scholarly journals Gut Microbiome Profiling Uncovers a Lower Abundance of Butyricicoccus in Advanced Stages of Chronic Kidney Disease

2021 ◽  
Vol 11 (11) ◽  
pp. 1118
Author(s):  
Tessa Gryp ◽  
Karoline Faust ◽  
Wim Van Biesen ◽  
Geert R. B. Huys ◽  
Francis Verbeke ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gut Microbiome ◽  
Amplicon Sequencing ◽  
Uremic Toxins ◽  
Microbial Composition ◽  
Cross Sectional ◽  
Organ Systems ◽  
Significant Difference ◽  
Advanced Stages

Chronic kidney disease (CKD) is characterized by the accumulation of uremic toxins which exert deleterious effects on various organ systems. Several of these uremic toxins originate from the bacterial metabolization of aromatic amino acids in the colon. This study assessed whether the gut microbial composition varies among patients in different stages of CKD. Uremic metabolites were quantified by UPLC/fluorescence detection and microbial profiling by 16S rRNA amplicon sequencing. Gut microbial profiles of CKD patients were compared among stages 1–2, stage 3 and stages 4–5. Although a substantial inter-individual difference in abundance of the top 15 genera was observed, no significant difference was observed between groups. Bristol stool scale (BSS) correlated negatively with p-cresyl sulfate and hippuric acid levels, irrespective of the intake of laxatives. Butyricicoccus, a genus with butyrate-generating properties, was decreased in abundance in advanced stages of CKD compared to the earlier stages (p = 0.043). In conclusion, in this cross-sectional study no gradual differences in the gut microbial profile over the different stages of CKD were observed. However, the decrease in the abundance of Butyricicoccus genus with loss of kidney function stresses the need for more in-depth functional exploration of the gut microbiome in CKD patients not on dialysis.

scholarly journals FGF-23 and Phosphate in Children with Chronic Kidney Disease: A Cross-Sectional Study in Kazakhstan

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 15
Author(s):  
Altynay Balmukhanova ◽  
Kairat Kabulbayev ◽  
Harika Alpay ◽  
Assiya Kanatbayeva ◽  
Aigul Balmukhanova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fibroblast Growth Factor 23 ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ckd Stage ◽  
Advanced Stages ◽  
Fgf 23 ◽  
Stage 1

Background and objectives: Chronic kidney disease (CKD) in children is a complex medical and social issue around the world. One of the serious complications is mineral-bone disorder (CKD-MBD) which might determine the prognosis of patients and their quality of life. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone which is involved in the pathogenesis of CKD-MBD. The purpose of the study was to determine what comes first in children with CKD: FGF-23 or phosphate. Materials and Methods: This cross-sectional study included 73 children aged 2–18 years with CKD stages 1–5. We measured FGF-23 and other bone markers in blood samples and studied their associations. Results: Early elevations of FGF-23 were identified in children with CKD stage 2 compared with stage 1 (1.6 (1.5–1.8) pmol/L versus 0.65 (0.22–1.08), p = 0.029). There were significant differences between the advanced stages of the disease. FGF-23 correlated with PTH (r = 0.807, p = 0.000) and phosphate (r = 0.473, p = 0.000). Our study revealed that the elevated level of FGF-23 went ahead hyperphosphatemia and elevated PTH. Thus, more than 50% of children with CKD stage 2 had the elevating level of serum FGF-23, and that index became increasing with the disease progression and it achieved 100% at the dialysis stage. The serum phosphate increased more slowly and only 70.6% of children with CKD stage 5 had the increased values. The PTH increase was more dynamic. Conclusions: FGF-23 is an essential biomarker, elevates long before other markers of bone metabolism (phosphate), and might represent a clinical course of disease.

scholarly journals Identification of Potential Biomarkers of Chronic Kidney Disease in Individuals with Diabetes: Protocol for a Cross-sectional Observational Study (Preprint)

