Letter to the Editor – Comments on published articles
Is there any association between overhydration and inflammation in dialysis patients?
¿Hay alguna relación entre la sobrehidratación y la inflamación en pacientes en diálisis?
a Department of Biochemistry, Agri Military Hospital, Agri, Turkey
b Department of Internal Medicine, Gulhane Military Medical Academy, Ankara, Turkey
c Department of Chest Diseases, Girne Military Hospital, Girne, Cyprus
d Department of Infectious Diseases and Clinical Microbiology, Agri Military Hospital, Agri, Turkey
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"tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "200" "paginaFinal" => "201" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Mehmet Agilli, Tolga Dogan, Mustafa Ilker Inan, Gonca Fidan" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Mehmet" "apellidos" => "Agilli" "email" => array:1 [ 0 => "mehmetagilli@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Tolga" "apellidos" => "Dogan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Mustafa Ilker" "apellidos" => "Inan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Gonca" "apellidos" => "Fidan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Department of Biochemistry, Agri Military Hospital, Agri, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Internal Medicine, Gulhane Military Medical Academy, Ankara, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Chest Diseases, Girne Military Hospital, Girne, Cyprus" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Department of Infectious Diseases and Clinical Microbiology, Agri Military Hospital, Agri, Turkey" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Hay alguna relación entre la sobrehidratación y la inflamación en pacientes en diálisis?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In a recent issue of <span class="elsevierStyleItalic">Nefrologia</span>, we read the paper of Dr Vega and colleagues entitled “Study on overhydration in dialysis patients and its association with inflammation”.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> We thank for their valuable research evaluating hydration status and body composition in patients on haemodialysis and its relation to inflammation. They found an association between hydration status and low prealbumin (transthyretin) levels. We want to make some comments on transthyretin (TTR) which was assessed in their study.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Serum TTR has been reported to be a reliable outcome predictor in patients with kidney disease.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Previous studies suggested that several factors can affect serum TTR levels. Disorders such as anorexia nervosa, bulimia nervosa, rheumatoid arthritis, ankylosing spondylitis, major depression, trauma, malignancy, protein losing enteropathy, Kawasaki disease, liver diseases, <span class="elsevierStyleItalic">Helicobacter pylori</span> infection and thyroid diseases were shown to alter serum TTR levels.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a> Vega et al. did not mention these contributing diseases in their paper.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Several drugs such as anabolic steroids, corticosteroids, progestational agents, estrogens, antithyroid drugs and nonsteroidal antinflammatory drugs can alter serum TTR levels.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5,6</span></a> Also, dietary supplements such as vitamin A, vitamin C, zinc and omega-3 fatty acids can alter these levels.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7,8</span></a> In this respect, the authors should define whether the participants use any of these drugs and dietary supplements. In addition, alcohol usage is another confounder that should be described whether the participants use.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Lastly, we think that body position is essential to state while taking blood specimen. It is recommended that blood specimens for measuring plasma proteins be taken after nearly 15–20<span class="elsevierStyleHsp" style=""></span>min in the sitting position.