Methods: Patients numbered 57: group A (GA), BMI < 25, n = 22; GB, BMI 25&ndash;30, n = 15; and GC, BMI > 30, n = 20. There were no statistical differences in age, sex, time on dialysis, cause of renal failure, diabetes, hypertension, C-reactive protein, or nutritional status. Measures were taken of 24-hour diuresis and proteinuria, ultrafiltration, albumin, pro-brain natriuretic peptide (Pro-BNP), insulin, adiponectin, leptin, and ghrelin. Results: Proteinuria was significantly higher in GC versus (vs) GA (1.5 g/day, range 0.30&ndash;14 vs 0.72 g/day, range 0.1&ndash;2.7; P < 0.01) and correlated significantly with leptin levels (&rho; = 0.47, P > 0.05). In GA, elevated levels of Pro-BNP, adiponectin, and ghrelin were associated with lower degrees of proteinuria. Significant correlations were found between adiponectin and leptin (&rho; = -0.54, P = 0.03), and adiponectin and Pro-BNP (&rho;= 0.59, P = 0.02). Though not significant, there were more diabetics in GC (GA four, GB three, GC ten). As BMI increased in GB and GC, Pro-BNP, adiponectin, and ghrelin levels decreased significantly, while proteinuria, insulin, and homeostasis model assessment of insulin resistance increased. Leptin levels were significantly elevated in GC vs GA and GB. In GC, ghrelin correlated significantly with Pro-BNP (&rho;= 0.51, P = 0.03), while leptin correlation with Pro-BNP was inverse and significant in GA (&rho; = -0.74, P > 0.001) and inverse and nonsignificant in GB and GC. Conclusion: In patients with BMI < 25, higher adiponectin, ghrelin, and Pro-BNP levels were associated with lower proteinuria and leptinemia. In obesity, hyperleptinemia and hyperinsulinemia associated with higher proteinuria; whether decreased adiponectin&ndash;ghrelin&ndash;ProBNP and/or elevated leptin&ndash;insulin levels aggravate proteinuria remains to be determined. Keywords: proteinuria, adiponectin, ghrelin, leptin, Pro-BNP, hemodialysis, BMI
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spelling doaj.art-18826d68dbd04f56acaac6e0b96133e02022-12-22T03:35:03ZengDove Medical PressInternational Journal of Nephrology and Renovascular Disease1178-70582013-06-012013default113119Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysisTrimarchi HMuryan ARa&amp;ntilde;a MSPaggi PLombi FForrester MPomeranz VKarl AAlonso MYoung PDicugno MHern&aacute;n Trimarchi,1 Alexis Muryan,2 Mar&iacute;a-Soledad Ra&ntilde;a,1 Pedro Paggi,2 Fernando Lombi,1 Mariano Forrester,1 Vanesa Pomeranz,1 Alejandra Karl,1 Mirta Alonso,2 Pablo Young,3 Mariana Dicugno2 1Department of Nephrology, 2Department of Biochemistry, 3Department of Internal Medicine Services, Hospital Brit&aacute;nico de Buenos Aires, Buenos Aires, Argentina Background: Certain adipokines exert direct effects on proteinuria, a cardiovascular risk factor ignored in hemodialysis. We measured different adipokines according to body mass index (BMI) in relation to proteinuria. Methods: Patients numbered 57: group A (GA), BMI < 25, n = 22; GB, BMI 25&ndash;30, n = 15; and GC, BMI > 30, n = 20. There were no statistical differences in age, sex, time on dialysis, cause of renal failure, diabetes, hypertension, C-reactive protein, or nutritional status. Measures were taken of 24-hour diuresis and proteinuria, ultrafiltration, albumin, pro-brain natriuretic peptide (Pro-BNP), insulin, adiponectin, leptin, and ghrelin. Results: Proteinuria was significantly higher in GC versus (vs) GA (1.5 g/day, range 0.30&ndash;14 vs 0.72 g/day, range 0.1&ndash;2.7; P < 0.01) and correlated significantly with leptin levels (&rho; = 0.47, P > 0.05). In GA, elevated levels of Pro-BNP, adiponectin, and ghrelin were associated with lower degrees of proteinuria. Significant correlations were found between adiponectin and leptin (&rho; = -0.54, P = 0.03), and adiponectin and Pro-BNP (&rho;= 0.59, P = 0.02). Though not significant, there were more diabetics in GC (GA four, GB three, GC ten). As BMI increased in GB and GC, Pro-BNP, adiponectin, and ghrelin levels decreased significantly, while proteinuria, insulin, and homeostasis model assessment of insulin resistance increased. Leptin levels were significantly elevated in GC vs GA and GB. In GC, ghrelin correlated significantly with Pro-BNP (&rho;= 0.51, P = 0.03), while leptin correlation with Pro-BNP was inverse and significant in GA (&rho; = -0.74, P > 0.001) and inverse and nonsignificant in GB and GC. Conclusion: In patients with BMI < 25, higher adiponectin, ghrelin, and Pro-BNP levels were associated with lower proteinuria and leptinemia. In obesity, hyperleptinemia and hyperinsulinemia associated with higher proteinuria; whether decreased adiponectin&ndash;ghrelin&ndash;ProBNP and/or elevated leptin&ndash;insulin levels aggravate proteinuria remains to be determined. Keywords: proteinuria, adiponectin, ghrelin, leptin, Pro-BNP, hemodialysis, BMIhttp://www.dovepress.com/proteinuria-and-its-relation-to-diverse-biomarkers-and-body-mass-index-a13508
spellingShingle Trimarchi H
Muryan A
Ra&amp;ntilde;a MS
Paggi P
Lombi F
Forrester M
Pomeranz V
Karl A
Alonso M
Young P
Dicugno M
Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis
International Journal of Nephrology and Renovascular Disease
title Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis
title_full Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis
title_fullStr Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis
title_full_unstemmed Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis
title_short Proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis
title_sort proteinuria and its relation to diverse biomarkers and body mass index in chronic hemodialysis
url http://www.dovepress.com/proteinuria-and-its-relation-to-diverse-biomarkers-and-body-mass-index-a13508
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