2019 ◽  
Author(s):  
Ashani R Lecamwasam ◽  
Mohammadreza Mohebbi ◽  
Elif I Ekinci ◽  
Karen M Dwyer ◽  
Richard Saffery
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Data Collection ◽  
Gut Microbiome ◽  
Single Point ◽  
Therapeutic Interventions ◽  
Kidney Dysfunction ◽  
Early Diabetes ◽  
Cross Sectional ◽  
Potential Biomarkers

BACKGROUND The importance of identifying people with diabetes and progressive kidney dysfunction relates to the excess morbidity and mortality of this group. Rates of cardiovascular disease are much higher in people with both diabetes and kidney dysfunction than in those with only one of these conditions. By the time these people are identified in current clinical practice, proteinuria and renal dysfunction are already established, limiting the effectiveness of therapeutic interventions. The identification of an epigenetic or blood metabolite signature or gut microbiome profile may identify those with diabetes at risk of progressive chronic kidney disease, in turn providing targeted intervention to improve patient outcomes. OBJECTIVE This study aims to identify potential biomarkers in people with diabetes and chronic kidney disease (CKD) associated with progressive renal injury and to distinguish between stages of chronic kidney disease. Three sources of biomarkers will be explored, including DNA methylation profiles in blood lymphocytes, the metabolomic profile of blood-derived plasma and urine, and the gut microbiome. METHODS The cross-sectional study recruited 121 people with diabetes and varying stages (stages 1-5) of chronic kidney disease. Single-point data collection included blood, urine, and fecal samples in addition to clinical data such as anthropometric measurements and biochemical parameters. Additional information obtained from medical records included patient demographics, medical comorbidities, and medications. RESULTS Data collection commenced in January 2018 and was completed in June 2018. At the time of submission, 121 patients had been recruited, and 119 samples remained after quality control. There were 83 participants in the early diabetes-associated CKD group with a mean estimated glomerular filtration rate (eGFR) of 61.2 mL/min/1.73 m2 (early CKD group consisting of stage 1, 2, and 3a CKD), and 36 participants in the late diabetic CKD group with a mean eGFR of 23.9 mL/min/1.73 m2 (late CKD group, consisting of stage 3b, 4, and 5), <i>P</i><.001. We have successfully obtained DNA for methylation and microbiome analyses using the biospecimens collected via this protocol and are currently analyzing these results together with the metabolome of this cohort of individuals with diabetic CKD. CONCLUSIONS Recent advances have improved our understanding of the epigenome, metabolomics, and the influence of the gut microbiome on the incidence of diseases such as cancers, particularly those related to environmental exposures. However, there is a paucity of literature surrounding these influencers in renal disease. This study will provide insight into the fundamental understanding of the pathophysiology of CKD in individuals with diabetes, especially in novel areas such as epigenetics, metabolomics, and the kidney-gut axis. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16277

scholarly journals Association between Protein-Bound Uremic Toxins and Asymptomatic Cardiac Dysfunction in Patients with Chronic Kidney Disease

Toxins ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 520 ◽  
Author(s):  
Shanmugakumar Chinnappa ◽  
Yu-Kang Tu ◽  
Yi Chun Yeh ◽  
Griet Glorieux ◽  
Raymond Vanholder ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiac Dysfunction ◽  
Serum Levels ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Uremic Toxins ◽  
Cross Sectional ◽  
The Individual

Although the relationship between protein-bound uremic toxins (PBUTs) and cardiac structure and cardiac mortality in chronic kidney disease (CKD) has been studied in the past, the association between cardiac dysfunction and PBUTs has not yet been studied. We therefore evaluated the association between impaired peak cardiac performance and the serum free and total concentrations of potentially cardiotoxic PBUTs. In a cross-sectional study of 56 male CKD patients (stages 2–5 (pre-dialysis)) who were asymptomatic with no known cardiac diseases or diabetes we measured peak cardiac power (CPOmax), aerobic exercise capacity (VO2max), and echocardiographic parameters of cardiac morphology and evaluated their association with PBUTs. The serum total and free concentrations of indoxyl sulfate (IXS), p-cresyl sulfate (PCS), p-cresyl glucuronide, indole acetic acid, and hippuric acid showed significant negative correlation with CPOmax and VO2max. IXS and PCS were independently associated with CPOmax and VO2max even after controlling for eGFR. No correlation between left ventricular mass index (LVMI) and PBUTs was seen. The present study for the first time has demonstrated the association between subclinical cardiac dysfunction in CKD and serum levels of a panel of PBUTs. Further studies are required to evaluate the mechanism of cardiotoxicity of the individual uremic toxins.

