scholarly journals Voxel-based morphometry and arterial spin labeling fMRI reveal neuropathic and neuroplastic features of brain processing of itch in end-stage renal disease

2014 ◽  
Vol 112 (7) ◽  
pp. 1729-1738 ◽  
Author(s):  
Alexandru D. P. Papoiu ◽  
Nichole M. Emerson ◽  
Tejesh S. Patel ◽  
Robert A. Kraft ◽  
Rodrigo Valdes-Rodriguez ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Gray Matter ◽  
End Stage Renal Disease ◽  
Matter Density ◽  
Gray Matter Density ◽  
Brain Responses ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Brain ◽  
Esrd Patients

Pruritus of end-stage renal disease (ESRD) is a multifactorial symptom of complex etiology not yet fully understood. In this study we have investigated the cerebral perfusion patterns at rest in ESRD patients on hemodialysis, compared with those in healthy volunteers. We have also studied the brain responses evoked by experimental itch induction in ESRD, after stimulating the two distinct histamine and cowhage itch pathways, and compared them with the responses evoked in healthy volunteers. To identify potential structural alterations in ESRD patients compared with a group of age-matched healthy volunteers, we calculated the density of gray matter for the entire brain using a voxel-based morphometric analysis. Our results indicated that gray matter density was significantly reduced in ESRD patients in the frontal, parietal, temporal, and occipital cortices, as well as in the S1, precuneus, and insula, whereas the brain stem, hippocampus, amygdala, midcingulate cortex, and nucleus accumbens displayed an increased gray matter density. Functionally, we found a significantly higher brain perfusion at baseline associated with ESRD pruritus in the anterior cingulate, insula, claustrum, hippocampus, and nucleus accumbens. The brain responses evoked by cowhage itch, which are mediated by protease-activated receptors (PAR2), displayed significant differences compared with responses in healthy individuals and were correlated with perceived itch intensity in a dual, complex manner. The inverse correlations in particular suggested that a negative feedback mechanism modulated itch intensity, when elicited in a preexistent chronic itch background.

scholarly journals Single-Dose Pharmacokinetics, Safety, and Tolerability of Albinterferon Alfa-2b in Subjects with End-Stage Renal Disease on Hemodialysis Compared to Those in Matched Healthy Volunteers

2010 ◽  
Vol 55 (2) ◽  
pp. 473-477 ◽  
Author(s):  
Denise B. Serra ◽  
Haiying Sun ◽  
Sylwia Karwowska ◽  
Jens Praestgaard ◽  
Atef Halabi ◽  
...  
Keyword(s):  
Renal Disease ◽  
Healthy Volunteers ◽  
End Stage Renal Disease ◽  
Hepatitis C Virus Infection ◽  
Time Curve ◽  
And Gender ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Laboratory Adverse Event

ABSTRACTAlbinterferon alfa-2b (albIFN) is being developed, in combination with ribavirin, for the treatment of hepatitis C virus infection. This study was designed to evaluate the pharmacokinetics, safety, and tolerability of a 900-μg dose of albIFN administered as a single subcutaneous injection in end-stage renal disease (ESRD) patients on hemodialysis and matched healthy volunteers (by age [±5 years], weight [±5 kg], and gender). The maximum concentration in plasma (Cmax) and the area under the concentration-time curve from time zero to infinity (AUC0-∞) were 42.8 ± 14.0 ng/ml and 16,414 ± 4,203 ng·h/ml, respectively, for healthy volunteers, while theCmaxand AUC0-∞were 49.9 ± 20.9 ng/ml and 18,919 ± 8,008 ng·h/ml, respectively, for ESRD patients. The geometric least-squares mean ratios were 1.15 (90% confidence interval [CI], 0.78, 1.68) forCmaxand 1.11 (90% CI, 0.83, 1.48) for AUC0-∞. Adverse events were as expected for an interferon (e.g., flu-like symptoms), with the main laboratory adverse event being a decline in total white blood cell count, which was specifically related to a decline in the neutrophil count. This effect was somewhat greater in the ESRD patients, with the maximal decreases in neutrophil counts from those at the baseline being (−2.6 ± 0.32) × 109and (−2.19 ± 0.58) × 109cells/liter for the ESRD patients and the healthy volunteers, respectively. This study indicates no significant effect of renal failure on the pharmacokinetics of albIFN. Safety and tolerability were as expected for an interferon.

