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

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.

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Fibrin clot structure in patients with end-stage renal disease

Thrombosis and Haemostasis ◽

10.1160/th06-12-0715 ◽

2007 ◽

Vol 98 (08) ◽

pp. 339-345 ◽

Cited By ~ 42

Author(s):

Johannes Sidelmann ◽

Mikkel Brabrand ◽

Robert Pedersen ◽

Jørgen Pedersen ◽

Kim Esbensen ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Healthy Controls ◽

Structure Characteristics ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients ◽

Fibrin Structure ◽

Plasma Markers ◽

Fibrin Clots

SummaryFibrin clots with reduced permeability, increased clot stiffness and reduced fibrinolysis susceptibility may predispose to cardiovascular disease (CVD). Little is known, however, about the structure of fibrin clots in patients with end-stage renal disease (ESRD).These patients suffer from a high risk of CVD in addition to their chronic low-grade inflammation. Using permeability, compaction and turbidity studies in 22 ESRD patients and 24 healthy controls, fibrin clots made from patient plasma were found to be less permeable (p<0.001), less compactable (p<0.001), and less susceptible to fibrinolysis (p<0.001) than clots from controls.The maximum rate of turbidity increase was also higher for the patients than controls (p<0.001), and scan-ning electron microscopy revealed higher clot density of fibrin fibers in clots from patients than clots from controls (p<0.001). Patients had higher plasma concentrations of fibrinogen, C-reative protein and interleukin 6 than controls.These plasma markers of inflammation correlated significantly with most of the fibrin structure characteristics observed in the patients. In contrast, plasma markers of azothemia showed no such correlations. The results suggest that in ESRD patients fibrin clots are significantly different from healthy controls, and that the fibrin structure characteristics in the patients are associated primarily with the inflammatory plasma milieu rather than with level of azothemia.

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Nationwide Glaucoma incidence in end stage renal disease patients and kidney transplant recipients

Scientific Reports ◽

10.1038/s41598-021-86846-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jong Joo Moon ◽

Yong Woo Kim ◽

Baek-Lok Oh ◽

Kyungdo Han ◽

Dong Ki Kim ◽

...

Keyword(s):

Kidney Transplantation ◽

Renal Disease ◽

End Stage Renal Disease ◽

Open Angle Glaucoma ◽

Angle Closure ◽

Healthy Controls ◽

Kidney Transplant Recipients ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

AbstractGlaucoma shares common risk factors with chronic kidney disease (CKD) but previous cross-sectional studies have demonstrated discrepancies in the risk of glaucoma in CKD patients. This study enrolled kidney transplantation recipients (KTRs) (n = 10,955), end stage renal disease (ESRD) patients (n = 10,955) and healthy controls (n = 10,955) from National Health Insurance Service database of the Republic of Korea. A Cox proportional hazard regression model was used to calculate the hazard ratios (HR) for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) incidences. The incidence of POAG was higher in ESRD patients (3.36/1,000 person-years, P < 0.0001) and KTRs (3.22 /1,000 person-years, P < 0.0001), than in healthy controls (1.20/1,000 person-years). However, POAG risk showed no significant increase in either ESRD patients (P = 0.07) or KTRs (P = 0.08) when adjusted for the confounding factors. The incidence of PACG was significantly higher in ESRD patients (0.41/1,000 person-years) than in healthy controls (0.14/1,000 person-years, P = 0.008). The PACG incidence was significantly lower in KTRs than in ESRD patients (HR = 0.35, P = 0.015). In conclusion, this nationwide cohort study demonstrated that kidney transplantation can reduce the risk of PACG but not POAG in ESRD patients.

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Serum Resistin, Adenylate Cyclase-Associated Protein 1 Gene Expression, and Carotid Intima-Media Thickness in Patients with End-Stage Renal Disease and Healthy Controls

Cardiorenal Medicine ◽

10.1159/000503416 ◽

2019 ◽

Vol 10 (1) ◽

pp. 51-60 ◽

Cited By ~ 1

Author(s):

Jelena Munjas ◽

Miron Sopić ◽

Nataša Bogavac-Stanojević ◽

Milica Kravljača ◽

Milica Miljković ◽

...