scholarly journals Clinico-biochemical profile of chronic kidney disease patients in elderly age group in a tertiary care centre

2019 ◽  
Vol 7 (11) ◽  
pp. 4227
Author(s):  
Atul V. Rajkondawar ◽  
Amit Yele
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Tertiary Care ◽  
P Value ◽  
Age Group ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Significant Difference

Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.

scholarly journals Silent brain infarcts in chronic kidney disease patients with nonspecific neurological symptoms

2021 ◽  
Vol 9 (4) ◽  
pp. 274-279
Author(s):  
P Sasanka ◽  
◽  
Dr. T. Jaya Chandra ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Exact Test ◽  
Brain Infarcts ◽  
Significant Difference

Introduction: Silent brain infarcts (SBI) are parenchymal lesions of previous infarcts, classified astype III cerebrovascular disorder. A study was undertaken to find the relation between SBIs andnonspecific neurological complaints, an association of high sensitivity C-reactive protein (hsCRP)with silent brain infarcts. Methodology: It was a cross-sectional study conducted in the departmentof Nephrology, GSL Medical College, from January to December 2020. Individuals aged > 18 yearswith nonspecific neurological complaints were included. MRI brain, hsCRP and electrocardiogramwere also carried as per the standard protocol. Fischer exact test was used to find the statisticalsignificance; P < 0.05 was considered statistically significant. Results: A total of 51 members haveincluded the male-female ratio was 1.04. SBI was presented in 27.4% (14). Age-wise, among thecortical SBI patients, maximum (75%) were in the> 61 years group. High density lipoprotein levelswere > 40 mg/dL in 39.2%, normal triglycerides (TGL) were observed in 71% and raised hsCRP in62.7% (32). Statistically, there was no significant difference in TGL levels. hsCRP levels were raisedin 3 (75%) members with cortical SBI; statistically, there was no significant difference. Conclusion:The traditional risk factors associated with stroke were present in the patients with SBI. hsCRP wasraised in chronic kidney disease patients having NSCL and having SBI.

scholarly journals Perbedaan Kadar Hemoglobin pada Penderita Gagal Ginjal Kronik Sebelum dan Setelah Melakukan Hemodialisa

2021 ◽  
Vol 8 (1) ◽  
pp. 146-151
Author(s):  
Virania Arvianti ◽  
◽  
Septian Septian ◽  
Aturut Yansen ◽  
◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Secondary Data ◽  
Sampling Technique ◽  
Chronic Kidney Failure ◽  
Wilcoxon Test ◽  
Cross Sectional ◽  
Significant Difference ◽  
Before And After

IntroductionAnemia is the most common occurrence in chronic kidney disease undergoing hemodialysis therapy. In the condition of chronic kidney disease, the decline in kidney function can occur slowly and chronically until the kidneys do not function at all. Hemodialysis is one of the therapies used to replaced kidney function. During hemodialysis, a decrease in hemoglobin levels often occurs, this is due to the disruption of the hormon erythropoietin. Objective:determine the differences in hemoglobin levels in patients with chronic kidney disease before and after hemodialysis at Bhayangkara TK. I Raden Said SukantoHospital. Method: The design of this research is cross sectional using secondary data and the sampling technique of this research was random sampling with a total of 133 patients. Result: The normality test was carried out first using the Kolmogorov-Smirnova test which showed the results were not normally distributed with a sig value of 0.001. the next test was the Wilcoxon test with a sig (2-tailed_ value of 0.002 with an average hemoglobin level of 8,81 g/dL before hemodialysis and 9,09 g/dL after hemodialysis. Conclusion:Based on the results of the study means that there is a significant difference in a patient with chronic kidney failure before and after hemodialysis.