scholarly journals The Allocation of Vertical Attention in Patients with End-Stage Renal Disease Receiving Dialysis

2021 ◽  
Vol 11 (12) ◽  
pp. 1549
Author(s):  
Aleksandra Mańkowska ◽  
Kenneth M. Heilman ◽  
Bogdan Biedunkiewicz ◽  
Alicja Dębska-Ślizień ◽  
John B. Williamson ◽  
...  
Keyword(s):  
Renal Disease ◽  
Spatial Attention ◽  
Attentional Bias ◽  
End Stage Renal Disease ◽  
Healthy Controls ◽  
Brain Mechanism ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Brain ◽  
Esrd Patients

Objectives: Alterations of spatial attention can have adverse effects, such a greater probability of accidents. Patients with end-stage renal disease (ESRD) receiving dialysis have stronger left-sided spatial attentional bias, suggesting that this disorder or treatment alters the brain networks that mediate spatial attention. The hemispheric networks that mediate the allocation of horizontal attention may also influence the allocation of vertical attention. However, the allocation of vertical spatial attention has not been studied in ESRD patients. Methods: Twenty-three ESRD patients receiving dialysis and 23 healthy right-handed controls performed line bisections using 24 vertical lines (24 cm long and 2 mm thick) aligned with the intersection of their midsagittal and coronal planes. Results: Hemodialyzed ESRD patients had a significantly greater upward bias than healthy controls. The magnitude of this bias was correlated with the duration of the kidney disease. Conclusions: The reason why upward attentional bias is increased in hemodialyzed ESRD patients is not known. Further research is needed to better understand the brain mechanism that might account for this bias, as well as its treatment. However, hemodialyzed ESRD patients and their families-caregivers should be made aware of this disorder to avoid accidents such as tripping.

scholarly journals Structural network topology correlates to cognitive impairment and iPTH level in End-stage renal disease patients with peritoneal dialysis

2019 ◽  
Author(s):  
Longsheng Wang ◽  
Liwei Zou ◽  
Hanqiu Wu ◽  
Yanqi Shan ◽  
Ru Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
End Stage Renal Disease ◽  
Cognitive Assessment ◽  
Path Length ◽  
Ipth Level ◽  
Structural Network ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Brain ◽  
Esrd Patients

Abstract Objective: The burden of cognitive impairment in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis has received more attention lately. It is associated with hospitalization, mortality and reduced quality of life. We aimed to assess the topological alterations of the brain white matter structural network in ESRD and the correlation between network metrics with Montreal Cognitive Assessment scores and clinical data. Methods: The study included 25 ESRD patients with secondary hyperparathyroidism (SHPT group), 25 patients without SHPT (Non-SHPT group) and 25 healthy controls (HC group) of comparable age and sex. Cognitive function was assessed using the Montreal Cognitive Assessment. The WM structural network was constructed by diffusion tensor imaging and a deterministic tractography method, and then we used graph theoretical approaches to investigate alterations in the global and regional properties of the WM networks in these participants. Results: ESRD patients showed cognitive impairment compared to HC, and the SHPT patients had lower cognitive scores than the Non-SHPT patients. The global topological organization and local efficiency of the WM network was significantly disrupted in the SHPT but not in the Non-SHPT patients compared with the HC group. Moreover, lower regional efficiency was found in the ESRD patients, mainly distributed in the frontal and parietal cortices. In addition, an association was found between iPTH, shortest path length and cognitive impairment, and the iPTH level was negatively correlated with small-worldness by two indexes, the normalized clustering coefficient and the normalized shortest path length. Conclusion: The present study indicated that the brain structural connectome in ESRD patients with high iPTH levels was disrupted in association with cognitive impairment and it is a potential connectome-based biomarker for early detection.

