Higher Serum Bisphenol A Levels in Diabetic Hemodialysis Patients

2016 ◽  
Vol 42 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Faruk Turgut ◽  
Sana Sungur ◽  
Ramazan Okur ◽  
Mustafa Yaprak ◽  
Muge Ozsan ◽  
...  
Keyword(s):  
Bisphenol A ◽  
High Performance ◽  
Patient Characteristics ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Dialysis Session ◽  
Laboratory Parameters ◽  
Hemodialysis Session ◽  
Before And After ◽  
Patients With Diabetes

Background: Bisphenol A (BPA) has been implicated as an ‘endocrine disruptor'. We aimed at exploring the association between serum BPA levels and patient characteristics, particularly the presence of diabetes mellitus, and laboratory parameters in hemodialysis patients. Methods: This study included 47 chronic hemodialysis patients. Patient characteristics were recorded. Blood was drawn before and after hemodialysis session. Serum BPA levels were measured by the high-performance-liquid-chromatography and laboratory parameters were measured by using standard methods. Results: In hemodialysis patients, postdialysis serum BPA levels were significantly higher than predialysis after a single hemodialysis session (5.57 ± 1.2 vs. 4.06 ± 0.73, p < 0.0001). Predialysis serum BPA levels were significantly higher in patients with diabetes than non-diabetics (4.4 ± 0.6 vs. 3.9 ± 0.7, p = 0.025). No association was found between serum BPA levels and patient characteristics, and particularly laboratory parameters. Conclusion: Serum BPA levels were rising significantly after a single dialysis session. Diabetic hemodialysis patients had higher predialysis serum BPA levels.

scholarly journals Triage of Patients Suspected of COVID-19 in Chronic Hemodialysis: Eosinophil Count Differentiates Low and High Suspicion of COVID-19

2020 ◽  
Vol 10 (1) ◽  
pp. 4
Author(s):  
Romain Vial ◽  
Marion Gully ◽  
Mickael Bobot ◽  
Violaine Scarfoglière ◽  
Philippe Brunet ◽  
...  
Keyword(s):  
Predictive Value ◽  
Eosinophil Count ◽  
Characteristic Curve ◽  
Final Analysis ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Screening Methods ◽  
Dialysis Session ◽  
Diagnostic Study ◽  
Rt Pcr

Background: Daily management to shield chronic dialysis patients from SARS-CoV-2 contamination makes patient care cumbersome. There are no screening methods to date and a molecular biology platform is essential to perform RT-PCR for SARS-CoV-2; however, accessibility remains poor. Our goal was to assess whether the tools routinely used to monitor our hemodialysis patients could represent reliable and quickly accessible diagnostic indicators to improve the management of our hemodialysis patients in this pandemic environment. Methods: In this prospective observational diagnostic study, we recruited patients from La Conception hospital. Patients were eligible for inclusion if suspected of SARS-CoV-2 infection when arriving at our center for a dialysis session between March 12th and April 24th 2020. They were included if both RT-PCR result for SARS-CoV-2 and cell blood count on the day that infection was suspected were available. We calculated the area under the curve (AUC) of the receiver operating characteristic curve. Results: 37 patients were included in the final analysis, of which 16 (43.2%) were COVID-19 positive. For the day of suspected COVID-19, total leukocytes were significantly lower in the COVID-19 positive group (4.1 vs. 7.4 G/L, p = 0.0072) and were characterized by lower neutrophils (2.7 vs. 5.1 G/L, p = 0.021) and eosinophils (0.01 vs. 0.15 G/L, p = 0.0003). Eosinophil count below 0.045 G/L identified SARS-CoV-2 infection with AUC of 0.9 [95% CI 0.81—1] (p < 0.0001), sensitivity of 82%, specificity of 86%, a positive predictive value of 82%, a negative predictive value of 86% and a likelihood ratio of 6.04. Conclusions: Eosinophil count enables rapid routine screening of symptomatic chronic hemodialysis patients suspected of being COVID-19 within a range of low or high probability.

