The Relation of Serum Dehydroepiandrosterone Sulfate Level to Protein Energy Wasting in Hemodialysis Patients.
Journal
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
ISSN: 1319-2442
Titre abrégé: Saudi J Kidney Dis Transpl
Pays: Saudi Arabia
ID NLM: 9436968
Informations de publication
Date de publication:
01 Sep 2022
01 Sep 2022
Historique:
medline:
14
11
2023
pubmed:
1
9
2022
entrez:
13
11
2023
Statut:
ppublish
Résumé
Protein-energy wasting (PEW) is a major risk for morbidity and mortality in hemodialysis (HD) patients. The change in the concentration of dehydroepiandrosterone sulfate (DHEA-S) may play a role in PEW. The aim of this work was to study the possible relationship between serum DHEA-S levels and various nutritional and inflammatory parameters in a cohort of HD patients. In total, 78 HD patients (47 males and 31 females) were included in this crosssectional observational study. In addition to taking their history, clinical examinations, and routine laboratory investigations, the nutritional status was assessed, and their serum DHEA-S was measured. Nutritional status was assessed by anthropometric measures, bioelectrical impedance analysis, malnutrition inflammation scores, and subjective global assessments. A diagnosis of malnutrition was made based on the recommendations of the International Society of Renal Nutrition and Metabolism. The relationship between DHEA-S and various nutritional parameters was analyzed. Eighteen patients (23.1%) suffered from PEW. Those with PEW had a longer duration of HD (P = 0.04), and lower serum levels of creatinine (P = 0.003), hemoglobin (P = 0.01), albumin (P <0.0001), cholesterol (P = 0.02), and DHEA-S (P = 0.01). Among the variables, serum DHEA-S levels were significant predictors of PEW in this cohort (odds ratio: 0.976; 95% confidence interval: 0.954-1.0; P = 0.04). PEW is frequently encountered in HD patients. Decreased serum DHEA-S levels were associated with PEW in male HD patients. Further studies are needed to assess the effect of hormone supplementation on this serious disorder in HD patients.
Identifiants
pubmed: 37955456
doi: 10.4103/1319-2442.389424
pii: 00936703-202233050-00005
doi:
Substances chimiques
Dehydroepiandrosterone Sulfate
57B09Q7FJR
Sulfates
0
Serum Albumin
0
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
639-649Informations de copyright
Copyright © 2022 Copyright: © 2022 Saudi Journal of Kidney Diseases and Transplantation.
Références
Tsur N, Menashe I, Haviv YS. Risk factors before dialysis predominate as mortality predictors in diabetic maintenance dialysis patients. Sci Rep 2019;9:10633.
Floege J, Gillespie IA, Kronenberg F, et al. Development and validation of a predictive mortality risk score from a European hemodialysis cohort. Kidney Int 2015;87:996-1008.
Cheung WW, Paik KH, Mak RH. Inflammation and cachexia in chronic kidney disease. Pediatr Nephrol 2010;25:711-24.
Albaaj F, Sivalingham M, Haynes P, et al. Prevalence of hypogonadism in male patients with renal failure. Postgrad Med J 2006;82:693-6.
Doumouchtsis KK, Kostakis AI, Doumouchtsis SK, et al. The effect of sexual hormone abnormalities on proximal femur bone mineral density in hemodialysis patients and the possible role of RANKL. Hemodial Int 2008;12:100-7.
Karakitsos D, Patrianakos AP, De Groot E, et al. Androgen deficiency and endothelial dysfunction in men with end-stage kidney disease receiving maintenance hemodialysis. Am J Nephrol 2006;26:536-43.
Ferrando AA, Sheffield-Moore M, Paddon-Jones D, Wolfe RR, Urban RJ. Differential anabolic effects of testosterone and amino acid feeding in older men. J Clin Endocrinol Metab 2003;88:358-62.
Park SG, Hwang S, Kim JS, Park KC, Kwon Y, Kim KC. The Association between Dehydroepi-androsterone Sulfate (DHEA-S) and bone mineral density in Korean men and women. J Bone Metab 2017;24:31-6.
Kakiya R, Shoji T, Hayashi T, et al. Decreased serum adrenal androgen dehydroepiandros-terone sulfate and mortality in hemodialysis patients. Nephrol Dial Transplant 2012;27:3915-22.
Hsu HJ, Yen CH, Chen CK, et al. Low plasma DHEA-S increases mortality risk among male hemodialysis patients. Exp Gerontol 2012;47:950-7.
Schwartz AG, Pashko LL. Dehydroepiandros-terone, glucose-6-phosphate dehydrogenase, and longevity. Ageing Res Rev 2004;3:171-87.
Antoniou-Tsigkos A, Zapanti E, Ghizzoni L, Mastorakos G. Adrenal Androgens, in Endotext. [Internet]MDText.com, Inc; 2019.
Baneijee T, Kim SJ, Astor B, Shafi T, Coresh J, Powe NR. Vascular access type, inflammatory markers, and mortality in incident hemodialysis patients: The Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) study. Am J Kidney Dis 2014;64:954-61.
Lobo RA, Paul WL, Goebelsmann U. Serum levels of DHEAS in gynecologic endocrinopathy and infertility. Obstet Gynecol 1981;57:607-12.
Lohman TG, Roche AF, Martorell R. Anthropometric Standardization Reference Manual. Vol. 177. Champaign: Human Kinetics Books; 1988.
Ruiz L, Colley JR, Hamilton PJ. Measurement of triceps skinfold thickness. An investigation of sources of variation. Br J Prev Soc Med 1971;25:165-7.