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Otherwise, concentrations should be evaluated with consideration of position. Lower levels are to be expected in bedridden patients.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Therefore, interpretation of results with its current form seems problematic.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Mears and many researchers suggested that serum TTR concentration was not affected by hydration status.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> In this respect, authors’ claim as association between hydration status and low TTR levels seems suspicious irrespective of taking into account above contributing factors. Clarifying these concerns will provide clearer picture to the readers.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-03-08" "fechaAceptado" => "2015-04-07" "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Study on overhydration in dialysis patients and its association with inflammation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 5 | 9 |
| 2024 October | 34 | 33 | 67 |
| 2024 September | 43 | 19 | 62 |
| 2024 August | 48 | 58 | 106 |
| 2024 July | 30 | 18 | 48 |
| 2024 June | 48 | 35 | 83 |
| 2024 May | 48 | 27 | 75 |
| 2024 April | 39 | 31 | 70 |
| 2024 March | 44 | 22 | 66 |
| 2024 February | 39 | 35 | 74 |
| 2024 January | 26 | 18 | 44 |
| 2023 December | 17 | 27 | 44 |
| 2023 November | 38 | 23 | 61 |
| 2023 October | 40 | 29 | 69 |
| 2023 September | 27 | 25 | 52 |
| 2023 August | 30 | 21 | 51 |
| 2023 July | 27 | 23 | 50 |
| 2023 June | 25 | 10 | 35 |
| 2023 May | 41 | 27 | 68 |
| 2023 April | 19 | 11 | 30 |
| 2023 March | 44 | 22 | 66 |
| 2023 February | 37 | 18 | 55 |
| 2023 January | 38 | 21 | 59 |
| 2022 December | 41 | 29 | 70 |
| 2022 November | 59 | 30 | 89 |
| 2022 October | 33 | 43 | 76 |
| 2022 September | 33 | 27 | 60 |
| 2022 August | 42 | 41 | 83 |
| 2022 July | 22 | 47 | 69 |
| 2022 June | 32 | 20 | 52 |
| 2022 May | 51 | 36 | 87 |
| 2022 April | 64 | 47 | 111 |
| 2022 March | 47 | 41 | 88 |
| 2022 February | 41 | 45 | 86 |
| 2022 January | 31 | 30 | 61 |
| 2021 December | 40 | 31 | 71 |
| 2021 November | 76 | 42 | 118 |
| 2021 October | 89 | 39 | 128 |
| 2021 September | 48 | 30 | 78 |
| 2021 August | 29 | 42 | 71 |
| 2021 July | 43 | 28 | 71 |
| 2021 June | 18 | 26 | 44 |
| 2021 May | 35 | 37 | 72 |
| 2021 April | 46 | 34 | 80 |
| 2021 March | 40 | 40 | 80 |
| 2021 February | 32 | 35 | 67 |
| 2021 January | 37 | 21 | 58 |
| 2020 December | 20 | 15 | 35 |
| 2020 November | 37 | 11 | 48 |
| 2020 October | 21 | 20 | 41 |
| 2020 September | 23 | 13 | 36 |
| 2020 August | 32 | 9 | 41 |
| 2020 July | 31 | 13 | 44 |
| 2020 June | 36 | 14 | 50 |
| 2020 May | 58 | 9 | 67 |
| 2020 April | 37 | 24 | 61 |
| 2020 March | 39 | 10 | 49 |
| 2020 February | 38 | 22 | 60 |
| 2020 January | 50 | 21 | 71 |
| 2019 December | 49 | 21 | 70 |
| 2019 November | 31 | 14 | 45 |
| 2019 October | 34 | 8 | 42 |
| 2019 September | 28 | 13 | 41 |
| 2019 August | 27 | 11 | 38 |
| 2019 July | 32 | 20 | 52 |
| 2019 June | 27 | 11 | 38 |
| 2019 May | 24 | 14 | 38 |
| 2019 April | 31 | 20 | 51 |
| 2019 March | 35 | 20 | 55 |
| 2019 February | 27 | 19 | 46 |
| 2019 January | 34 | 14 | 48 |
| 2018 December | 111 | 41 | 152 |
| 2018 November | 236 | 24 | 260 |
| 2018 October | 175 | 16 | 191 |
| 2018 September | 108 | 17 | 125 |
| 2018 August | 80 | 18 | 98 |
| 2018 July | 78 | 20 | 98 |
| 2018 June | 75 | 16 | 91 |
| 2018 May | 64 | 9 | 73 |
| 2018 April | 89 | 6 | 95 |
| 2018 March | 90 | 13 | 103 |
| 2018 February | 103 | 4 | 107 |
| 2018 January | 51 | 10 | 61 |
| 2017 December | 78 | 5 | 83 |
| 2017 November | 44 | 13 | 57 |
| 2017 October | 37 | 7 | 44 |
| 2017 September | 38 | 7 | 45 |
| 2017 August | 27 | 7 | 34 |
| 2017 July | 38 | 12 | 50 |
| 2017 June | 30 | 6 | 36 |
| 2017 May | 50 | 11 | 61 |
| 2017 April | 48 | 5 | 53 |
| 2017 March | 22 | 15 | 37 |
| 2017 February | 30 | 10 | 40 |
| 2017 January | 22 | 6 | 28 |
| 2016 December | 36 | 6 | 42 |
| 2016 November | 43 | 5 | 48 |
| 2016 October | 48 | 4 | 52 |
| 2016 September | 74 | 1 | 75 |
| 2016 August | 102 | 2 | 104 |
| 2016 July | 122 | 4 | 126 |
| 2016 June | 93 | 0 | 93 |
| 2016 May | 65 | 0 | 65 |
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