Keyword(s):

Gene Expression ◽

Renal Disease ◽

End Stage Renal Disease ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Healthy Controls ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients ◽

Resistin Mrna

Background: Human resistin is a proinflammatory cytokine with significant proatherogenic effects which acts through adenylyl cyclase-associated protein 1 (CAP1). Chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients have increased cardiovascular risk and resistin levels. Previous studies indicated resistin significance as a predictor of mortality in CKD. Aims: We sought to investigate plasma resistin levels, peripheral blood mononuclear cell (PBMC) resistin mRNA, and for the first time CAP1 mRNA levels in ESRD patients and healthy controls. We also sought to investigate the relation of resistin and CAP1 to carotid intima media thickness (CIMT), CD36 gene expression, and matrix metalloproteinase 9 (MMP-9) circulating levels in ESRD patients and healthy controls. Methods: This study included 33 patients with ESRD and 27 healthy controls. Resistin and MMP-9 levels were measured by ELISA. Resistin, CAP1, and CD36 PBMC mRNA were measured by quantitative PCR. Results: Our study showed that ESRD patients have significantly higher levels of circulatory resistin compared to healthy controls (p < 0.001), while there was no significant difference in resistin mRNA. A significant upregulation of CAP1 and CD36 was observed in the ESRD group (p < 0.001; p < 0.001). Resistin concentration correlated with CIMT in healthy controls (r = 0.512, p = 0.036), and with MMP-9 concentration in ESRD (r = 0.353, p = 0.044) and healthy controls (r = 0.463, p = 0.026). CAP1 correlated positively with CIMT (r = 0.464, p = 0.008) in ESRD, and with CD36 in healthy controls (r = 0.447, p = 0.022) and ESRD (r = 0.824, p < 0.001). Conclusion: The obtained data suggest that high levels of circulating resistin acting upon cells with an upregulated CAP1 gene could contribute to the increased inflammation and accelerated atherosclerosis seen in CKD patients.

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Ghrelin and Obestatin Levels in End-stage Renal Disease

Journal of International Medical Research ◽

10.1177/147323000903700319 ◽

2009 ◽

Vol 37 (3) ◽

pp. 757-765 ◽

Cited By ~ 22

Author(s):

B Aygen ◽

A Dogukan ◽

FE Dursun ◽

S Aydin ◽

N Kilic ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Energy Homeostasis ◽

Serum Levels ◽

Healthy Controls ◽

Stage Renal Disease ◽

End Stage ◽

Study Participants ◽

Serum Ghrelin ◽

Esrd Patients

Malnutrition is fairly common in end-stage renal disease (ESRD) patients, persistent lack of appetite being a major symptom. Ghrelin and obestatin are two hormones that are involved in appetite and energy homeostasis. The present study examined ghrelin and obestatin levels in 24 ESRD patients undergoing haemodialysis and 24 age-matched healthy controls. Serum and saliva ghrelin and obestatin levels in the ESRD patients were significantly higher compared with controls, while saliva ghrelin and obestatin levels in all study participants were significantly higher than serum levels. Saliva ghrelin correlated with serum ghrelin and saliva obestatin correlated with serum obestatin in all study participants, although there was no correlation between ghrelin and obestatin levels. In conclusion, the results suggest that the kidneys may have a role in the metabolism and/or clearance of obestatin, as they do for ghrelin. Further studies are needed to determine if elevated levels of these hormones in ESRD patients contribute to the malnutrition that is common in these patients.

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Neurovascular coupling dysfunction in end-stage renal disease patients related to cognitive impairment

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x211007960 ◽

2021 ◽

pp. 0271678X2110079

Author(s):

Peng Li ◽

Junya Mu ◽

Xueying Ma ◽

Dun Ding ◽

Shaohui Ma ◽

...

Keyword(s):

Cognitive Impairment ◽

Renal Disease ◽

End Stage Renal Disease ◽

Neurovascular Coupling ◽

Healthy Controls ◽

Stage Renal Disease ◽

End Stage ◽

The Impact ◽

The Relationship ◽

Esrd Patients

We aimed to investigate the neurovascular coupling (NVC) dysfunction in end-stage renal disease (ESRD) patients related with cognitive impairment. Twenty-five ESRD patients and 22 healthy controls were enrolled. To assess the NVC dysfunctional pattern, resting-state functional MRI and arterial spin labeling were explored to estimate the coupling of spontaneous neuronal activity and cerebral blood perfusion based on amplitude of low-frequency fluctuation (ALFF)-cerebral blood flow (CBF), fractional ALFF (fALFF)-CBF, regional homogeneity (ReHo)-CBF, and degree centrality (DC)-CBF correlation coefficients. Multivariate partial least-squares correlation and mediation analyses were used to evaluate the relationship among NVC dysfunctional pattern, cognitive impairment and clinical characteristics. The NVC dysfunctional patterns in ESRD patients were significantly decreased in 34 brain regions compared with healthy controls. The decreased fALFF-CBF coefficients in the cingulate gyrus (CG) were associated positively with lower kinetic transfer/volume urea (Kt/V) and lower short-term memory scores, and were negatively associated with higher serum urea. The relationship between Kt/V and memory deficits of ESRD patients was partially mediated by the fALFF-CBF alteration of the CG. These findings reveal the NVC dysfunction may be a potential neural mechanism for cognitive impairment in ESRD. The regional NVC dysfunction may mediate the impact of dialysis adequacy on memory function.

