title: Vascular access versus the effect of statins on inflammation and fibrinolysis in renal dialysis patients.
abstract: OBJECTIVE
  The aim of this work was to assess the effect of statin therapy on inflammatory and fibrinolytic/endothelial (dys)function markers in end-stage renal disease (ESRD) patients under hemodialysis (HD), according to the type of vascular access.
  
  
  METHODS
  This transversal study includes 191 ESRD patients under regular HD, divided into four groups according to vascular access and statin therapy: 87 patients with arteriovenous fistula (AVF) and no statins (AVF-NS), 61 with AVF and statins (AVF-S), 27 with central venous dialysis catheter (CVC) and no statins (CVC-NS) and 16 with CVC and statins (CVC-S). The basic lipid profile and fibrinolytic/endothelial cell function markers were assessed.
  
  
  RESULTS
  Patients with CVC presented significantly higher levels of D-dimers compared with AVF groups. CVC-NS patients also presented the highest IL-6 values, which were significantly higher than those presented by CVC-S patients. AVF-S patients presented significantly higher t-PA and PAI-1 values and lower adiponectin levels compared with AVF-NS.
  
  
  CONCLUSIONS
  Our results demonstrate that patients with CVC, particularly those not under statin therapy, present a higher production and turnover of fibrin. We also found that statin therapy decreases inflammation in CVC patients but is associated with a reduction of adiponectin and increased endothelial function marker levels in AVF patients.
authors: FMC, Dinefro - Diálises e Nefrologia, SA - Portugal and Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto - Portugal.
authors: Maria
authors: M
authors: do Sameiro Faria
authors: Sandra
authors: S
authors: Ribeiro
authors: Petronila
authors: P
authors: Rocha-Pereira
authors: Vasco
authors: V
authors: Miranda
authors: Alexandre
authors: A
authors: Quintanilha
authors: Flávio
authors: F
authors: Reis
authors: Elísio
authors: E
authors: Costa
authors: Luís
authors: L
authors: Belo
authors: Alice
authors: A
authors: Santos-Silva
mesh_terms: D052242:Adiponectin / Q000097:blood; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D002405:Catheterization, Central Venous / Q000009:adverse effects; D000068256:Darbepoetin alfa; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism; D004921:Erythropoietin / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis / Q000187:drug effects*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control*; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D017270:Lipoprotein(a) / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D006435:Renal Dialysis; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000097:blood; D016896:Treatment Outcome
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; D006397:Hematinics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D017270:Lipoprotein(a); D008077:Lipoproteins, LDL; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; C036309:fibrin fragment D; C099252:oxidized low density lipoprotein; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D010959:Tissue Plasminogen Activator