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 ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Cognitive Assessment ◽  
Path Length ◽  
Ipth Level ◽  
Structural Network ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Objective: The burden of cognitive impairment in end-stage renal disease (ESRD) undergoing peritoneal dialysis received more attention, which associated with hospitalization, mortality and quality of life. We aimed to assess the topological alterations of 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 Montreal Cognitive Assessment. WM structural network constructed by diffusion tensor imaging and deterministic tractography method, and then used graph theoretical approaches to investigate alterations in the global and regional properties of the WM network in these participants. Results: ESRD patients showed cognitive impairment compared to HC and SHPT patients was lower cognitive scores than Non-SHPT patients. The global topological organization and local efficiency of WM network was significantly disrupted in SHPT but not in Non-SHPT patients, as compared with HC group. Moreover, lower regional efficiency was found in ESRD patients mainly distributed in the frontal and parietal cortices. In addition, association was found between iPTH, shortest path length and cognitive impairment, and iPTH level was negatively correlated with small-worldness by two indexes normalized clustering coefficient and normalized shortest path length. Conclusion: The present study indicated that brain structural connectome in ESRD patients with high iPTH level was disrupted as cognitive impairment and it has the potential connectome-based biomarkers 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 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 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.

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.

Iron Chelation Therapy in CAPD: A New and Effective Treatment of Iron Overload Disease in Esrd Patients

1983 ◽  
Vol 3 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Glen H Stanbaugh ◽  
A. W, Holmes Diane Gillit ◽  
George W. Reichel ◽  
Mark Stranz
Keyword(s):  
Peritoneal Dialysis ◽  
Iron Overload ◽  
End Stage Renal Disease ◽  
Chelation Therapy ◽  
Iron Chelation ◽  
Iron Chelation Therapy ◽  
Peritoneal Dialysate ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

A patient with end-stage renal disease on CAPD, and with massive iron overload is reported. This patient had evidence of myocardial and hepatic damage probably as a result of iron overload. Treatment with desferoxamine resulted in removal of iron in the peritoneal dialysate. On the basis of preliminary studies in this patient it would appear that removal of iron by peritoneal dialysis in conjunction with chelation therapy is safe and effective. This finding should have wide-ranging signficance for patients with ESRD.

The Phantom of Metformin-Induced Lactic Acidosis in End-Stage Renal Disease Patients: Time to Reconsider with Peritoneal Dialysis Treatment

2017 ◽  
Vol 37 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Abdullah K. Al-Hwiesh ◽  
Ibrahiem Saeed Abdul-Rahman ◽  
Abdul-Salam Noor ◽  
Mohammed A. Nasr-El-Deen ◽  
Abdalla Abdelrahman ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Lactic Acidosis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Diabetic Control ◽  
Plasma Lactate ◽  
Lactate Levels ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

ObjectiveMetformin continues to be the safest and most widely used antidiabetic drug. In spite of its well-known benefits; metformin use in end-stage renal disease (ESRD) patients is still restricted. Little has been reported about the effect of peritoneal dialysis (PD) on metformin clearance and the phantom of lactic acidosis deprives ESRD patients from metformin therapeutic advantages. Peritoneal dialysis is probably a safeguard against lactic acidosis, and it is likely that using this drug would be feasible in this group of patients.Material and methodsThe study was conducted on 83 PD patients with type 2 diabetes mellitus. All patients were on automated PD (APD). Metformin was administered in a dose of 500 - 1,000 mg daily. Patients were monitored for glycemic control. Plasma lactic acid and plasma metformin levels were monitored on a scheduled basis. Peritoneal fluid metformin levels were measured. In addition, the relation between plasma metformin and plasma lactate was studied.ResultsMean fasting blood sugar (FBS) was 10.9 ± 0.5 and 7.8 ± 0.7, and mean hemoglobin A1-C (HgA1C) was 8.2 ± 0.8 and 6.4 ± 1.1 at the beginning and end of the study, respectively (p < 0.001). The mean body mass index (BMI) was 29.1 ± 4.1 and 27.3 ± 4.5 at the beginning and at the end of the study, respectively (p < 0.001). The overall mean plasma lactate level across all blood samples was 1.44 ± 0.6. Plasma levels between 2 and 3 mmol/L were found in 11.8% and levels of 3 - 3.6 mmol/L in 2.4% plasma samples. Hyperlactemia (level > 2 and < 5 mmol/L) was not associated with overt acidemia. None of our patients had lactic acidosis (levels > 5 mmol/L). Age ≥ 60 was a predictor for hyperlactemia. No relationship was found between plasma metformin and lactate levels.ConclusionMetformin may be used with caution in a particular group of ESRD patients who are on APD. Metformin allows better diabetic control with significant reduction of BMI. Information on the relationship between metformin and plasma lactate levels is lacking. Peritoneal dialysis appears to be a safeguard against the development of lactic acidosis in this group of patients.

scholarly journals Lipid status association with 25-hydroxy vitamin D: Cross sectional study of end stage renal disease patients

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Neda Milinković ◽  
Marija Sarić ◽  
Snežana Jovičić ◽  
Duško Mirković ◽  
Višnja Ležaić ◽  
...  
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Density Lipoprotein ◽  
Dialysis Patients ◽  
25 Hydroxy Vitamin D ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Lipid Parameters

SummaryBackgroundSome observational studies indicate an association of 25-hydroxy vitamin D (25(OH)D) insufficiency and atherogenic cholesterol concentrations. The aim of this study was to investigate relationship between 25(OH)D concentrations and lipid parameters in end stage renal disease (ESRD) patients, separately for predialysis, hemodialysis and peritoneal dialysis patients.MethodsWe have adjusted 25(OH)D concentrations for seasonal variability with cosinor analysis, and performed all further analysis using these corrected 25(OH)D concentrations. Concentrations of 25(OH)D and the lipid parameters were determined in 214 ESRD patients and 50 control group participants. The analysis included the measurement of 25(OH)D by HPLC, apolipoprotein (Apo) AI, ApoB and Lp(a) by nephelometry, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) by spectrophotometry and manually calculated ApoB/ApoAI and LDL-C/HDL-C ratio.ResultsESRD patients with adjusted 25(OH)D concentrations of ≤ 50 nmol/L had significantly higher TC (P = 0.005) and ApoAI (P = 0.049). Significantly higher HDL-C (P = 0.011) and ApoAI (P = 0.020) were found in hemodialysis patients with the 25(OH)D concentrations of ≤ 50 nmol/L. The other analyzed lipid parameters differed significantly between predialysis, hemodialysis and peritoneal dialysis patients with 25(OH)D concentrations of < 50 nmol/L.ConclusionsOur study indicate the significant relationship between 25(OH)D repletion and optimal concentrations of lipid parameters in ESRD patients. Further research is necessary to explain whether joint evaluation of vitamin D status and lipid abnormalities could improve cardiovascular outcome in ESRD patients.

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