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IMPACT OF DURATION OF HEMODIALYSIS ON LIPID PROFILE IN END STAGE RENAL DISEASE PATIENTS RECEIVING HEMODIALYSIS.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.4188 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1230-1236

Author(s):

Sadia Rehman ◽

Santosh Kumar ◽

Fatima Mehboob ◽

Fatima Rehman ◽

Syed Hidayat Ali ◽

...

Keyword(s):

Renal Disease ◽

Lipid Profile ◽

End Stage Renal Disease ◽

Serum Triglyceride ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Healthy Controls ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

End Stage Renal Disease (ESRD) patients receiving hemodialysis are at a higher risk of developing dyslipidemia which is undoubtedly a predisposing factor of cardiac related disease in these patients. Objectives: To assess serum lipid profile in subjects having end stage renal disease and receiving maintenance hemodialysis and to compare it with normal healthy controls and also to assess the effects of duration of hemodialysis on the lipid profile. Study Design: A case-control study. Setting: Executed in the Nephrology Department of JPMC. Period: January 2018 to January 2019. Material and Methods: Blood samples were obtained from a total of 90 subjects. Subjects were stratified into 3 groups including cases of ESRD receiving maintenance hemodialysis and matched healthy controls. Analysis for serum triglyceride, serum VLDL, total cholesterol, LDL and HDL was done. Results: A significant rise in serum triglyceride content and total serum cholesterol of hemodialysis patients (p < 0.01) was detected as compared to healthy controls. A statistically significant decrease was found in serum HDL level (p < 0.01) in hemodialysis patients in comparison to healthy controls. The impact of the hemodialysis duration was found to deteriorate the lipid profile of patients having longer duration of hemodialysis. Conclusion: Dyslipidemia was found to be evident in hemodialysis patients. The duration of hemodialysis sessions was found to affect the lipid profile of ESRD patients, which may play a role in higher incidence of atherosclerotic related cardiac events among these patients.

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The Landscape and Potential Regulatory Mechanism of Lysine 2-Hydroxyisobutyrylation of Protein in End-Stage Renal Disease

Nephron ◽

10.1159/000518424 ◽

2021 ◽

pp. 1-10

Author(s):

Fengping Zheng ◽

Huixuan Xu ◽

Shaoying Huang ◽

Cantong Zhang ◽

Shanshan Li ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Bioinformatics Analysis ◽

Healthy Controls ◽

Blood Monocytes ◽

Affinity Enrichment ◽

Modified Proteins ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Background: Acetylation has a vital role in the pathogenesis of end-stage renal disease (ESRD). Lysine 2-hydroxyisobutyrylation (Khib) is a novel type of acetylation. In this study, we aimed to reveal the key features of Khib in peripheral blood monocytes (PBMCs) of patients with ESRD. Method: We combined TMT labeling with LC-MS/MS analysis to compare Khib modification of PBMCs between 20 ESRD patients and 20 healthy controls. The pan 2-hydroxyisobutyrylation antibody-based affinity enrichment method was used to reveal the features of Khib, and the bioinformatics analysis was conducted to analyze the pathology of these Khib-modified proteins. Result: Compared to healthy controls, we identified 440 upregulated proteins and 552 downregulated proteins in PBMCs of ESRD, among which 579 Khib sites on 324 upregulated proteins and 287 Khib sites on 188 downregulated proteins were identified. The site abundance, distribution, and function of the Khib protein were further analyzed. The bioinformatics analysis revealed that the Rho/ROCK signaling pathway was highly enriched in ESRD, suggesting that it might contribute to renal fibrosis in ESRD patients. Conclusion: In this study, we found that Khib-modified proteins correlated with the occurrence and progression of ESRD.

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Vasodilation and Exercise Capacity in Patients with End-Stage Renal Disease: A Prospective Proof-of-Concept Study

Cardiorenal Medicine ◽

10.1159/000449174 ◽

2016 ◽

Vol 7 (1) ◽

pp. 50-59 ◽

Cited By ~ 1

Author(s):

Dirk Habedank ◽

Joerg C. Schefold ◽

Carolin Bernhardt ◽

Tim Karhausen ◽

Wolfram Doehner ◽

...

