You are here

CAPD Hastalarında Atorvastatin Tedavisinin İnfl amasyon Belirteçleri (CRP) ve Diyalizat IL-6 ve CA-125 Düzeyi Üzerine Etkisi

The Effect of Atorvastatin Therapy in CAPD Patients on Infl ammatory Markers (CRP) and dialysate IL-6 and CA-125 Level

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2011.1003.13

Keywords (Original Language):

Abstract (2. Language): 
OBJECTIVE: Dialysate concentrations of CA-125 refl ect the mesothelial cell mass. In patients with peritoneal dialysis ultrafi ltration failure, low concentrations of CA-125 have been demonstrated. Statins have anti-infl ammatory properties which may be of value in modulating responses to injury. In this study, the lipid-lowering effect of atorvastatin and its effects on the CA-125 levels were evaluated. MATERIALS and METHODS: The 100 patients included in the study were followed with CRF in the CAPD program. The patients were divided into two groups as those who used atorvastatin (group 1, n=60) and the control group (group 2, n=40). All patients were evaluated before treatment and 6 months later for serum total cholesterol, LDL, HDL, TG, CRP, and peritoneal effl uent was analyzed for interleukin-6, and CA-125 levels. RESULTS: In group 1 patients, serum CRP and dialysate IL-6 values decreased and the dialysate CA- 125 level increased (p<0.001), whereas there was no change in the group 2 control patients. CONCLUSION: Atorvastatin use in patients with markers of infl ammation caused decreased levels of CRP and IL-6, and the anti-infl ammatory effects of statins may have played a role. The increased CA-125 levels in patients in group 1 may also be related to the anti-infl ammatory effects in addition to the antihyperlipidemic effects.
Abstract (Original Language): 
AMAÇ: Diyalizat CA-125 konsantrasyonu periton mezotel hücre kitlesini yansıtmaktadır. Ultrafi ltrasyon yetersizliği uzun dönem periton diyalizinde en sık görülen transport anomalisidir. Periton diyalizi ultrafi ltrasyon yetersizliği olan hastalarda, CA-125 düzeyinin düşük konsantrasyonlarda olduğu gösterilmiştir. Statinler anti-infl amatuvar özellikleri de olan ilaçlardır. Bu çalışmada, atorvastatinin lipid düşürücü etkisinin yanısıra infl amasyonu baskılayarak infl amatuvar belirteçler ve dolayısıyla CA-125 düzeyi üzerine olan etkilerinin değerlendirilmesi amaçlanmıştır. GEREÇ ve YÖNTEMLER: SDBY’i olan ve periton diyalizi programında olan toplam 100 hasta çalışmaya dahil edildi. Hastalar hiperlipidemisi olan ve atorvastatin tedavisi alan grup 1 (60 hasta) ve tedavi almayan grup 2 (kontrol grubu, 40 hasta) olmak üzere 2 gruba ayrıldı. Tüm hastalardan çalışma öncesi ve 6. ayda serum total kollesterol, LDL, HDL, TG, CRP ve periton sıvısında interleukin-6 (IL-6) ve CA-125 düzeyleri çalışıldı. BULGULAR: Grup 1‘deki hastalarda kontrol grubuyla karşılaştırıldığında serum CRP ve diyalizat IL-6 düzeylerinde istatistiksel olarak anlamlı azalma gözlendi (p<0,001). Yine grup 1’deki hastalarda diyalizat CA-125 düzeylerinde istatistiksel olarak anlamlı artış gözlendi (p<0,001). SONUÇ: Atorvastatin kullanan hastalarda infl amasyon belirteçlerinden olan CRP ve IL-6 düzeylerinde azalma gözlenmiş olup, bu durum üzerine statinlerin anti-infl amatuvar etkilerinin rol oynadığı düşünülmektedir. Grup 1’deki hastalarda CA-125 düzeylerindeki artışta da yine antihiperlipidemik etkilerinin yanı sıra antiinfl amatuvar etkilerinin rol oynadığı söylenebilir
284-289

REFERENCES

References: 

