Skip to main content

Advertisement

SpringerLink
Log in

Association between absolute blood eosinophil count and CKD stages among cardiac patients

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hasegawa M, Ishii J, Kitagawa F, Kanayama K, Takahashi H, Ozaki Y, Yuzawa Y (2013) Prognostic value of highly sensitive troponin T on cardiac events in patients with chronic kidney disease not on dialysis. Heart Vessels 28:473–479

    Article  PubMed  Google Scholar 

  2. Takaya Y, Yoshihara F, Yokoyama H, Kanzaki H, Kitakaze M, Goto Y, Anzai T, Yasuda S, Ogawa H, Kawano Y (2014) Impact of onset time of acute kidney injury on outcomes in patients with acute decompensated heart failure. Heart Vessels. doi:10.1007/s00380-014-0572-x

    PubMed  Google Scholar 

  3. Kronzon I, Saric M (2010) Cholesterol embolization syndrome. Circulation 122:631–641

    Article  PubMed  Google Scholar 

  4. Saric M, Kronzon I (2011) Cholesterol embolization syndrome. Curr Opin Cardiol 26:472–479

    Article  PubMed  Google Scholar 

  5. Fukumoto Y, Tsutsui H, Tsuchihashi M, Masumoto A, Takeshita A (2003) The incidence and risk factors of cholesterol embolization syndrome, a complication of cardiac catheterization: a prospective study. J Am Coll Cardiol 42:211–216

    Article  PubMed  Google Scholar 

  6. Ramirez G, O’Neill WM Jr, Lambert R, Bloomer HA (1978) Cholesterol embolization: a complication of angiography. Arch Intern Med 138:1430–1432

    Article  CAS  PubMed  Google Scholar 

  7. Quinones A, Saric M (2013) The cholesterol emboli syndrome in atherosclerosis. Curr Atheroscler Rep 15:315

    Article  PubMed  Google Scholar 

  8. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53:982–992

    Article  CAS  PubMed  Google Scholar 

  9. Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, De Zeeuw D, Hostetter TH, Lameire N, Eknoyan G (2005) Definition and classification of chronic kidney disease: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int 67:2089–2100

    Article  PubMed  Google Scholar 

  10. Fauci AS, Harley JB, Roberts WC, Ferrans VJ, Gralnick HR, Bjornson BH (1982) NIH conference. The idiopathic hypereosinophilic syndrome. Clinical, pathophysiologic, and therapeutic considerations. Ann Intern Med 97:78–92

    Article  CAS  PubMed  Google Scholar 

  11. Machino-Ohtsuka T, Seo Y, Ishizu T, Sekiguchi Y, Sato A, Tada H, Watanabe S, Aonuma K (2010) Combined assessment of carotid vulnerable plaque, renal insufficiency, eosinophilia, and hs-CRP for predicting risky aortic plaque of cholesterol crystal embolism. Circ J 74:51–58

    Article  PubMed  Google Scholar 

  12. Hospers JJ, Rijcken B, Schouten JP, Postma DS, Weiss ST (1999) Eosinophilia and positive skin tests predict cardiovascular mortality in a general population sample followed for 30 years. Am J Epidemiol 150:482–491

    Article  CAS  PubMed  Google Scholar 

  13. Hospers JJ, Schouten JP, Weiss ST, Postma DS, Rijcken B (2000) Eosinophilia is associated with increased all-cause mortality after a follow-up of 30 years in a general population sample. Epidemiology 11:261–268

    Article  CAS  PubMed  Google Scholar 

  14. Date A, Jacob M, Johny KV (1977) Eosinophilic leukocytes in diffuse proliferative and exudative glomerulonephritis. Am J Trop Med Hyg 26:1028–1031

    CAS  PubMed  Google Scholar 

  15. Gabizon D, Kaufman S, Shaked U, Evans SY, Modai D (1981) Eosinophilia in uremia. Nephron 29:36–39

    Article  CAS  PubMed  Google Scholar 

  16. Diskin CJ, Stokes TJ, Dansby LM, Radcliff L, Carter TB (2011) The prevalence and meaning of eosinophilia in renal diseases on a nephrology consultation service. Nephrol Dial Transplant 26:2549–2558

