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

Takkavatakarn, Kullaya; Puapatanakul, Pongpratch; Phannajit, Jeerath; Sukkumme, Warumphon; Chariyavilaskul, Pajaree; Sitticharoenchai, Patita; Leelahavanichkul, Asada; Katavetin, Pisut; Praditpornsilpa, Kearkiat; Eiam‐Ong, Somchai; Susantitaphong, Paweena

doi:10.3390/toxins13100688

Cited by 6 publications

(3 citation statements)

References 33 publications

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“…In recent years, therapeutic strategies have also been developed aiming at lowering PBUTs, mainly represented by the serum concentrations of PCS and IS in CKD patients to observe their beneficial effects, including prebiotic [ 26–28 ], Curcumin [ 29 ], Shen-Shuai-Ning [ 17 ], and Sevelamer [ 30 , 31 ]. Our group previously conducted a case-control study investigating the effect of Shen-Shuai-Ning granule on the serum PCS and IS concentrations in 60 PD patients.…”

Section: Discussionmentioning

confidence: 99%

p -Cresyl sulfate predicts clinical outcomes in sustained peritoneal dialysis: a 5-year follow-up cohort study and meta-analysis

Chen

Xing

et al. 2022

Renal Failure

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Background The impact of p -cresyl sulfate (PCS) and indoxyl sulfate (IS) on the prognosis of patients with uremia remains controversial. We performed a prospective study on peritoneal dialysis (PD) to investigate the relationship between PCS or IS levels with clinical outcomes. Methods This prospective cohort study investigated the association of serum PCS and IS with clinical outcomes in patients undertaking PD. We performed a correlations analysis to explore the influencing factors of PCS an IS. Meta-analysis was conducted to objectively evaluate the prognostic effects of PCS and IS on different stages of CKD patients. Results A total of 127 patients were enrolled consecutively and followed with an average period of 51.3 months. Multivariate Cox regression showed that serum total PCS not only contributed to the occurrence of PD failure event (HR: 1.05, 95% CI = 1.02 to 1.07, p < 0.001), but also increased the risk of cardiovascular event (HR: 1.08, 95% CI = 1.04 to 1.13, p < 0.001) and PD-associated peritonitis (HR: 1.04, 95% CI = 1.02 to 1.08, p = 0.001). Dividing the total PCS level by 18.99 mg/L, which was calculated from the best cutoff value of the ROC curve, patients with total PCS higher than 18.99 mg/L had worse prognosis. Meta-analysis confirmed its value in cardiovascular event in PD. Conclusion The serum total PCS concentration was a detrimental factor for higher PD failure event, cardiovascular event, and PD-associated peritonitis. It could be used as an innovative marker in predicting poor clinical outcome in PD.

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Section: Discussionmentioning

confidence: 99%

p -Cresyl sulfate predicts clinical outcomes in sustained peritoneal dialysis: a 5-year follow-up cohort study and meta-analysis

Chen

Xing

et al. 2022

Renal Failure

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“…A trial randomly assigned 40 patients with advanced non-dialysis CKD (90% were CKD G5), to receive either sevelamer carbonate or calcium carbonate before meals. At the 24-week follow-up, serum p-cresyl sulfate levels were reduced in the sevelamer arm but serum indoxyl sulfate concentrations remained unchanged [17].…”

Section: Pharmacological Treatmentmentioning

confidence: 92%

Rationale for a New Classification of Solutes of Interest in Chronic Kidney Disease and Hemodialysis

et al. 2023

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A hallmark of chronic kidney disease is the retention of solutes that normally are eliminated by the kidneys. The current classification defines uremic toxins based on molecular weight and protein affinity. The retention of solutes is already detected in the early stages of the disease when patients are pauci-symptomatic or asymptomatic but the role of therapies to retard the loss of kidney function in patients with chronic kidney disease (e.g., modulators of the renin-angiotensin-aldosterone system, sodium-glucose cotransporter inhibitors) in reducing uremic toxins is poorly understood. Most of the research evaluating the impact of therapies to lower serum concentrations of those toxic compounds is carried out in patients with kidney failure already undergoing kidney replacement therapy. The removal of those molecules relies in physicochemical mass transfer phenomena, i.e., adsorption, diffusion, and convection. In the past 2 decades, the rise and broad adoption of blood purification strategies with enhanced convective properties, such as high-volume online hemodiafiltration and expanded hemodialysis, considerably amplified the ability to mechanically extract middle molecules (molecular weight >0.5 kDa) from the blood compartment. Nonetheless, the classification of uremic toxins has not evolved in parallel with dialysis advancements. Mounting evidence demonstrates the link between middle molecules with uremic symptoms, cardiovascular and mortality risks. An urgent need for updating the classification exists. Defining the causative relationship between specific solutes and specific clinical outcomes will promote the development of targeted therapies. In parallel, the inclusion of new pertinent dimensions to the classification like the influence of new dialysis membranes, sorbents, and intestinal chelators in the concentration of uremic toxins would improve the understanding of the pathogenesis of chronic kidney disease, setting the pace for future research in nephrology.

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“…Patients undergoing hemodialysis will also experience an imbalance in protein energy that causes patients will experience a diminution of muscle (Schlüter et al, 2020). More low muscle mass is also associated with a disturbance function physical, and research latest has researching have more muscle mass low look height internal fat content body in the dialysis population (sarcopenic obesity ) as well find that sarcopenic obesity is associated with condition physique, performance and extremity-poor bottom (Sheshadri, Kittiskulnam, et al, 2020); thus in patients hemodialysis importance guard intake nutrition to stay in the circumstances good nutrition and avoid from disturbance function physical (Takkavatakarn et al, 2021).…”

Section: Alireza Et Al (2019)mentioning

confidence: 99%

Identification of Maslow's Hierarchy Needs in Patients Undergoing Hemodialysis in The Hemodialysis Room: Scoping Review

Arofiati

2023

jika

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Background: Chronic kidney disease is a syndrome of the kidney and a national health problem with significant morbidity and mortality. This disease not only attacks physically but also attacks psychologically. Patients undergoing hemodialysis therapy require actions according to what the patient needs. Method: The journal selection method uses PRISMA using databases at Scopus, Pubmed, ProQuest, and Sciencedirect. Results: A total of 11 studies of 2415 articles were included in this study with 2244 respondents. Most of the research discusses psychological needs (n:8). On the other hand, what is least discussed is the need for belonging and love and the need for self-esteem (n:2). Based on research conducted by previous researchers, patients undergoing hemodialysis have several factors that support the needs of chronic kidney failure patients. Conclusion: The needs of hemodialysis patients can be explained through Maslow's hierarchy theory. This theory suggests that humans have tiered needs, starting from the most basic needs to more complex needs. In this literature, the most widely needed need is physiological needs. So that nurse intervention can meet the needs of hemodialysis patients by paying attention to and meeting the needs at each level of Maslow's hierarchy optimally.

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

Cited by 6 publications

References 33 publications

p -Cresyl sulfate predicts clinical outcomes in sustained peritoneal dialysis: a 5-year follow-up cohort study and meta-analysis

p -Cresyl sulfate predicts clinical outcomes in sustained peritoneal dialysis: a 5-year follow-up cohort study and meta-analysis

Rationale for a New Classification of Solutes of Interest in Chronic Kidney Disease and Hemodialysis

Identification of Maslow's Hierarchy Needs in Patients Undergoing Hemodialysis in The Hemodialysis Room: Scoping Review

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