Wu LW, Lin YY, Kao TW, et al. Mid-arm muscle circumference as a significant predictor of all-cause mortality in male individuals. PLoS One 2017;12:e0171707.
Heymsfield SB, McManus C, Smith J, Stevens V, Nixon DW. Anthropometric measurement of muscle mass: Revised equations for calculating bone-free arm muscle area. Am J Clin Nutr 1982;36:680-90.
Newman AB, Kupelian V, Visser M, et al. Sarcopenia: Alternative definitions and associations with lower extremity function. J Am Geriatr Soc 2003;51:1602-9.
Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis 2001;38:1251-63.
Kalantar-Zadeh K, Kleiner M, Dunne E, Lee GH, Luft FC. A modified quantitative subjective global assessment of nutrition for dialysis patients. Nephrol Dial Transplant 1999;14:1732-8.
Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int 2008;73:391-8.
Moraes C, Marinho SM, da Nobrega AC, et al. Resistance exercise: A strategy to attenuate inflammation and protein-energy wasting in hemodialysis patients? Int Urol Nephrol 2014;46:1655-62.
Fouque D, Guebre-Egziabher F. An update on nutrition in chronic kidney disease. Int Urol Nephrol 2007;39:239-46.
Mak RH, Cheung W. Energy homeostasis and cachexia in chronic kidney disease. Pediatr Nephrol 2006;21:1807-14.
Mak RH, Cheung W, Cone RD, Marks DL. Mechanisms of disease: Cytokine and adipokine signaling in uremic cachexia. Nat Clin Pract Nephrol 2006;2:527-34.
Nieszporek T, Witkowicz J, Nowak L, Chudek J, Wiecek A. Low plasma dehydroepiandros-terone sulfate level and its relationship to adiponectin in hemodialysis patients. Ren Fail 2007;29:417-21.
Ruperto M, Sánchez-Muniz FJ, Barril G. Predictors of protein-energy wasting in haemodialysis patients: A cross-sectional study. J Hum Nutr Diet 2016;29:38-47.
Kalantar-Zadeh K, Ikizler TA, Block G, Avram MM, Kopple JD. Malnutrition-inflammation complex syndrome in dialysis patients: Causes and consequences. Am J Kidney Dis 2003;42:864-81.
Kalantar-Zadeh K, McAllister CJ, Lehn RS, Lee GH, Nissenson AR, Kopple JD. Effect of malnutrition-inflammation complex syndrome on EPO hyporesponsiveness in maintenance hemodialysis patients. Am J Kidney Dis 2003;42:761-73.
Locatelli F, Andrulli S, Memoli B, et al. Nutritional-inflammation status and resistance to erythropoietin therapy in haemodialysis patients. Nephrol Dial Transplant 2006;21:991-8.
Nakanishi T, Kimura T, Kuragano T. The Hepcidin-Anemia axis: Pathogenesis of anemia in chronic kidney disease. In: CKD-Associated Complications: Progress in the Last Half Century. S. Karger: Karger Publishers; 2019. p. 124-34.
Molnar MZ, Czira ME, Rudas A, et al. Association between the malnutrition-inflammation score and post-transplant anaemia. Nephrol Dial Transplant 2011;26:2000-6.
Stenvinkel P, Ketteler M, Johnson RJ, et al. IL-10, IL-6, and TNF-alpha: Central factors in the altered cytokine network of uremia-the good, the bad, and the ugly. Kidney Int 2005;67:1216-33.
de Waal D, Heaslip E, Callas P. Medical nutrition therapy for chronic kidney disease improves biomarkers and slows time to dialysis. J Ren Nutr 2016;26:1-9.
de Vries CP, Gooren LJ, Oe PL. Haemodialysis and testicular function. Int J Androl 1984;7:97-103.
Orentreich N, Brind JL, Rizer RL, Vogelman JH. Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. J Clin Endocrinol Metab 1984;59:551-5.
Cigarrán S, Pousa M, Castro MJ, et al. Endogenous testosterone, muscle strength, and fat-free mass in men with chronic kidney disease. J Ren Nutr 2013;23:e89-95.
Auyeung TW, Lee JS, Kwok T, et al. Testosterone but not estradiol level is positively related to muscle strength and physical performance independent of muscle mass: A cross-sectional study in 1489 older men. Eur J Endocrinol 2011;164:811-7.
Arlt W, Hewison M. Hormones and immune function: Implications of aging. Aging Cell 2004;3:209-16.
Altman R, Motton DD, Kota RS, Rutledge JC. Inhibition of vascular inflammation by dehydroepiandrosterone sulfate in human aortic endothelial cells: Roles of PPARalpha and NF-kappaB. Vascul Pharmacol 2008;48:76-84.
Urata Y, Goto S, Kawakatsu M, et al. DHEA attenuates PDGF-induced phenotypic proliferation of vascular smooth muscle A7r5 cells through redox regulation. Biochem Biophys Res Commun 2010;396:489-94.
Adey D, Kumar R, McCarthy JT, Nair KS. Reduced synthesis of muscle proteins in chronic renal failure. Am J Physiol Endocrinol Metab 2000;278:E219-25.
Christeff N, Melchior JC, Mammes O, Gherbi N, Dalle MT, Nunez EA. Correlation between increased cortisol: DHEA ratio and malnutrition in HIV-positive men. Nutrition 1999;15:534-9.
Kähönen MH, Tilvis RS, Jolkkonen J, PitkäläK Härkönen M. Predictors and clinical significance of declining plasma dehydroepiandrosterone sulfate in old age. Aging (Milano) 2000;12:308-14.
Tilvis RS, Kähönen M, Härkönen M. Dehydroepiandrosterone sulfate, diseases and mortality in a general aged population. Aging (Milano) 1999;11:30-4.