Microbiota Quality and Mitochondrial Activity Link with Occurrence of Muscle Cramps in Hemodialysis Patients using Citrate Dialysate: A Pilot Study

Background/Aims: Hemodialysis-associated muscle cramp (HAMC) is a common complication under citrate dialysate (CD) occurring in 30% of cases. Our objectives were to assess the gut microbiota quality, mitochondrial activity, and to investigate their possible relationship with HAMC. Methods: Ten end-stage renal disease patients (78.9 ± 2.1 years) treated by hemodialysis (HD) with CD were enrolled and then classified according to the frequency of HAMCs: “frequent HAMCs group” (n = 5) and “absence of HAMCs group” (n = 5). Gut microbiota quality, mitochondrial activity, and some markers of oxidative stress (OS) were investigated. Results: In patients with cramps, gut microbiota diversity seemed lower and some genera including Helicobacter, Lachnospira, Roseburia, and Haemophilus seemed over-expressed, a significant increase of citratemia and significant lowering mitochondrial function were observed. No difference was observed on the OS markers. Conclusion: This first clinical study revealed a possible dysbiosis of microbiota and a mitochondrial dysfunction into HD patients with cramps under CD compared to patients without cramp.

Download Full-text

Intradialytic Muscle Cramp and its Association with Peripheral Arterial Disease in End Stage Renal Disease Patients on Hemodialysis

Journal of Nepal Medical Association ◽

10.31729/jnma.2795 ◽

2014 ◽

Vol 52 (196) ◽

pp. 967-971 ◽

Cited By ~ 1

Author(s):

Madhav Ghimire ◽

Sanjib Kumar Sharma ◽

Romila Chimoriya ◽

Gopal Chandra Das

Keyword(s):

Peripheral Arterial Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Arterial Disease ◽

Hemodialysis Patients ◽

Muscle Cramp ◽

Muscle Cramps ◽

Peripheral Arterial ◽

Stage Renal Disease ◽

End Stage

Introduction: Muscle cramp is a common intradialytic complication observed in hemodialysis patients. Similarly Peripheral arterial disease is a common condition in the hemodialysis population. No study on intradialytic muscle cramp and its association with Peripheral arterial disease is yet reported from Nepal. Methods: Fifty patients with a diagnosis of End Stage Renal Disease who were on hemodialysis were studied over a period of one year. Muscle cramp was defined clinically as contractions of a large muscle group and Peripheral arterial disease was diagnosed on the basis of the ankle –brachial index. Chi square (X2) test was used to determine the association between Intradialytic Muscle cramps and Peripheral Arterial Disease. Results: A total of 50 End Stage Renal Disease patients were analyzed. The mean age of the patient was 49.81±12.63 years. The major causes of End Stage Renal Disease in the study population was Chronic Glomerulonephritis 40 % (n=20). Muscle cramps were present in 26% (n=13) cases. Peripheral arterial disease was present in 30% (n=15) of patients. However there was no statistically significant association between the presence of Intradialytic Muscle cramps and peripheral arterial disease (p value =0.18) Conclusions: Intradialytic Muscle cramps and peripheral arterial disease were common occurrence in end stage renal disease patients on hemodialysis patients, however there was no association between the presence of intradialytic Muscle cramps and peripheral arterial disease. Keywords: end stage renal disease; intradialytic muscle cramps; peripheral arterial disease.

Download Full-text

Application of regularized regression to identify novel predictors of mortality in a cohort of hemodialysis patients

Scientific Reports ◽

10.1038/s41598-021-88655-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Stanislas Werfel ◽

Georg Lorenz ◽

Bernhard Haller ◽

Roman Günthner ◽

Julia Matschkal ◽

...

