scholarly journals Hemodilution Impacts Assessment of Thyroid Status before and after Hemodialysis in Patients with End-Stage Renal Disease

2020 ◽  
pp. 988-994
Author(s):  
Toru Sanai ◽  
Ken Okamura ◽  
Tomoaki Onoue ◽  
Takashi Ono ◽  
Kenichi Motomura ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Thyroid Stimulating Hormone ◽  
Chronic Glomerulonephritis ◽  
Thyroid Status ◽  
Before And After ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

<b><i>Background:</i></b> To elucidate the role of hemodilution in the alteration of thyroid hormone levels in end-stage renal disease (ESRD), we compared thyroid function before and after hemodialysis (HD). <b><i>Methods:</i></b> Twenty-three male ESRD patients (age &#x3c;65 years) with either chronic glomerulonephritis (CGN) or diabetic nephropathy (DN), who were enrolled between June 2019 and August 2019, were included in the study. The free thyroxine (fT<sub>4</sub>), free tri-iodothyronine (fT<sub>3</sub>), and thyroid-stimulating hormone (TSH), thyroxine-binding globulin (TBG), and thyroglobulin (Tg), measured before and after HD in 12 patients with CGN (48.7 ± 11.8 years [mean ± standard deviation]) and 11 patients with DN (57.6 ± 6.5 years), were compared with 45 healthy controls (52.5 ± 11.9 years). <b><i>Results:</i></b> The fT<sub>4</sub>, fT<sub>3</sub>, and TBG were significantly low before HD and increased in parallel with an increase in hematocrit and albumin after HD in both ESRD subgroups. The TSH was high before HD and decreased significantly after HD, while Tg remained almost unchanged. In DN, the fT<sub>4</sub> levels were nearly identical, while fT<sub>3</sub> was lower with slightly higher TSH, compared with CGN. The TSH/fT<sub>4</sub> ratios before HD were significantly higher in both subgroups, and the fT<sub>3</sub>/fT<sub>4</sub> ratios after HD were significantly lower in DN than the control. <b><i>Conclusions:</i></b> Our findings suggest that the low fT<sub>4</sub> and fT<sub>3</sub> levels found in ESRD are due to hemodilution before HD, resulting in a slightly higher TSH level but almost unchanged Tg level, and that DN is associated with decreased T<sub>4</sub>-to-T<sub>3</sub> conversion.

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 The Effects of Hemodialysis and Peritoneal Dialysis on the Gut Microbiota of End-Stage Renal Disease Patients, and the Relationship Between Gut Microbiota and Patient Prognoses

2021 ◽  
Vol 11 ◽  
Author(s):  
Dan Luo ◽  
Wenbo Zhao ◽  
Zhiming Lin ◽  
Jianhao Wu ◽  
Hongchun Lin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Gut Microbiota ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Before And After ◽  
Patient Prognosis ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Relationship ◽  
Esrd Patients

Gut microbiota alterations occur in end-stage renal disease (ESRD) patients with or without dialysis. However, it remains unclear whether changes in gut microbiota of dialysis ESRD patients result from dialysis or ESRD, or both. Similarly, there is a dearth of information on the relationship between gut microbiota and ESRD prognoses. We collected fecal samples and tracked clinical outcomes from 73 ESRD patients, including 33 pre-dialysis ESRD patients, 19 peritoneal dialysis (PD) patients, and 21 hemodialysis (HD) patients. 16S rRNA sequencing and bioinformatics tools were used to analyze the gut microbiota of ESRD patients and healthy controls. Gut microbiota diversity was different before and after dialysis. Bacteroidetes were significantly deceased in HD patients. Twelve bacterial genera exhibited statistically significant differences, due to dialysis (all P &lt; 0.05, FDR corrected). HD reversed abnormal changes in Oscillospira and SMB53 in pre-dialysis patients. Functional predictions of microbial communities showed that PD and HD altered signal transduction and metabolic pathways in ESRD patients. Furthermore, Bacteroides and Phascolarctobacterium were associated with cardiovascular mortality. Dorea, Clostridium, and SMB53 were related to peritonitis in PD patients. This study not only demonstrated differences in gut microbiota between pre-dialysis and dialysis ESRD patients, but also firstly proposed gut bacteria may exert an impact on patient prognosis.

scholarly journals Association of thyroid status prior to transition to end-stage renal disease with early dialysis mortality

2018 ◽  
Vol 34 (12) ◽  
pp. 2095-2104 ◽  
Author(s):  
Amy S You ◽  
John J Sim ◽  
Csaba P Kovesdy ◽  
Elani Streja ◽  
Danh V Nguyen ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Dialysis Initiation ◽  
Case Mix ◽  
Thyroid Status ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Esrd Patients ◽  
Tsh Levels

