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Diforti JF, Cunningham T, Piccinini E, Marmisollé WA, Piccinini JM, Azzaroni O. Noninvasive and Multiplex Self-Test of Kidney Disease Biomarkers with Graphene-Based Lab-on-a-Chip (G-LOC): Toward Digital Diagnostics in the Hands of Patients. Anal Chem 2024; 96:5832-5842. [PMID: 38573917 DOI: 10.1021/acs.analchem.3c05148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Chronic kidney disease is one of the major health issues worldwide. However, diagnosis is now highly centralized in large laboratories, resulting in low access to patient monitoring and poor personalized treatments. This work reports the development of a graphene-based lab-on-a-chip (G-LOC) for the digital testing of renal function biomarkers in serum and saliva samples. G-LOC integrates multiple bioelectronic sensors with a microfluidic system that enables multiplex self-testing of urea, potassium, sodium, and chloride. The linearity, limit of detection (LOD), accuracy, and coefficient of variability (CV) were studied. Accuracy values higher than 95.5% and CV lower than 9% were obtained for all of the biomarkers. The analytical performance was compared against three reference lab benchtop analyzers by measuring healthy- and renal-failure-level samples of serum. From receiver operating characteristic (ROC) plots, sensitivities (%) of 99.7, 97.6, 99.1, and 89.0 were obtained for urea, potassium, sodium, and chloride, respectively. Then, the test was evaluated in noninvasive saliva samples and compared against reference methods. Correlation and Bland-Altman plots showed good correlation and agreement of the G-LOC with the reference methods. It is noteworthy that the precision of G-LOC was similar to better than benchtop lab analyzers, with the advantage of being highly portable. Finally, a user testing study was conducted. The analytical performance obtained with untrained volunteers was similar to that obtained with trained chemists. Additionally, based on a user experience survey, G-LOC was found to have very simple usability and would be suitable for at-home diagnostics.
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Affiliation(s)
- Joaquin F Diforti
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)-Departamento de Química-Facultad de Ciencias Exactas, Universidad Nacional de La Plata (UNLP), CONICET. 64 and 113, 1900 Buenos Aires, Argentina
- Department of Bioelectronic, GISENS BIOTECH, 2150 Shattuck Ave PH, Berkeley, California 94704, United States
| | - Thomas Cunningham
- Department of Bioelectronic, GISENS BIOTECH, 2150 Shattuck Ave PH, Berkeley, California 94704, United States
| | - Esteban Piccinini
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)-Departamento de Química-Facultad de Ciencias Exactas, Universidad Nacional de La Plata (UNLP), CONICET. 64 and 113, 1900 Buenos Aires, Argentina
| | - Waldemar A Marmisollé
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)-Departamento de Química-Facultad de Ciencias Exactas, Universidad Nacional de La Plata (UNLP), CONICET. 64 and 113, 1900 Buenos Aires, Argentina
| | - Jose M Piccinini
- Department of Bioelectronic, GISENS BIOTECH, 2150 Shattuck Ave PH, Berkeley, California 94704, United States
| | - Omar Azzaroni
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)-Departamento de Química-Facultad de Ciencias Exactas, Universidad Nacional de La Plata (UNLP), CONICET. 64 and 113, 1900 Buenos Aires, Argentina
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Joshi NP, Shrestha A, Bhagat T, Agrawal SK, Chhetri R. The Oral Health Condition of Patients on Hemodialysis at a Tertiary Healthcare Facility in Eastern Nepal. Int J Dent 2024; 2024:3776702. [PMID: 38375436 PMCID: PMC10876310 DOI: 10.1155/2024/3776702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
Objectives This study was done to compare the oral health of chronic kidney disease (CKD) patients on hemodialysis to healthy individuals and to assess the effect of the duration of dialysis on oral health. Materials and Methods A comparative cross-sectional study was conducted among purposively selected 54 cases undergoing dialysis and 54 apparently healthy controls. Caries experience and periodontal status were recorded under similar examination conditions and compared between cases and controls. The correlation between oral health and the duration of dialysis was assessed. A p value of <0.05 was considered significant. Results The mean age of the participants was 47.09 ± 12.23 years. Median caries experience among cases and controls was two (0-26) and three (0-15), respectively (p=0.013). Periodontitis among the two groups was found to be significantly different with a greater number of cases showing increased severity (p < 0.001). The severe form of periodontitis was associated with a greater mean duration of dialysis. Conclusion Significant differences exist between the periodontal health of patients undergoing dialysis compared to healthy controls. Longitudinal studies are required to check the causal effect of CKD on periodontitis.