scholarly journals OCT angiography metrics predict intradialytic hypotension episodes in chronic hemodialysis patients: a pilot, prospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppe Coppolino ◽  
Adriano Carnevali ◽  
Valentina Gatti ◽  
Caterina Battaglia ◽  
Giorgio Randazzo ◽  
...  
Keyword(s):  
Chronic Hemodialysis ◽  
Dialysis Session ◽  
Intradialytic Hypotension ◽  
Inverse Association ◽  
Non Invasive ◽  
Kaplan Meier ◽  
Optimal Thresholds ◽  
Scanning Area ◽  
Before And After ◽  
Capillary Plexus

AbstractIn chronic hemodialysis (HD) patients, intradialytic hypotension (IDH) is a complication that increases mortality risk. We run a pilot study to analyzing possible relationships between optical coherence tomography angiography (OCT-A) metrics and IDH with the aim of evaluating if OCT-A could represent a useful tool to stratify the hypotensive risk in dialysis patients. A total of 35 eyes (35 patients) were analyzed. OCT-A was performed before and after a single dialysis session. We performed OCT-A 3 × 3 mm and 6 × 6 mm scanning area focused on the fovea centralis. Patients were then followed up to 30 days (10 HD sessions) and a total of 73 IDHs were recorded, with 12 patients (60%) experiencing at least one IDH. Different OCT-A parameters were reduced after dialysis: central choroid thickness (CCT), 6 × 6 mm foveal whole vessel density (VD) of superficial capillary plexus (SPC) and 6 × 6 mm foveal VD of deep capillary plexus (DCP). At logistic regression analysis, IDH was positively associated with baseline foveal VD of SCP and DCP, while an inverse association was found with the choroid. In Kaplan–Meier analyses of patients categorized according to the ROC-derived optimal thresholds, CCT, the 3 × 3 foveal VD of SCP, the 3 × 3 mm and 6 × 6 mm foveal VD of DCP and the 6 × 6 mm foveal VD of SCP were strongly associated with a higher risk of IDH over the 30-days follow-up. In HD patients, a single OCT-A measurement may represent a non-invasive, rapid tool to evaluate the compliance of vascular bed to HD stress and to stratify the risk of IDH in the short term.

scholarly journals Evaluation of Assays for Measurement of Serum (Anti)oxidants in Hemodialysis Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Tatjana Ruskovska ◽  
Eugene H. J. M. Jansen ◽  
Risto Antarorov
Keyword(s):  
Oxidative Stress ◽  
Statistical Significance ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Total Serum ◽  
Antioxidant Assays ◽  
Hemodialysis Session ◽  
Anti Oxidant ◽  
Oxidant Status ◽  
Healthy Persons

Background. Various biomarkers and assays have been used for assessment of (anti)oxidant status in hemodialysis patients, including those intended for measurement of serum total (anti)oxidants, most often as a part of panel biomarkers.Methods. Serum (anti)oxidant status was measured in 32 chronically hemodialyzed patients and in 47 healthy persons, using two oxidations and three antioxidant assays.Results. The patients before the hemodialysis session have had higher values of total oxidants in comparison to the healthy persons, with a further increase during the hemodialysis. These findings were confirmed with both oxidation assays, but they differ in the percentage of increase and the statistical significance. All three antioxidant assays showed significantly higher values of the total serum antioxidants in the patients before the hemodialysis session in comparison to the healthy persons, and their significant decrease during the hemodialysis. However, the assays differ in the percentage of decrease, its statistical significance, and the correlations with uric acid.Conclusion. The variability of results of total (anti)oxidants which are obtained using different assays should be taken into account when interpreting data from clinical studies of oxidative stress, especially in complex pathologies such as chronic hemodialysis.

L-Carnitine Consecutively Administered to Patients on Hemodialysis Improves Beta-Cell Response

2003 ◽  
Vol 26 (4) ◽  
pp. 304-307 ◽  
Author(s):  
E. Vazelov ◽  
A-M. Borissova ◽  
G. Kirilov ◽  
B. Assenova ◽  
M. Tchetirska ◽  
...  
Keyword(s):  
Beta Cell ◽  
Chronic Hemodialysis ◽  
Dialysis Session ◽  
Carnitine Level ◽  
Peripheral Tissues ◽  
Before And After ◽  
Oxidative Processes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Beta Cell Response