AbstractBackgroundAdvanced chronic kidney disease (CKD) patients, including those receiving dialysis, have a high prevalence of thyroid dysfunction. Although hypothyroidism is associated with higher death risk in end-stage renal disease (ESRD) patients, no studies have examined whether thyroid status in the pre-ESRD period impacts mortality after dialysis initiation.MethodsAmong US veterans with CKD identified from the national Veterans Affairs database that transitioned to dialysis over the period from October 2007 to September 2011, we examined the association of pre-ESRD serum thyrotropin (TSH) levels averaged over the 1-year pre-dialysis (‘prelude’) period with all-cause mortality in the first year following dialysis initiation.ResultsAmong 15 335 patients in the 1-year prelude cohort, TSH levels &gt;5.0 mIU/L were associated with higher mortality in expanded case-mix Cox models (reference: TSH 0.5–5.0 mIU/L): adjusted hazard ratio (aHR) [95% confidence interval (CI) 1.20 (1.07–1.33). Similar findings were observed for TSH &gt;5.0 mIU/L and mortality in the 2- and 5-year cohorts: aHRs (95% CI) 1.11 (1.02–1.21) and 1.15 (1.07–1.24), respectively. Analyses of finer gradations of TSH in the 1-year prelude cohort demonstrated that incrementally higher levels &gt;5.0 mIU/L were associated with increasingly higher mortality in expanded case-mix models (reference: TSH 0.5–3.0 mIU/L): aHRs (95% CI) 1.18 (1.04–1.33) and 1.28 (1.03–1.59) for TSH levels &gt;5.0–10.0 mIU/L and &gt;10.0 mIU/L, respectively. In the 2- and 5-year cohorts, mortality associations persisted most strongly for those with TSH &gt;10.0 mIU/L, particularly after laboratory covariate adjustment.ConclusionsAmong new ESRD patients, there is a dose-dependent relationship between higher pre-ESRD TSH levels &gt;5.0 mIU/L and post-ESRD mortality. Further studies are needed to determine the impact of TSH reduction with thyroid hormone supplementation in this population.

P1554AEFFECT OF HAEMODILUTION ON THYROID FUNCTION BEFORE AND AFTER HAEMODIALYSIS IN PATIENT WITH END-STAGE RENAL DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Toru Sanai ◽  
Ken Okamura ◽  
Yuji Ikeda ◽  
Motoaki Miyazono ◽  
Tomorow Onoue ◽  
...  
Keyword(s):  
Renal Disease ◽  
Thyroid Function ◽  
End Stage Renal Disease ◽  
Chronic Glomerulonephritis ◽  
Free Triiodothyronine ◽  
Senile Changes ◽  
Before And After ◽  
Stage Renal Disease ◽  
End Stage ◽  
Serum Tsh

Abstract Background and Aims To study the factors involved in the low thyroid hormones in end - stage renal disease (ESRD), we compared thyroid function before and after hemodialysis (HD). Method The serum free thyroxine (fT4), free triiodothyronine (fT3), and thyroid - simulating hormone (TSH), thyroxine binding globulin (TBG) and thyroglobulin (Tg) levels were measured before and after HD in 12 patients with chronic glomerulonephritis (CGN, age; 48.7 ± 11.8 [mean ± SD]) and 11 patients with diabetic nephropathy (DN, age; 57.6 ± 6.5), comparing with controls (n = 13, age; 40.9 ± 11.3). Results The serum fT4, fT3 and TBG levels were low before HD but increased almost in parallel with the increase in hematocrit and albumin levels after HD in both ESRD groups. The serum TSH level was high before HD but decreased after HD and Tg level remained almost unchanged. In DN, serum fT4 levels was almost the same, but fT3 levels was lower with slightly higher TSH level, compared with CGN. Conclusion Significantly lower fT4, fT3 and TBG levels in ESRD before HD seemed to be due to hemodilution and almost corrected after HD. The TSH level was promptly normalized with elevated fT4, and Tg levels remained unchanged probably due to the balance between corrected hemodilution and rapid response to decreased TSH stimulation. It may better to evaluate thyroid function after HD in ESRD. Accelerated senile changes were suggested in DN.

Does Peritoneal Dialysis Affect Halitosis in Patients with End-Stage Renal Disease?