scholarly journals A potential role of fecal oxalate-degrading activity in oxalate homeostasis in end-stage renal disease patients; a descriptive pilot study

2021 ◽  
Vol 10 (3) ◽  
pp. e19-e19
Author(s):  
Natalia Stepanova ◽  
Ganna Tolstanova ◽  
Lesya Korol ◽  
Iryna Akulenko ◽  
Olena Savchenko ◽  
...  
Keyword(s):  
Pilot Study ◽  
Renal Disease ◽  
Healthy Volunteers ◽  
Effect Size ◽  
End Stage Renal Disease ◽  
Potential Role ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Introduction: End-stage renal disease (ESRD) patients have significant differences in plasma oxalic acid (POx) concentration under the same treatment conditions. Objectives: In the present study, we adopted the method of redoximetric titration with a KMnO4 solution to evaluate the effect of total fecal oxalate-degrading activity (ODA) on oxalate homeostasis in ESRD patients which has never been reported before. Patients and Methods: A total of 56 participants were enrolled in this cross-sectional pilot study, including 24 healthy volunteers (a control reference group) and 32 ESRD patients. Among the ESRD patients, there were 21 hemodialysis (HD) and 11 peritoneal dialysis (PD) patients. Total ODA in fecal samples as well as POx concentration, daily urinary oxalate (UOx) and PD effluent oxalate excretion were determined. Cohen’s d was computed to calculate the effect size using post-hoc analysis. Results: Total ODA in fecal microbiota ranged from -23 to 24%/0.01 g of feces and was statistically higher in healthy volunteers compared with the ESRD patients. The ESRD patients with positive total fecal ODA status had higher UOx excretion level and lower POx concentration compared with the patients with negative total fecal ODA status. Cohen’s d effect size was 1.99 and 1.05, respectively. Total fecal ODA was an independent risk factor associated with POx elevation in the ESRD patients. Conclusion: Our pilot study firstly demonstrated a potential role of total fecal ODA in oxalate homeostasis in ESRD patients. The results might be useful for determining sample size considerations and providing groundwork for future research projects.

scholarly journals Structural network topology correlates to cognitive impairment and iPTH level in End-stage renal disease patients with peritoneal dialysis

2019 ◽  
Author(s):  
Longsheng Wang ◽  
Liwei Zou ◽  
Hanqiu Wu ◽  
Yanqi Shan ◽  
Ru Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
End Stage Renal Disease ◽  
Cognitive Assessment ◽  
Path Length ◽  
Ipth Level ◽  
Structural Network ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Brain ◽  
Esrd Patients

Abstract Background: The burden of cognitive impairment in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis has received more attention lately. It associates with hospitalization, mortality and poorer quality of life. We aimed to assess the topological alterations of the brain white matter structural network in ESRD and the correlation between network metrics with Montreal Cognitive Assessment scores and clinical data. Methods: The study included 25 ESRD patients with secondary hyperparathyroidism (SHPT group), 25 patients without SHPT (Non-SHPT group) and 25 healthy controls (HC group) of comparable age and sex. Montreal Cognitive Assessment was used to assess the cognitive function. The white matter (WM) structural network was constructed by diffusion tensor imaging (DTI) technique, and then we used graph theoretical approaches to detect changes in the global and regional properties of the WM networks in these participants through deterministic tractography method. Results: ESRD patients showed cognitive impairment compared to HC, and the SHPT patients had lower cognitive scores than the Non-SHPT patients. The global topological organization and local efficiency of the WM network was significantly disrupted in the SHPT but not in the Non-SHPT patients compared with the HC group. Moreover, lower regional efficiency was found in the ESRD patients, mainly distributed in the frontal and parietal cortices. In addition, an association was observed between intact parathyroid hormone (iPTH), shortest path length and cognitive impairment, and the iPTH level was negatively correlated with small-worldness by two indexes, the normalized clustering coefficient and the normalized shortest path length. Conclusion: The present study indicated that the brain structural connectome in ESRD patients with high iPTH levels was disrupted in association with cognitive impairment and it is a potential connectome-based biomarker for early detection.