Keyword(s):

Blood Flow ◽

Renal Disease ◽

Exercise Capacity ◽

End Stage Renal Disease ◽

Healthy Controls ◽

Proof Of Concept ◽

Concept Study ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Background: Previous data have pointed to the fact that vascular function is significantly impaired in patients with end-stage renal disease (ESRD). We aimed to better characterise vasodilation and exercise capacity in both ESRD and chronic heart failure (CHF) patients. Methods: A total of 30 ESRD patients (23 male; mean age 45.7 ± 9.9 years) were included in a prospective proof-of-concept study at a tertiary care academic centre. The patients underwent forearm venous plethysmography with post-ischaemic peak blood flow (PF) and flow-dependent flow (FDF) testing as well as cardiopulmonary exercise testing during the morning of the day following the last haemodialysis. After matching for age, gender, and body mass index, the data were compared to 30 patients with CHF and 20 age-matched healthy controls. Results: PF in ESRD patients was reduced when compared to that in CHF patients (12.5 ± 4.2 vs. 15.6 ± 6.9 ml/100 ml/min; p = 0.048) and healthy controls (26.4 ± 9.3 ml/100 ml/min; p < 0.001). When compared to controls, FDF was significantly reduced in ESRD patients (7.6 ± 3.1 vs. 6.0 ± 2.5 ml/100 ml/min; p = 0.03), but not in CHF patients, whereas resting blood flow did not differ between the ESRD, CHF, and healthy control groups. In contrast to indices of vasodilative capacity, maximum exercise capacity (peakVO2) was higher in ESRD when compared to CHF patients (23.8 ± 7.3 vs. 18.8 ± 5.2 ml/min/kg), but significantly impaired when compared to controls (32.8 ± 6.7 ml/min/kg; p < 0.001). Conclusion: In this proof-of-concept study, exercise capacity was relatively preserved, while vasodilative capacity was substantially impaired in ESRD patients. Additional studies are warranted to examine the underlying mechanisms and potential clinical implications of our findings.

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Homocysteine clearance and methylation flux rates in health and end-stage renal disease: association withS-adenosylhomocysteine

AJP Renal Physiology ◽

10.1152/ajprenal.00376.2003 ◽

2004 ◽

Vol 287 (2) ◽

pp. F215-F223 ◽

Cited By ~ 24

Author(s):

Frank Stam ◽

Coen van Guldener ◽

Piet M. ter Wee ◽

Willem Kulik ◽

Desirée E. C. Smith ◽

...

Keyword(s):

Renal Disease ◽

Whole Blood ◽

End Stage Renal Disease ◽

Carbon Flux ◽

Disease Association ◽

Healthy Controls ◽

Significant Determinant ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Hyperhomocysteinemia is a risk factor for cardiovascular disease and occurs frequently in end-stage renal disease (ESRD), but its pathogenesis is poorly understood. We aimed to evaluate one-carbon flux rates of methionine and homocysteine (Hcy) in ESRD patients and healthy controls. Transmethylation (TM), remethylation (RM), and transsulfuration (TS), as well as Hcy clearance by TS (i.e., TS/plasma total Hcy concentration) and by RM (i.e., RM/plasma total Hcy concentration) were evaluated in relation to body composition, vitamins, and S-adenosylhomocysteine (AdoHcy) and S-adenosylmethionine (AdoMet) levels. After a fixed protein diet for 3 days, primed-continuous infusion of [2H3-methyl-1-13C]methionine was performed in the postabsorptive state in 12 hemodialysis patients and 16 healthy volunteers. Hcy clearance by TS (−80%, P < 0.001) and by RM (−77%, P < 0.001) in ESRD patients was decreased compared with healthy controls. The absolute flux rates of TM (−27%, P < 0.01) and RM (−28%, P = 0.02) were lower in the ESRD patients. After adjustment for age, TS was not significantly reduced. Whole blood AdoHcy was significantly elevated in ESRD and was a significant determinant of TM (standardized β = −1.24, P = 0.01) and RM (standardized β = −1.43, P = 0.03). In conclusion, patients with ESRD have impaired Hcy clearance by TS and RM. Elevated whole blood AdoHcy levels are associated with impaired RM and TM flux rates in these patients, and AdoHcy may be a key regulatory compound in one-carbon flux.

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

The Journal of Vascular Access ◽

10.5301/jva.5000630 ◽

2016 ◽

Vol 18 (1) ◽

pp. 47-51 ◽

Cited By ~ 19

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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