2011 ◽  
Vol 31 (2) ◽  
pp. 168-172 ◽  
Author(s):  
Mustafa Keles ◽  
Ummuhan Tozoglu ◽  
Abdullah Uyanik ◽  
Abubekir Eltas ◽  
Yusuf Ziya Bayindir ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Salivary Flow ◽  
Flow Rates ◽  
Before And After ◽  
Dmft Index ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Objective There are various causes of halitosis, one of which is chronic renal failure. The objective of this study was to investigate halitosis levels in end-stage renal disease (ESRD) patients before and after peritoneal dialysis (PD) therapy. Methods 42 subjects with ESRD were included in this study. The presence of halitosis was assessed using an organoleptic measurement and compared with blood urea nitrogen (BUN) levels and salivary flow rates. Decayed, missing, and filled teeth (DMFT) index and Community Periodontal Index (CPI) were calculated. All measurements were done before and after patients had received 3 months of PD therapy. Results Mean serum BUN level was found to be lower (46.05 ± 13.30 vs 91.24 ± 31.28 mg/dL), salivary flow rate higher (0.34 ± 0.07 vs 0.26 ± 0.04 mL/minute), and halitosis level lower (2.39 ± 0.60 vs 3.90 ± 0.37) at the end of 3 months of PD therapy than at the beginning of PD therapy. There was no significant difference in CPI or DMFT index before and after PD therapy (p > 0.05). There was statistically significant positive correlation between the presence of halitosis and BUN levels ( r = 0.702, p = 0.001 before PD; r = 0.45, p = 0.002 after PD) and a negative correlation between the presence of halitosis and salivary flow rates ( r = -0.69, p = 0.000 before PD; r = -0.37, p = 0.01 after PD). Conclusion High BUN levels and low salivary flow rates were found to be associated with halitosis. PD may play an important role in decreasing the level of halitosis in ESRD patients.

scholarly journals Potential Hepatoprotective Role of Galectin-3 during HCV Infection in End-Stage Renal Disease Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ruzica Lukic ◽  
Nevena Gajovic ◽  
Ivan Jovanovic ◽  
Milena Jurisevic ◽  
Zeljko Mijailovic ◽  
...  
Keyword(s):  
Renal Disease ◽  
Disease Severity ◽  
End Stage Renal Disease ◽  
Chronic Renal Disease ◽  
Hcv Infection ◽  
Galectin 3 ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hepatitis C virus infection (HCV), one of the greatest causes of liver disease, is a frequent complication in patients with end-stage renal disease (ESRD) on dialysis. ESRD is defined as decreased glomerular filtration and also accompanied by impaired function of the immune system. Galectin-3 is aβ-galactoside-binding lectin, involved in various biological processes including pathogenesis of chronic renal disease. The aim of our study was to estimate disease severity in ESRD HCV+patients and analyze the serum concentrations of IL-1β, IL-4, IL-23, and IL-6; anti-HCV antibodies; and galectin-3. Also, we attempted to determine potential correlation between galectin-3 level and parameters of disease severity ALT and AST. Our results showed decreased levels of ALT and AST (p=0.00), demonstrating less liver destruction in ESRD HCV+patients in comparison to HCV+patients. Increased levels of IL-6 (p=0.03) implicate a hepatoprotective role of IL-6 in these patients. Also, level of galectin-3 (p=0.00) in the serum of ESRD HCV+patients was higher than that of HCV+patients. This alteration was accompanied with negative correlation between galectin-3 and AST and ALT, respectively (p=0.029;p=0.033). The presence of increased systemic levels of IL-6 and Gal-3 in ESRD HCV+patients may be an attempt to counteract or limit ongoing proinflammatory processes and to downregulate chronic inflammation, suggesting the new aspects of HCV infection in ESRD patients.

Adipokines and Gut Hormones in End-Stage Renal Disease

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 298-302
Author(s):  
Robert H. Mak ◽  
Wai Cheung
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peptide Yy ◽  
Gut Hormones ◽  
Poor Quality ◽  
Mortality And Morbidity ◽  
Novel Therapeutic Strategies ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Cachexia is common in end-stage renal disease (ESRD) patients, and it is an important risk factor for poor quality of life and increased mortality and morbidity. Chronic inflammation is an important cause of cachexia in ESRD patients. In the present review, we examine recent evidence suggesting that adipokines or adipocytokines such as leptin, adiponectin, resistin, tumor necrosis factor α, interleukin-6, and interleukin-1β may play important roles in uremic cachexia. We also review the physiology and the potential roles of gut hormones, including ghrelin, peptide YY, and cholecystokinin in ESRD. Understanding the molecular pathophysiology of these novel hormones in ESRD may lead to novel therapeutic strategies.

scholarly journals Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3471
Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son
Keyword(s):  
Systematic Review ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Associated Factors ◽  
Meta Analysis ◽  
Screening Tools ◽  
Cochrane Library ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.

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