scholarly journals Cognitive impairment of patients with chronic renal disease on hemodialysis and its relationship with sociodemographic and clinical characteristics

2017 ◽  
Vol 11 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Gabriela Dutra Gesualdo ◽  
Juliana Gomes Duarte ◽  
Marisa Silvana Zazzetta ◽  
Luciana Kusumota ◽  
Karina Gramani Say ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Kidney Disease ◽  
Cognitive Ability ◽  
Clinical Characteristics ◽  
Chronic Renal Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Advanced Stages

ABSTRACT Cognitive impairment and dementia commonly occur in individuals with chronic kidney disease, especially in advanced stages, but are still poorly diagnosed. OBJECTIVE: To evaluate the cognitive ability of patients with chronic kidney disease on hemodialysis and its relationship with sociodemographic and clinical characteristics. METHODS: A cross-sectional study was carried out in a Renal Replacement Therapy Unit in the interior of the State of São Paulo involving 99 patients. The data were collected through an individual interview, using the Sociodemographic and Clinical Characterization questionnaires and the Addenbrooke's Cognitive Examination – Revised (ACE-R) questionnaire. RESULTS: Participants were predominantly male, with a mean age of 54.68 years. The mean ACE-R score was 64.26 points, and 76.76% of patients had lower-than-expected scores, suggesting the presence of cognitive impairment. A moderate, negative correlation was found between total score on the ACE-R and age (r= –0.38, p≤0.001), a moderate positive correlation with years of education (r=0.52, p≤0.001), and a weak positive correlation of total score with hemodialysis time (r=0.26, p≤0.001). CONCLUSION: A relationship was found between cognitive ability and age, years of education and hemodialysis time, suggesting that individuals who were older, had less education and longer hemodialysis time presented greater cognitive impairment.

scholarly journals Dermatological Disorders in Chronic Kidney Disease

2013 ◽  
Vol 52 (190) ◽  
Author(s):  
Aparna Shah ◽  
Rajani Hada ◽  
Bhasker Mohan Mehar Kayastha
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Maintenance Hemodialysis ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Female Ratio ◽  
Nail Changes ◽  
Significant Difference ◽  
Dermatological Disorders ◽  
Mucosal Changes

Introduction: Dermatological conditions are common complications of Chronic Kidney Disease (CKD) affecting all most all patients. Present study aimed to evaluate the dermatological conditions and their association with age, sex and severity of CKD - without and with maintenance hemodialysis (MHD).Methods: It is a cross sectional and comparative study. Eighty-three patients with established CKD, without MHD (n=35) and with MHD (n= 48), attending nephrology unit, Bir Hospital and Shree Birendra Hospital from June 2008 to May 2009 were examined for dermatological disorders.Results: The mean age of patients were 46+15.6 years with male to female ratio of 1.8:1. Comparison of CKD without MHD and with MHD showed no statistical difference of age, sex, duration of treatment, blood urea and haemoglobin and significant difference of serum creatinine (5.3 + 3.0 mg/dl vs 9.1 + 4.5 mg/dl, p<0.001) respectively.Dermatological conditions were found in 100% CKD patients with pallor 91.5%, xerosis 75.9%, pigmentary changes 65%, pruritus 60.2%, skin infection 36.9%, vascular changes 16.8%, mucosal changes 67.4%, hair changes 59%, non -specific nail changes 81.9% and specific nail changes14.4%,.Specific (23.2% vs. 8.4%, p<0.03) and non- specific (91.4% vs 75%, p < 0.05) nail changes and hair abnormalities (74.3% vs. 47.9%, p<0.01) were significantly higher in CKD without MHD.Conclusions: Dermatological conditions are present in all CKD patients with or without MHD. A further prospective study is necessary to find out pathophysiology and beneficial effect of dialysis and transplantation in these conditions.Key words: chronic kidney disease, dermatological disorder, maintenance hemodialysis.

scholarly journals Pharmacogenomics of hypertension in chronic kidney disease: the CKD-PGX study

