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 ◽  
...  

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.

2010 ◽  
Vol 55 (2) ◽  
pp. 473-477 ◽  
Author(s):  
Denise B. Serra ◽  
Haiying Sun ◽  
Sylwia Karwowska ◽  
Jens Praestgaard ◽  
Atef Halabi ◽  
...  

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.


2020 ◽  
pp. 988-994
Author(s):  
Toru Sanai ◽  
Ken Okamura ◽  
Tomoaki Onoue ◽  
Takashi Ono ◽  
Kenichi Motomura ◽  
...  

<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.


2007 ◽  
Vol 18 (2) ◽  
pp. 613-620 ◽  
Author(s):  
Gérard M. London ◽  
Alain P. Guérin ◽  
Francis H. Verbeke ◽  
Bruno Pannier ◽  
Pierre Boutouyrie ◽  
...  

Open Medicine ◽  
2013 ◽  
Vol 8 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Felix Liebscher ◽  
Tobias Arnold ◽  
Ying Liang ◽  
Thomas Reiter ◽  
Georg Böhmig ◽  
...  

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.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ruzica Lukic ◽  
Nevena Gajovic ◽  
Ivan Jovanovic ◽  
Milena Jurisevic ◽  
Zeljko Mijailovic ◽  
...  

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.


2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 298-302
Author(s):  
Robert H. Mak ◽  
Wai Cheung

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.


Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son

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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