Keyword(s):

Statistical Learning ◽

Cox Regression ◽

Serum Levels ◽

Hemodialysis Patients ◽

Derivation Cohort ◽

Predictors Of Mortality ◽

Stage Renal Disease ◽

End Stage ◽

Study Participants ◽

Related Mortality

AbstractCohort studies often provide a large array of data on study participants. The techniques of statistical learning can allow an efficient way to analyze large datasets in order to uncover previously unknown, clinically relevant predictors of morbidity or mortality. We applied a combination of elastic net penalized Cox regression and stability selection with the aim of identifying novel predictors of mortality in a cohort of prevalent hemodialysis patients. In our analysis we included 475 patients from the “rISk strAtification in end-stage Renal disease” (ISAR) study, who we split into derivation and confirmation cohorts. A wide array of examinations was available for study participants, resulting in over a hundred potential predictors. In the selection approach many of the well established predictors were retrieved in the derivation cohort. Additionally, the serum levels of IL-12p70 and AST were selected as mortality predictors and confirmed in the withheld subgroup. High IL-12p70 levels were specifically prognostic of infection-related mortality. In summary, we demonstrate an approach how statistical learning can be applied to a cohort study to derive novel hypotheses in a data-driven way. Our results suggest a novel role of IL-12p70 in infection-related mortality, while AST is a promising additional biomarker in patients undergoing hemodialysis.

Download Full-text

Depression in end-stage renal disease hemodialysis patients

Nature Clinical Practice Nephrology ◽

10.1038/ncpneph0359 ◽

2006 ◽

Vol 2 (12) ◽

pp. 678-687 ◽

Cited By ~ 101

Author(s):

Daniel Cukor ◽

Rolf A Peterson ◽

Scott D Cohen ◽

Paul L Kimmel

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Stage Renal Disease ◽

End Stage

Download Full-text

Correlation between Calcium Phosphorus Product and Mean Arterial Pressure among Hemodialysis Patients with End Stage Renal Disease

The International Journal of Frontier Sciences ◽

10.37978/tijfs.v5i1.324 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Muhammad Nadeem ◽

Mansoor Abbas Qaisar ◽

Ali Hassan Al Hakami ◽

Fateh Sher Chattah ◽

Muhammad Muzammil ◽

...

Keyword(s):

Mean Arterial Pressure ◽

Arterial Pressure ◽

Renal Disease ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Age Group ◽

Calcium Phosphorus ◽

The Mean ◽

Stage Renal Disease ◽

End Stage

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.

Download Full-text

Comparison of the Efficacy of Gabapentin Versus Levodopa-C for the Treatment of Restless Legs Syndrome in End-Stage Renal Disease on Hemodialysis Patients

Cureus ◽

10.7759/cureus.12034 ◽

2020 ◽

Author(s):

Muhammad Ali ◽

Hina Iram ◽

Fahad Nasim ◽

Shafique A Solangi ◽

Abdul Manan Junejo ◽

...

Keyword(s):

Renal Disease ◽

Restless Legs Syndrome ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Restless Legs ◽

Stage Renal Disease ◽

End Stage

Download Full-text

Extended erythrocyte and reticulocyte parameters in the diagnosis of iron deficiency in hemodialysis patients

Chinese Journal of Medical Research ◽

10.37515/cjmr.091x.3405 ◽

2020 ◽

Vol 3 (4) ◽

pp. 109-113

Author(s):

Mohammed Nazim Bennaoum ◽

◽

Affaf Adda ◽

Mohamed Chekkal ◽

Fatima Seghier ◽

...

Keyword(s):

Iron Deficiency ◽

Iron Status ◽

High Sensitivity ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Red Cells ◽