Eight patients with end stage renal disease (ESRD) on chronic hemodialysis (CHD) treatment were supplemented with 1 g L-carnitine intravenously (i.v.) after each dialysis session for one month. A Tolbutamide test was done and blood sugar (BS), serum C-peptide (CP) were measured at 0, 20 and 60 minutes, as well as the plasma L-carnitine level before and after treatment. Delta CP and the area under CP curve were ascertained. After L-carnitine application delta CP was significantly increased (1.33 ± 0.63 vs. 2.24 ± 1.0 nmol/L; p <0.05) and also the area of the stimulated secretion under the CP curve (14.93 ± 11.11 vs. 36.88 ± 25.36 nmol/L × 60 min.; p <0.05). The fasting BS-level was significantly lower after the treatment - 3.85 ± 0.43 vs. 4.76 ± 1.02 mmol/L; p <0.05 and plasma L-carnitine level significantly increased (72.8 ± 43.2 vs. 35.2 ± 18.3 mcmol/L; p <0.05) Improving the oxidative processes in peripheral tissues, L-carnitine increases the peripheral effectiveness of insulin and relieves the overstretched beta-cell apparatus.

scholarly journals Usefulness of foot-to-foot bioimpedance analysis for assessing volume status in chronic hemodialysis patients at the Aristide Le Dantec University Hospital (Senegal)

2021 ◽  
Vol 5 (2) ◽  
pp. 056-060
Author(s):  
Keita Niakhaleen ◽  
Faye Maria ◽  
Seck Sidy Mouhamed ◽  
Ndong Boucar ◽  
Faye Moustapha ◽  
...  
Keyword(s):  
Bioelectrical Impedance ◽  
Dry Weight ◽  
Impedance Analysis ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
University Hospital ◽  
Single Frequency ◽  
Cross Sectional ◽  
Before And After

Introduction: Determination of dry weight is one of the daily goals to achieve in hemodialysis. The aim of this study was to validate the use of bioelectrical impedance analysis (BIA) in estimation of dry weight in a population of Senegalese chronic hemodialysis patients. Patients and methods: A 9-week cross-sectional study was carried out at the hemodialysis unit of Aristide Le Dantec University Hospital. Adult patients with no previous hospital history were included. The total body water (TBW) was measured with a single frequency bioelectric impedance foot-to-foot analyzer, before and after six successive hemodialysis sessions. These results were compared with those from clinical measurements with the Watson equation using a Student’s t-test and Bland-Altman analysis. Results: 264 measurements were made in 22 patients (46.6 years, 54.5% men, 92.3 months on dialysis, 62.7 kg mean dry weight). A significant reduction in weight (ΔWeight = 2.0 ± 1.1 kg; p < 0.0001) and in TBW measured by the BIA (ΔTBWBIA = 3.3 ± 1.0 liters; p < 0.0001)) or calculated by Watson’s equation (ΔTBWWatson = 0.5 ± 0.2 liter; p = 0.0001) was observed. There was a strong linear correlation and agreement between the 2 TBW measurements in pre-dialysis. In post-dialysis the concordance diagram indicated a bias = –2.2 and wide agreement limits. Conclusion: The BIA allows reproducible and reliable measurements and a fair estimate of the TBW in pre-dialysis.

Analytical Evaluation of BioRad D-100 HPLC Analyzer and Workflow Comparison to BioRad TurboLink Variant II HPLC With Reflex to Boronate Affinity

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S12-S13
Author(s):  
Kornelia Galior ◽  
Lisha Leonard ◽  
Christopher Dolan ◽  
Ryan Deiter ◽  
Nikola A Baumann ◽  
...  
Keyword(s):  
Cation Exchange ◽  
High Performance ◽  
Exchange Chromatography ◽  
Rule Violation ◽  
Before And After ◽  
Patients With Diabetes ◽  
Unknown Peak ◽  
Reflex Testing ◽  
Boronate Affinity Chromatography ◽  
Hemoglobin Variants