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0005362021
Author(s):  
Michael T. Eadon ◽  
Judith Maddatu ◽  
Sharon M. Moe ◽  
Arjun D. Sinha ◽  
Ricardo Melo Ferreira ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Antihypertensive Agents ◽  
Pressure Control ◽  
Safety Net ◽  
Uncontrolled Hypertension ◽  
Cross Sectional ◽  
Significant Difference ◽  
Safety Net Hospital

Background: Patients with chronic kidney disease (CKD) often have uncontrolled hypertension despite polypharmacy. Pharmacogenomic drug-gene interactions (DGIs) may impact the metabolism or efficacy of antihypertensive agents. We report changes in hypertension control after providing a panel of 11 pharmacogenomic predictors of antihypertensive response. Methods: A prospective cohort with CKD and hypertension was followed to assess feasibility of pharmacogenomic testing implementation, self-reported provider utilization, and blood pressure control. The analysis population included 382 hypertensive subjects genotyped for cross-sectional assessment of DGIs and 335 subjects followed for 1 year to assess systolic (SBP) and diastolic blood pressure (DBP). Results: Most participants (58.2%) with uncontrolled hypertension had a DGI reducing the efficacy of > 1 antihypertensive agent. Subjects with a DGI had 1.85-fold (95% CI 1.2-2.8) higher odds of uncontrolled hypertension as compared to those without a DGI, adjusted for race, health system (safety net hospital versus other locations) and advanced CKD (eGFR < 30 ml/min). CYP2C9 reduced metabolism genotypes were associated with losartan response and uncontrolled hypertension (Odds Ratio 5.2, CI 1.9 -14.7). CYP2D6 intermediate or poor metabolizers had less frequent uncontrolled hypertension compared to normal metabolizers taking metoprolol or carvedilol (OR 0.55, CI 0.3-0.95). In 335 subjects completing 1 year follow-up, SBP (-4.0 mmHg, CI 1.6- 6.5) and DBP (-3.3 mmHg, CI 2.0-4.6) were improved. No significant difference in SBP or DBP change were found between individuals with and without a DGI. Conclusions: There is a potential role for the addition of pharmacogenomic testing to optimize antihypertensive regimens in patients with CKD.

scholarly journals Protein-Bound Uremic Toxins Lowering Effect of Sevelamer in Pre-Dialysis Chronic Kidney Disease Patients with Hyperphosphatemia: A Randomized Controlled Trial

Toxins ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 688
Author(s):  
Kullaya Takkavatakarn ◽  
Pongpratch Puapatanakul ◽  
Jeerath Phannajit ◽  
Warumphon Sukkumme ◽  
Pajaree Chariyavilaskul ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Randomized Controlled Trial ◽  
Calcium Carbonate ◽  
Kidney Disease ◽  
Controlled Trial ◽  
Uremic Toxins ◽  
Indoxyl Sulfate ◽  
Total Serum ◽  
Randomized Controlled ◽  
Significant Difference

P-cresyl sulfate and indoxyl sulfate are strongly associated with cardiovascular events and all-cause mortality in chronic kidney disease (CKD). This randomized controlled trial was conducted to compare the effects between sevelamer and calcium carbonate on protein-bound uremic toxins in pre-dialysis CKD patients with hyperphosphatemia. Forty pre-dialysis CKD patients with persistent hyperphosphatemia were randomly assigned to receive either 2400 mg of sevelamer daily or 1500 mg of calcium carbonate daily for 24 weeks. A significant decrease of total serum p-cresyl sulfate was observed in sevelamer therapy compared to calcium carbonate therapy (mean difference between two groups −5.61 mg/L; 95% CI −11.01 to −0.27 mg/L; p = 0.04). There was no significant difference in serum indoxyl sulfate levels (p = 0.36). Sevelamer had effects in terms of lowering fibroblast growth factor 23 (p = 0.01) and low-density lipoprotein cholesterol levels (p = 0.04). Sevelamer showed benefits in terms of retarding CKD progression. Changes in vascular stiffness were not found in this study.

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