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Association between absolute blood eosinophil count and CKD stages among cardiac patients
Rui Ishii1, Shu-Ichi Fujita1, Shun Kizawa1
1Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan.
Insights
Elevated absolute eosinophil count (AEC) is linked to advanced chronic kidney disease (CKD) stages in cardiac patients. Higher AEC and eosinophilia correlate with severe renal dysfunction, suggesting potential links to subclinical cholesterol embolization.
Area of Science:
- Nephrology
- Cardiology
- Hematology
Background:
- Elevated eosinophil counts are linked to cholesterol embolization syndrome after procedures.
- Chronic kidney disease (CKD) is a common comorbidity in cardiac patients.
Purpose of the Study:
- To investigate the association between CKD stages and absolute eosinophil count (AEC) in cardiac patients.
- To determine if eosinophilia predicts severe renal dysfunction.
Main Methods:
- Retrospective analysis of 1022 cardiac patients.
- CKD staging based on estimated glomerular filtration rate or hemodialysis requirement.
- Logistic regression analysis adjusted for sex, age, blood pressure, and white blood cell count.
Main Results:
- A positive association was found between higher CKD stages and increased AEC quartiles or eosinophilia.
- The highest AEC quartile was associated with severe renal dysfunction (CKD stage 4 or 5) with an odds ratio of 1.99.
- Eosinophilia (AEC > 500/μL) was significantly associated with severe renal dysfunction (odds ratio 2.60).
Conclusions:
- Absolute eosinophil count is positively associated with higher stages of CKD in cardiology patients.
- Eosinophilia may serve as a potential indicator for severe renal dysfunction in this population.
- Findings suggest a possible link between eosinophil counts and subclinical cholesterol embolization in CKD patients.
Abstract:
Elevated eosinophil count was shown to be associated with the development of cholesterol embolization syndrome, a potentially life-threatening condition, after catheter-based procedures. We investigated the association between stages of chronic kidney disease (CKD) and the absolute eosinophil count (AEC) among cardiac patients. CKD stages were determined solely on the estimated glomerular filtration rate or requirement for hemodialysis. Eosinophilia is defined as an eosinophil count exceeding 500/μL. A total of 1022 patients were enrolled in the current study, and eosinophil counts (/μL) in the first through fourth eosinophil count quartiles were <88, 88 to 154, 155 to <238, and 238 ≤, respectively, and 29 patients (2.8 %) had eosinophilia. Correlation coefficient between the AEC and age was -0.188 (P = 0.001) in women and -0.042 (n.s.) in men (by Spearman's correlation test). Patients with higher CKD stages had a higher prevalence of the highest AEC quartile or eosinophilia. Logistic regression analysis using severe renal dysfunction (i.e., CKD stage 4 or 5) as the dependent variable, the highest AEC quartile had a significant positive association with an odds ratio of 1.99 (95 % confidence interval, 1.20-3.31, P < 0.01) after adjustment for sex, age, systolic blood pressure, and total white blood cell count. Similarly, after adjustment for the same variables, eosinophilia was associated with severe renal dysfunction with an odds ratio of 2.60 (95 % confidence interval, 1.08-6.26, P < 0.05). Eosinophil count was positively associated with higher CKD stages among cardiology patients, some fraction of which might be related to subclinical cholesterol embolization.
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