Vimentin cleavage in end-stage renal disease is not related to apoptosis

Open Medicine ◽  
2013 ◽  
Vol 8 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Felix Liebscher ◽  
Tobias Arnold ◽  
Ying Liang ◽  
Thomas Reiter ◽  
Georg Böhmig ◽  
...  
Keyword(s):  
Renal Disease ◽  
Healthy Volunteers ◽  
End Stage Renal Disease ◽  
Caspase 3 ◽  
Vimentin Expression ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

AbstractAnti-vimentin auto-antibodies contribute to chronic allograft nephropathy. They exist in sera of end-stage renal disease patients on hemodialysis (ESRD) already before renal transplantation. We found recently that a 49 kDa vimentin fragment is increased in lymphocytes of ESRD patients which is presented on the cell surface. In vitro studies showed that such a fragment is formed during apoptosis by active caspase-3. We hypothesized that vimentin degradation in leukocytes of ESRD patients correlates to caspase-3 activation in vivo. Lymphocytes and monocytes were isolated from ESRD patients and from healthy volunteers and analyzed for vimentin expression and caspase-3 activation. In addition, apoptosis was induced in vitro and quantified by flow cytometry. ESRD monocytes have shown only the full length 60 kDa vimentin isoform. ESRD lymphocytes, however, showed in addition a strongly increased expression of the 49 kDa vimentin in all samples. Caspase-3 activation was found in 60% of ESRD lymphocytes and 66% of ESRD monocytes but not in healthy volunteers. UV-mediated induction of apoptosis was not associated with vimentin degradation. These experiments could confirm increased vimentin degradation in ESRD lymphocytes. However, we could not validate any correlation to apoptosis.

scholarly journals Structural network topology correlates to cognitive impairment and iPTH level in End-stage renal disease patients with peritoneal dialysis

2019 ◽  
Author(s):  
Longsheng Wang ◽  
Liwei Zou ◽  
Hanqiu Wu ◽  
Yanqi Shan ◽  
Ru Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
End Stage Renal Disease ◽  
Cognitive Assessment ◽  
Path Length ◽  
Ipth Level ◽  
Structural Network ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Brain ◽  
Esrd Patients

Abstract Objective: The burden of cognitive impairment in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis has received more attention lately. It is associated with hospitalization, mortality and poorer quality of life. We aimed to assess the topological alterations of the brain white matter structural network in ESRD and the correlation between network metrics with Montreal Cognitive Assessment scores and clinical data. Methods: The study included 25 ESRD patients with secondary hyperparathyroidism (SHPT group), 25 patients without SHPT (Non-SHPT group) and 25 healthy controls (HC group) of comparable age and sex. Montreal Cognitive Assessment was used to assess the cognitive function. The WM structural network was constructed by DTI technique, and then we used graph theoretical approaches to detect changes in the global and regional properties of the WM networks in these participants through deterministic tractography method. Results: ESRD patients showed cognitive impairment compared to HC, and the SHPT patients had lower cognitive scores than the Non-SHPT patients. The global topological organization and local efficiency of the WM network was significantly disrupted in the SHPT but not in the Non-SHPT patients compared with the HC group. Moreover, lower regional efficiency was found in the ESRD patients, mainly distributed in the frontal and parietal cortices. In addition, an association was found between iPTH, shortest path length and cognitive impairment, and the iPTH level was negatively correlated with small-worldness by two indexes, the normalized clustering coefficient and the normalized shortest path length. Conclusion: The present study indicated that the brain structural connectome in ESRD patients with high iPTH levels was disrupted in association with cognitive impairment and it is a potential connectome-based biomarker for early detection.