Abstract Introduction Measurement of hemoglobin A1c (HbA1C) is used for the diagnosis and management of patients with diabetes. Methods for measuring HbA1C are classified on the basis of charge differences (cation exchange chromatography) or structural differences (boronate affinity chromatography). Some cation exchange high-performance liquid chromatography (HPLC) analyzers may be prone to interferences from hemoglobin variants. Historically, our lab used two methods to report HbA1C results: cation exchange HPLC (VariantII) with reflex to boronate affinity HPLC (Ultra2) methods. A new analyzer (BioRad D-100) with improved interference detection and thresholds for interference was evaluated. The objectives of this study were (1) assess the comparability of HbA1c results between D-100, VariantII, and Ultra2; (2) evaluate the need for maintaining a reflex method; and (3) calculate cancellation rates before and after implementing D-100. Methods HbA1c was measured by cation exchange methods using VariantII Turbolink, D-100 (BioRad), and boronate affinity using Ultra2Affinity (Trinity Biotech) according to the manufacturer’s recommendations with the following analytical measuring ranges (AMRs), 4.0% to 17.6%, 4.0% to 18.0%, and 4.0% to 17.6%, respectively. D-100 was compared to VariantII (n = 26) and Ultra2 (n = 31) using residual patient samples from provider-ordered HbA1c having no chromatography flags and with the following chromatography flags on VariantII (n = 113): variant window (n = 41), HbA1c <4.0% (n = 24), HbA1a + HbA1b >5% (n = 19), HbF >5% (n = 9), P3 >10% (n = 6), HbA1c >17.6% (n = 4), unknown peak (n = 3), labile 5% to 15% (n = 3), labile >15% (n = 3), and HbS >60% (n = 1). The cancelation rates were calculated at baseline (January 1-31, 2018) and postimplementation of D-100 (September 20, 2018, to January 22, 2019). Results HbA1c results from D-100 were within ±0.3 or 5% with the following frequencies: Ultra2 in 96.2% (25/26) with VariantII in 96.8% (30/31) using samples with no chromatography flags. A total of 113 samples with abnormal VariantII flags were tested using D-100 with 82% (n = 92) not exceeding interference limits for result reporting. These D-100 results were within ±0.3 or 5% of Ultra2 results with the following frequencies: 38.5% (10/26) of samples below (n = 23) or above (n = 3) the AMR, 85.3% (29/34) of results with Hb variant flags, 68.0% (17/25) with unknown/minor peaks, and 71.4% (5/7) with HbF <15%. The clinical concordance was also assessed according to the following decision limits: normal <5.6%, prediabetic = 5.7% to 6.4%, and diabetic >6.5%. Results were concordant in 88% with variant peaks (12/13 w/HbA1c <5.6%, 8/11 w/HbA1c = 5.7%-6.4%, 10/10 w/HbA1c >6.5%), 84% with minor peaks (5/6 w/HbA1c <5.6%, 0/2 w/HbA1c = 5.7%-6.4%, 16/17 w/HbA1c >6.5%), and 86% with HbF (3/3 w/HbA1c <5.6%, 2/3 w/HbA1c = 5.7%-6.4%, 1/1 w/HbA1c >6.5%). Results above/below AMR had 100% concordance (>16.0% or <4.4%). The frequency of VariantII rule violation was 2.1% in January 2018, with 53 of 117 having results confirmed as <4.0% or >16.0% by Ultra2, 2 of 117 reported by Ultra2, and 62 being cancelled due to HbF >15% (n = 23) or variant Hb >60% (n = 39). The frequency of rule violation using only D-100 since implementation was 2.2%. Conclusion Implementation of D-100 has removed the need for boronate affinity reflex testing and maintained similar cancellation rates.

Annual Iron Loss Associated with Hemodialysis

2016 ◽  
Vol 43 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Tatsuo Tsukamoto ◽  
Takayuki Matsubara ◽  
Yuka Akashi ◽  
Morihiro Kondo ◽  
Motoko Yanagita
Keyword(s):  
Whole Blood ◽  
Iron Content ◽  
Iron Supplementation ◽  
Iron Status ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Total Iron ◽  
Iron Loss ◽  
Dialysis Session ◽  
Residual Blood

