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Chlamydial infection and progression of carotid atherosclerosis in patients on regular haemodialysis.
Nephrol Dial Transplant 2004; 19(10):2539-46ND

Abstract

BACKGROUND

Recent findings have suggested a possible contribution of chlamydial infection to the pathogenesis of atherosclerosis in the general population. However, the role that chlamydial antibody status plays in atherosclerosis generation in haemodialysis (HD) patients remains uncertain.

METHODS

We measured carotid artery intima medial thickness (IMT) over 4 years in 100 HD subjects (age: 58+/-10 years; time on HD: 13+/-7 years; male/female: 67/33) and examined potential associations between Chlamydia pneumoniae (Cp) antibody seropositivity and changes in carotid artery IMT.

RESULTS

During 4 years, carotid artery IMT increased significantly from 0.62+/-0.13 to 0.73+/-0.12 mm (P< 0.01). IMT progression was significantly and positively correlated with age (r = 0.37, P<0.01), log-transformed C-reactive protein (CRP; r = 0.33, P<0.01) and log-transformed interleukin-6 (IL-6; r = 0.22, P<0.04), but inversely correlated with blood creatinine (r = -0.36, P<0.01) and albumin (r = -0.24, P<0.02). IMT increases were more prominent in patients positive for IgA antibodies (0.039+/- 0.022 mm/year, n = 52) compared with those without IgA antibodies (0.025+/-0.032 mm/year, n = 48) (P<0.01). IgA seropositivity did not accelerate IMT progression in patients with increased CRP (>0.11 mg/dl, n = 53), but significantly increased IMT to a greater extent in IgA-positive subjects than in IgA-negative subjects having lower CRP (</=0.11 mg/dl, n = 47) (0.017+/-0.024 vs 0.034+/- 0.021 mm/year; P = 0.01). Multivariate regression analysis revealed that serum creatinine, log-transformed CRP and IgA Cp seropositivity were independent risk factors for IMT progression (P<0.01). In contrast, IgG Cp antibody did not affect IMT progression or carotid plaque formation.

CONCLUSIONS

IMT progression is associated with inflammation and malnutrition. In addition, persistent chlamydial infection may be associated with IMT progression, but only in HD patients having low blood CRP.

Authors+Show Affiliations

Renal, Endocrine and Metabolic Division, Shizuoka Cancer Center Hospital, Nagaizumi-cho, Shizuoka 411-8777, Japan. a.kato@scch.jpNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15280523

Citation

Kato, Akihiko, et al. "Chlamydial Infection and Progression of Carotid Atherosclerosis in Patients On Regular Haemodialysis." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 19, no. 10, 2004, pp. 2539-46.
Kato A, Takita T, Maruyama Y, et al. Chlamydial infection and progression of carotid atherosclerosis in patients on regular haemodialysis. Nephrol Dial Transplant. 2004;19(10):2539-46.
Kato, A., Takita, T., Maruyama, Y., & Hishida, A. (2004). Chlamydial infection and progression of carotid atherosclerosis in patients on regular haemodialysis. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 19(10), pp. 2539-46.
Kato A, et al. Chlamydial Infection and Progression of Carotid Atherosclerosis in Patients On Regular Haemodialysis. Nephrol Dial Transplant. 2004;19(10):2539-46. PubMed PMID: 15280523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chlamydial infection and progression of carotid atherosclerosis in patients on regular haemodialysis. AU - Kato,Akihiko, AU - Takita,Takako, AU - Maruyama,Yukitaka, AU - Hishida,Akira, Y1 - 2004/07/27/ PY - 2004/7/29/pubmed PY - 2005/1/14/medline PY - 2004/7/29/entrez SP - 2539 EP - 46 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 19 IS - 10 N2 - BACKGROUND: Recent findings have suggested a possible contribution of chlamydial infection to the pathogenesis of atherosclerosis in the general population. However, the role that chlamydial antibody status plays in atherosclerosis generation in haemodialysis (HD) patients remains uncertain. METHODS: We measured carotid artery intima medial thickness (IMT) over 4 years in 100 HD subjects (age: 58+/-10 years; time on HD: 13+/-7 years; male/female: 67/33) and examined potential associations between Chlamydia pneumoniae (Cp) antibody seropositivity and changes in carotid artery IMT. RESULTS: During 4 years, carotid artery IMT increased significantly from 0.62+/-0.13 to 0.73+/-0.12 mm (P< 0.01). IMT progression was significantly and positively correlated with age (r = 0.37, P<0.01), log-transformed C-reactive protein (CRP; r = 0.33, P<0.01) and log-transformed interleukin-6 (IL-6; r = 0.22, P<0.04), but inversely correlated with blood creatinine (r = -0.36, P<0.01) and albumin (r = -0.24, P<0.02). IMT increases were more prominent in patients positive for IgA antibodies (0.039+/- 0.022 mm/year, n = 52) compared with those without IgA antibodies (0.025+/-0.032 mm/year, n = 48) (P<0.01). IgA seropositivity did not accelerate IMT progression in patients with increased CRP (>0.11 mg/dl, n = 53), but significantly increased IMT to a greater extent in IgA-positive subjects than in IgA-negative subjects having lower CRP (</=0.11 mg/dl, n = 47) (0.017+/-0.024 vs 0.034+/- 0.021 mm/year; P = 0.01). Multivariate regression analysis revealed that serum creatinine, log-transformed CRP and IgA Cp seropositivity were independent risk factors for IMT progression (P<0.01). In contrast, IgG Cp antibody did not affect IMT progression or carotid plaque formation. CONCLUSIONS: IMT progression is associated with inflammation and malnutrition. In addition, persistent chlamydial infection may be associated with IMT progression, but only in HD patients having low blood CRP. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/15280523/Chlamydial_infection_and_progression_of_carotid_atherosclerosis_in_patients_on_regular_haemodialysis_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfh416 DB - PRIME DP - Unbound Medicine ER -