scholarly journals Structural network topology correlates to cognitive impairment and iPTH level in End-stage renal disease patients with peritoneal dialysis

2019 ◽  
Author(s):  
Longsheng Wang ◽  
Liwei Zou ◽  
Hanqiu Wu ◽  
Yanqi Shan ◽  
Ru Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
End Stage Renal Disease ◽  
Cognitive Assessment ◽  
Path Length ◽  
Ipth Level ◽  
Structural Network ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Brain ◽  
Esrd Patients

Abstract Objective: The burden of cognitive impairment in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis has received more attention lately. It is associated with hospitalization, mortality and poorer quality of life. We aimed to assess the topological alterations of the brain white matter structural network in ESRD and the correlation between network metrics with Montreal Cognitive Assessment scores and clinical data. Methods: The study included 25 ESRD patients with secondary hyperparathyroidism (SHPT group), 25 patients without SHPT (Non-SHPT group) and 25 healthy controls (HC group) of comparable age and sex. Montreal Cognitive Assessment was used to assess the cognitive function. The WM structural network was constructed by DTI technique, and then we used graph theoretical approaches to detect changes in the global and regional properties of the WM networks in these participants through deterministic tractography method. Results: ESRD patients showed cognitive impairment compared to HC, and the SHPT patients had lower cognitive scores than the Non-SHPT patients. The global topological organization and local efficiency of the WM network was significantly disrupted in the SHPT but not in the Non-SHPT patients compared with the HC group. Moreover, lower regional efficiency was found in the ESRD patients, mainly distributed in the frontal and parietal cortices. In addition, an association was found between iPTH, shortest path length and cognitive impairment, and the iPTH level was negatively correlated with small-worldness by two indexes, the normalized clustering coefficient and the normalized shortest path length. Conclusion: The present study indicated that the brain structural connectome in ESRD patients with high iPTH levels was disrupted in association with cognitive impairment and it is a potential connectome-based biomarker for early detection.

Tissue ischemia worsens during hemodialysis in end-stage renal disease patients

2016 ◽  
Vol 18 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Jan Malik ◽  
Jaroslav Kudlicka ◽  
Jana Lachmanova ◽  
Anna Valerianova ◽  
Katarina Rocinova ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cognitive Deficit ◽  
Dialysis Access ◽  
Dialysis Patients ◽  
Tissue Ischemia ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Brain ◽  
Esrd Patients

Background Cognitive deficit is a common problem in end-stage renal disease (ESRD) patients. Ultrafiltration and hemodialysis lead to profound hemodynamic changes. The aim of this pilot study was to describe brain and hand oxygenation values in ESRD patients and their changes during hemodialysis. Methods Twenty-seven patients treated by chronic hemodialysis and 17 controls patients of the same age were included in the study. Regional saturation of oxygen (SrO2) was measured at the brain frontal lobe and at the hand with dialysis access using the INVOS 5100C. In 17 of ESRD patients, SrO2 was also monitored throughout hemodialysis. Finger systolic blood pressure and basic hemodialysis and laboratory data were collected. Results Dialysis patients had lower brain and also hand SrO2 values at rest (51.5 ± 10.9 vs. 68 ± 7%, p<0.0001 and 55 ± 16 vs. 66 ± 8%, p = 0.03, respectively). Both values further decreased during the first 35 minutes of hemodialysis (brain SrO2 to 47 ± 8%, p<0.0001 and hand to 45 ± 14%, p<0.0001, respectively). The brain SrO2 decrease was related to the ultrafiltration rate, the hand SrO2 decrease to the finger pressure and to blood hemoglobin. Conclusions Chronic dialysis patients suffer from tissue ischemia and that even worsens after the beginning of hemodialysis. This observation may contribute to the understanding of cognitive deficit etiology.

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