1. Davies SJ, Bryan J, Phillips L, Russell GI: Longitudinal changes in
peritoneal kinetics: The effects of peritoneal dialysis and peritonitis.
Nephrol Dial Transplant 1996; 11: 498-506
2. Davies SJ, Phillips L, Griffi ths AM, Russell LH, Naish PF, Russell
GI: What really happens to people on long-term peritoneal dialysis?
Kidney Int 1998; 54: 2207-2217
3. Visser CE, Brouwer-Steenbergen JJE, Betjes MG, Koomen GC,
Beelen RH, Krediet RT: Cancer antigen 125: A bulk marker for the
mesothelial mass in stable peritoneal dialysis patients. Nephrol Dial
Transplant 1995; 10: 64-69
4. Koomen GC, Betjes MG, Zemel D, Krediet RT, Hoek FJ: Cancer
antigen 125 is locally produced in the peritoneal cavity during
continuous ambulatory peritoneal dialysis. Perit Dial Int 1994; 14
(2): 132-136
5. Krediet RT: Dialysate cancer antigen 125 concentration as marker
of peritoneal membrane status in patients treated with chronic
peritoneal dialysis. Perit Dial Int 2001; 21: 560-567
6. Di Paolo N, Sacchi G: Atlas of peritoneal histology. Perit Dial Int
2000; 20 (Suppl 3): 5-96
7. Topley N, Jörres A, Luttmann W, Petersen MM, Lang MJ, Thierauch
KH, Müller C, Coles GA, Davies M, Williams JD: Human peritoneal
mesothelial cells synthesize interleukin-6: Induction by IL-1 beta
and TNF alpha. Kidney Int 1993; 43: 226-233
8. Ascer E, Bertolami MC, Venturinelli ML, Buccheri V, Souza J,
Nicolau JC, Ramires JA, Serrano CV Jr: Atorvastatin reduces
proinfl ammatory markers in hypercholesterolemic patients.
Atherosclerosis 2004; 177(1): 161-166
9. Afzali B, Goldsmith DJ: Benefi cial effects of statins on the kidney.
J Clin Pathol 2004; 57(7): 673-674
10. Smit W, Schouten N, van den Berg N, Langedijk MJ, Struijk DG,
Krediet RT: Analysis of the prevalencen and causes of ultrafi ltration
failure during long-term peritoneal dialysis: A cross-sectional study.
Perit Dial Int 2004; 24: 562-570
289
Tiryaki Ö ve Usalan C : CAPD Hastalarında Atorvastatin Tedavisinin İnfl amasyon
Belirteçleri (CRP) ve Diyalizat IL-6 ve CA-125 Düzeyi Üzerine Etkisi
Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
Turkish Nephrology, Dialysis and Transplantation Journal
Turk Neph Dial Transpl 2011; 20 (3): 284-289
11. Gabay C, Kushner I: Acute-phase proteins and other systemic
responses to infl ammation. N Engl J Med 1999; 340: 448-454
12. Rippe B, Simonsen O, Heimburger O, Christensson A, Haraldsson
B, Stelin G, Weiss L, Nielsen FD, Bro S, Friedberg M, Wieslander
A: Long-term clinical effects of a peritoneal dialysis fl uid with less
glucose degradation products. Kidney Int 2001; 59: 348-357
13. Tsirpanlis G, Boufi dou F, Manganas S, Chantzis K, Bleta A,
Stamatelou K, Psimenou E, Nicolaou C: Treatment with fl uvastatin
rapidly modulates, via different pathways and in dependence on the
baseline level, infl ammation in hemodialysis patients. Blood Purif
2004; 22(6): 518-524
14. Mori S, Saito Y: Pleiotropic effects of statins. Nippon Rinsho 2002;
60: 875-881
15. Farmer JA: Pleiotropic effects of statins. Curr Atheroscler Rep
2000; 2: 208-217
16. Takemoto M, Liao JK: Pleiotropic effects of 3-hydroxy-3-
methylglutaryl coenzyme A reductase inhibitors. Arterioscler
Thromb Vasc Biol 2001; 21: 1712-1719
17. Sugiyama M, Ohashi M, Takase H, Sato K, Ueda R, Dohi Y: Effects
of atorvastatin on infl ammation and oxidative stress. Heart Vessels
2005; 20:133-136
18. Jialal I, Stein D, Balis D, Grundy SM, Adams-Huet B, Devaraj S:
Effect of hydroxymethyl glutaryl coenzyme a reductase inhibitor
therapy on high sensitive C-reactive protein levels. Circulation
2001; 103: 1933-1935
19. Pecoits-Filho R, Carvalho MJ, Stenvinkel P, Lindholm B,
Heimbürger O: Systemic and intraperitoneal interleukin-6 system
during the fi rst year of peritoneal dialysis. Perit Dial Int 2006; 26:
53-63
20. Topley N, Williams JD: The role of the peritoneal membrane in the
control of infl ammation in the peritoneal cavity. Kidney Int 1994;
46 (Suppl 48): 71-78
21. Topley N, Liberek T, Davenport A, Li FK, Fear H, Williams JD:
Activation of infl ammation and leukocyte recruitment into the
peritoneal cavity. Kidney Int 1996; 50 (Suppl 56): 17-21

Thank you for copying data from http://www.arastirmax.com