ArticleJournal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation2012
Examining associations of circulating endotoxin with nutritional status, inflammation, and mortality in hemodialysis patients.
Article in Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 98 citations in OpenAlex.
- Pooled it
- The SLE transcriptome exhibits evidence of chronic endotoxin exposure and has widespread dysregulation of non-coding and coding RNAs.PloS one · 2014Trial
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- Nutritional Modulation of the Gut-Kidney Axis.Nutrients · 2026Review
- The mechanism of enterogenous toxin methylmalonic acid aggravating calcium-phosphorus metabolic disorder in uremic rats by regulating the Wnt/β-catenin pathway.Molecular medicine (Cambridge, Mass.) · 2025Article
- The alternations of gut microbiota in diabetic kidney disease: insights from a triple comparative cohort.Frontiers in cellular and infection microbiology · 2025Article
- Review
- Review
- Gut permeability, circulating bacterial fragments and measures of congestion in peritoneal dialysis.Clinical kidney journal · 2024Article
- Gut Microbiota-Targeted Interventions in the Management of Chronic Kidney Disease.Seminars in nephrology · 2023Review
- Exploring the clinical efficacy and mechanism of high-position colon dialysis combined with Traditional Chinese Medicine retention enema in real-world patients with stage 3-5 chronic kidney disease (non-dialysis) based on the theory of the Gut-Kidney axis.Frontiers in pharmacology · 2023Article
- The effect and mechanism of Fushen Granule on gut microbiome in the prevention and treatment of chronic renal failure.Frontiers in cellular and infection microbiology · 2023Article
- Panax notoginseng saponins alleviate damage to the intestinal barrier and regulate levels of intestinal microbes in a rat model of chronic kidney disease.Renal failure · 2022Article
- Article
- Oncogenic mechanisms in renal insufficiency.Clinical kidney journal · 2021Review
- Pro-Inflammatory Effects of Indoxyl Sulfate in Mice: Impairment of Intestinal Homeostasis and Immune Response.International journal of molecular sciences · 2021Article
- Single Cell RNA-Seq and Machine Learning Reveal Novel Subpopulations in Low-Grade Inflammatory Monocytes With Unique Regulatory Circuits.Frontiers in immunology · 2021Article
- Plant-Dominant Low-Protein Diet for Conservative Management of Chronic Kidney Disease.Nutrients · 2020Review
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveLipopolysaccharide or endotoxin constitutes most part of the outer portion of the cell wall in the gram-negative bacteria. Subclinical endotoxemia could contribute to increased inflammation and mortality in hemodialysis (HD) patients. Endotoxin level and clinical effect are determined by its soluble receptor sCD14 and high-density lipoprotein. We examine the hypothesis that endotoxin level correlates with mortality.
methodsIn this cohort study, endotoxin levels were measured in 306 long-term HD patients who were then followed up for a maximum of 42 months. Soluble CD14 and cytokines levels were also measured.
resultsThe mean (±SD) endotoxin level was 2.31 ± 3.10 EU/mL (minimum: 0.26 EU/mL, maximum: 22.94 EU/mL, interquartile range: 1.33 EU/mL, median: 1.27 EU/mL). Endotoxin correlated with C-reactive protein (r = 0.11, P < .04). On multivariate logistic regression analysis, high body mass index and low high-density lipoprotein (HDL) cholesterol levels were associated with higher endotoxemia (endotoxin below or above of median). In multivariate Cox regression analysis adjusted for case-mix and nutritional/inflammatory confounders, endotoxin levels in the third quartile versus first quartile were associated with a trend toward increased hazard ratio for death (hazard ratio: 1.83, 95% confidence interval: 0.93 to 3.6, P = .08).
conclusionsIn this HD cohort, we found associations between endotoxemia and C-reactive protein, body composition, and HDL. Moderately high endotoxin levels tended to correlate with increased mortality than the highest circulating endotoxin level. Additional studies are required to assess the effect of endotoxemia on mortality in dialysis population.
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Registered trials
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