    Article  PubMed  Google Scholar 

  17. Sjogren U, Thysell H (1977) Bone marrow morphology in patients on regular haemodialysis treatment. Acta Haematol 58:332–338

    Article  CAS  PubMed  Google Scholar 

  18. Hertel J, Kimmel PL, Phillips TM, Bosch JP (1992) Eosinophilia and cellular cytokine responsiveness in hemodialysis patients. J Am Soc Nephrol 3:1244–1252

    CAS  PubMed  Google Scholar 

  19. Kojima K, Oda K, Homma H, Takahashi K, Kanda Y, Inokami T, Uchida S (2005) Effect of vitamin E-bonded dialyzer on eosinophilia in haemodialysis patients. Nephrol Dial Transplant 20:1932–1935

    Article  CAS  PubMed  Google Scholar 

  20. Kato A, Ohtsuji A, Terada T, Goto T, Fukasawa H, Yasuda H, Togawa A, Fujimoto T, Suzuki H, Fujigaki Y, Yamamoto T, Yonemura K, Hishida A (2002) Recovery from hemodialysis therapy in a patient with renal cholesterol crystal embolism. Nephron 92:240–243

    Article  PubMed  Google Scholar 

  21. Kawakami T, Fujita A, Takeuchi S, Muto S, Soma Y (2009) Drug-induced hypersensitivity syndrome: drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome induced by aspirin treatment of Kawasaki disease. J Am Acad Dermatol 60:146–149

    Article  PubMed  Google Scholar 

  22. Teragaki M, Kawano H, Makino R, Inoue K, Sai Y, Hosono M, Suehiro S, Okamura M (2012) A case of warfarin-induced eosinophilia. Intern Med 51:1627–1629

    Article  PubMed  Google Scholar 

  23. Ishizaka N, Ishizaka Y, Toda E, Shimomura H, Koike K, Seki G, Nagai R, Yamakado M (2008) Association between cigarette smoking and chronic kidney disease in Japanese men. Hypertens Res 31:485–492

    Article  PubMed  Google Scholar 

  24. Noborisaka Y (2013) Smoking and chronic kidney disease in healthy populations. Nephrourol Mon 5:655–667

    Article  PubMed Central  PubMed  Google Scholar 

  25. Fukui M, Tanaka M, Hamaguchi M, Senmaru T, Sakabe K, Shiraishi E, Harusato I, Yamazaki M, Hasegawa G, Nakamura N (2009) Eosinophil count is positively correlated with albumin excretion rate in men with type 2 diabetes. Clin J Am Soc Nephrol 4:1761–1765

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Funabiki K, Masuoka H, Shimizu H, Emi Y, Mori T, Ito M, Nakano T (2003) Cholesterol crystal embolization (CCE) after cardiac catheterization: a case report and a review of 36 cases in the Japanese literature. Jpn Heart J 44:767–774

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are highly appreciative of Chieko Ohta, Yumiko Ohgami, and Megumi Hashimoto for their excellent technical assistance. The authors received no specific funding for this work.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Cardiology, Osaka Medical College, Takatsuki-shi Daigaku-machi 2-7, Osaka, 569-8686, Japan

    Rui Ishii, Shu-ichi Fujita, Shun Kizawa, Kazushi Sakane, Hideaki Morita, Michishige Ozeki, Koichi Sohmiya, Masaaki Hoshiga & Nobukazu Ishizaka

Authors
  1. Rui Ishii
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shu-ichi Fujita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shun Kizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazushi Sakane
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hideaki Morita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michishige Ozeki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Koichi Sohmiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masaaki Hoshiga
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nobukazu Ishizaka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nobukazu Ishizaka.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ishii, R., Fujita, Si., Kizawa, S. et al. Association between absolute blood eosinophil count and CKD stages among cardiac patients. Heart Vessels 31, 198–205 (2016). https://doi.org/10.1007/s00380-014-0590-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-014-0590-8

Keywords

Search

Navigation