Background: In order to keep up the optimal iron status in chronic hemodialysis patients, it is important to know how much iron is lost due to hemodialysis. Residual blood associated with the hemodialysis procedure together with blood sampling inevitably causes the loss of iron in chronic hemodialysis patients. Recent advances in hemodialysis techniques might have reduced this complication. In this cross-sectional study, we directly measured total iron loss by hemodialysis. Methods: Two hundred thirty-nine patients who received chronic hemodialysis at Otowa Memorial Hospital were enrolled; 65.7% of patients were men, and mean age was 67 ± 6.4 years (mean ± SD) and 43.2% were diabetic. Residual blood in blood tubing set and dialyzer after rinse back with saline was collected and homogenized. The iron content including free, protein-bound and heme iron was measured using an atomic absorption spectrometry. Results: The mean iron content in residual blood was 1,247.3 ± 796.2 µg (mean ± SD) and the median was 1,002 µg (95% CI 377.6-3,461.6 µg), indicating 160.8 mg (95% CI 58.9-540.0 mg) iron loss annually when hemodialysis was performed 156 times a year. Fifty milliliter whole blood for monthly blood test and another 2 ml of whole blood lost by paracentesis at every dialysis session contains 228.6 and 118.9 mg iron at 11 g/dl hemoglobin, respectively. Therefore, an annual total iron loss due to hemodialysis comes to 508.3 mg (95% CI 406.4-887.5 mg). Conclusions: Five hundred milligram of annual iron supplementation might be sufficient to maintain iron status in hemodialysis patients, which is less than the dose recommended as 1,000-2,000 mg a year. Further study will be required to verify this iron supplementation dosage with recent hemodialysis procedure.

scholarly journals Assessment of the Role of Lung Ultrasonography for the Accuracy of Clinically Estimated Dry Weight in Chronic Hemodialysis Patients

2021 ◽  
pp. 94-103
Author(s):  
Yasmin S. Hammad ◽  
Samy A. Khodier ◽  
Ghada M. Al-Ghazaly ◽  
Ibrahim A. Nassar
Keyword(s):  
Dry Weight ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Percentage Change ◽  
Dialysis Session ◽  
Lung Ultrasonography ◽  
Cross Sectional ◽  
Fluid Removal ◽  
B Lines ◽  
Positive Significant Correlation

Objective: The aim of this study was to  evaluate  the utility  of lung  ultrasonography  to  determine   the accuracy of prescribed  dry  weight in chronic hemodialysis patients  and  to  ascertain   the  adequacy  of  fluid  removal . Methods: In this cross sectional study LUS was performed immediately before and after (within 15 min) the dialysis session on 60 patients on regular hemodialysis, 4-hours per session, three times weekly at Tanta university hospitals, Internal Medicine Department, Nephrology units, Egypt. The ultrasonography B-lines was tabulated and compared to the intradialytic ultrafltration parameters and dry weight. Results: Positive significant correlation (P 0.02) was achieved between the intradialytic percentage change in B-lines and the percent change in total body weight reduction and also Positive significant correlation (P 0.05) was achieved between the intradialytic percentage change in B-lines and the ultrafiltration rate. Conclusion: LUS is a valuable diagnostic tool for recognizing the adequacy of fluid removal and to avoid inaccurate estimation of dry weight by usual clinical parameters or even radiologic studies including chest X-ray.

Identification and quantification of a protein-bound ligand in uremic serum.

1987 ◽  
Vol 33 (5) ◽  
pp. 682-685 ◽  
Author(s):  
N Takeda ◽  
T Niwa ◽  
A Tatematsu ◽  
M Suzuki
Keyword(s):  
Mass Spectrometry ◽  
High Performance ◽  
Secondary Ion Mass Spectrometry ◽  
Authentic Sample ◽  
Normal Subjects ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Gas Chromatography Mass Spectrometry ◽  
Major Protein ◽  
Uremic Serum

Abstract A major protein-bound ligand in the serum of chronic hemodialysis patients was isolated from heat-deproteinized uremic serum by "high-performance" liquid chromatography (HPLC). The isolated compound was identified as 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid by use of liquid secondary-ion mass spectrometry and gas chromatography-mass spectrometry. On HPLC, an authentic sample of this compound showed a retention time identical to that of the protein-bound ligand peak. The concentration of the furancarboxylic acid in serum, as estimated by HPLC, is markedly greater in chronic hemodialysis patients than in normal subjects.

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