Corpuscular Hemoglobin ◽

Cellular Concentration ◽

Stage Renal Disease ◽

End Stage

Objective: Iron deficiency (ID) is a frequent complication in end stage renal insufficiency. These patients have to be diagnosed and treated to reduce the prevalence of anemia. Functional iron deficiency (FID) is a situation that can disrupt biochemical iron tests and mask an eventual association with ID. In this study, we tried to prove the ability of extended parameters of red cells and reticulocytes to diagnose ID without being influenced by FID. Design and methods: 164 chronic hemodialysis patients (CHP) in end stage renal disease were enrolled. Research parameters of red cells and reticulocytes determined on ADVIA 2120i were studied in the diagnosis of ID associated or not with chronic inflammation. Results: Parameters such as corpuscular hemoglobin of mature red cells (CHm), corpuscular hemoglobin of reticulocytes (CHr), cellular concentration of hemoglobin in mature red cells (CHCMm), cellular concentration of hemoglobin in reticulocytes (CHCMr) and percentage of microcytic and hypochromic red cells (HYMI) showed a high sensitivity to diagnose ID. However, the distinction of combined iron deficiency (CID) from other entities was not possible with all parameters. In chronic inflammatory states, the decrease of CHm, CHCMm and CHCMr with the rise of percentage hypochromic mature red cells (HYPOm) and reticulocytes (HYPOr) is in favor of CID. So, determination of inflammatory state is needed to complete research parameters of blood count in CHP. Conclusion: Extended erythrocyte and reticulocyte parameters can be useful to check iron status in CHP.

Download Full-text

RELATIONSHIP BETWEEN INTERDIALYTIC WEIGHT GAIN AND PRE HEMODIALYSIS BLOOD PRESSURE IN HEMODIALYSIS PATIENTS

10.36106/gjra/4611884 ◽

2020 ◽

pp. 169-171

Author(s):

M Manasa ◽

Aravind Reddy. Gangula

Keyword(s):

Blood Pressure ◽

Weight Gain ◽

Water Retention ◽

Salt Intake ◽

Hemodialysis Patients ◽

Interdialytic Weight Gain ◽

Stage Renal Disease ◽

End Stage ◽

The Relationship ◽

Esrd Patients

Interdialytic weight gain in patients with hemodialysis depends on fluid, salt intake in interdialytic period and compliance of dialysis patients. In end stage renal disease(ESRD) patients due to decreased and absent residual urine output there is salt and water retention in body which leads to interdialytic weight gain. Overhydration and IDWG is assumed to be the main cause of pre hemodialysis raised blood pressure(BP) in ESRD patients. Here the relationship between IDWG and pre HD blood pressure is studied in 40 hemodialysis patients. We recorded pre HD BP and IDWG in four subsequent hemodialysis sessions for each patient during the period of 2 weeks in patients who are on twice weekly hemodialysis. so, in total we studied 160 hemodialysis sessions. Mean of four pre HD BP is compared with mean of four IDWG for each patient. Then correlation between 40 mean IDWG and 40 mean pre HD BP is studied and also correlation between IDWG and pre HD blood pressure during 160 hemodidlysis sessions studied individually.

Download Full-text

Effect of Intradialytic Parenteral Nutrition on Quality of Life in Hemodialysis Patients

The International Journal of Artificial Organs ◽

10.1177/039139889301600806 ◽

1993 ◽

Vol 16 (8) ◽

pp. 599-603 ◽

Cited By ~ 16

Author(s):

M.S. Siskind ◽

Y-H. H. Lien

Keyword(s):

Quality Of Life ◽

Parenteral Nutrition ◽

High Efficiency ◽

Hemodialysis Patients ◽

Dialysis Session ◽

Eligibility Requirements ◽

Stage Renal Disease ◽

End Stage ◽

Intradialytic Parenteral Nutrition

The purpose of this study was to determine the effect of intradialytic parenteral nutrition (IDPN) on the quality of life of malnourished patients with end-stage renal disease on high-efficiency and high-flux hemodialysis therapy. Patients, who met the Medicare eligibility requirements for IDPN, were asked to fill out and extensive questionnaire covering several measures of quality of life prior to initiating and again after completing four months of IDPN therapy. Although the IDPN improved serum albumin levels significantly, aside from improved sleep patterns, no significant improvements in quality of life could be demonstrated. The mortality rate of these enrolled patients was as high as 28% within 4 months. We concluded that the limited amount of nutrition delivered over the course of a short dialysis session may not be enough to appreciably change the lives of our malnourished patients.

Download Full-text