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Affiliation(s)
| | - Ashish Shrestha
- Department of Public Health Dentistry, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Tarakant Bhagat
- Department of Public Health Dentistry, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Santosh Kumari Agrawal
- Department of Public Health Dentistry, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Roshan Chhetri
- Department of Internal Medicine, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
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Basilicata M, Pieri M, Marrone G, Nicolai E, Di Lauro M, Paolino V, Tomassetti F, Vivarini I, Bollero P, Bernardini S, Noce A. Saliva as Biomarker for Oral and Chronic Degenerative Non-Communicable Diseases. Metabolites 2023; 13:889. [PMID: 37623833 PMCID: PMC10456419 DOI: 10.3390/metabo13080889] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Saliva is a very complex fluid and it is essential to maintain several physiological processes and functions, including oral health, taste, digestion and immunological defenses. Saliva composition and the oral microbiome can be influenced by several factors, like diet and smoking habits, and their alteration can represent an important access point for pathogens and, thus, for systemic illness onset. In this review, we explore the potentiality of saliva as a new tool for the early detection of some pathological conditions, such as oral diseases, chronic degenerative non-communicable diseases, among these chronic kidney disease (CKD). We also examined the possible correlation between oral and systemic diseases and oral and gut microbiota dysbiosis. In particular, we deeply analyzed the relationship between oral diseases and CKD. In this context, some salivary parameters can represent a new device to detect either oral or systemic pathologies. Moreover, the positive modulation of oral and gut microbiota induced by prebiotics, postbiotics, or symbiotics could represent a new possible adjuvant therapy in the clinical management of oral diseases and CKD.
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Affiliation(s)
- Michele Basilicata
- UOSD Special Care Dentistry, Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Giulia Marrone
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Eleonora Nicolai
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Manuela Di Lauro
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenza Paolino
- UOSD Special Care Dentistry, Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Flaminia Tomassetti
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Ilaria Vivarini
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Patrizio Bollero
- UOSD Special Care Dentistry, Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Annalisa Noce
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- UOSD Nephrology and Dialysis, Policlinico Tor Vergata, 00133 Rome, Italy
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Sangalli L, Eldomiaty W, Miller CS. Xerogenic medications may contribute to decreased unstimulated salivary flow in patients with oral burning and/or gastro-esophageal reflux disease. FRONTIERS IN DENTAL MEDICINE 2023. [DOI: 10.3389/fdmed.2023.1047235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
BackgroundPatients who complain of mucosal burning sensations (i.e., glossodynia and gastro-esophageal reflux disease, GERD) often take multiple medications. However, the relationship between xerogenic medication intake and salivary flow in these patients has not been thoroughly examined.MethodsA retrospective study of 192 consecutive patients diagnosed with glossodynia (ICD-10-CM) at a regional center over a six-year period was performed. Data from electronic health records were extracted and relationships between medication intake, unstimulated whole salivary flow rate (UWSFR), xerostomia and GERD were determined by chi-square, t-test, and correlation analysis.ResultsOf 134 records that met inclusion criteria, 87.1% of patients reported daily intake of one or more xerogenic medications. Two or more xerogenic medications were taken significantly more often by patients with glossodynia reporting GERD than those with glossodynia without GERD (p = .02). UWSFR was negatively correlated with number of medications [r(103) = −.277, p = .005] and xerogenic medications [r(103) = −.195, p = .049]. The lowest UWSFR was observed with use of trazodone and cyclobenzaprine.ConclusionsDaily xerogenic medication intake, hyposalivation, and xerostomia were commonly present and potentially interrelated in patients who suffer from glossodynia and/or GERD.Practical implicationsClinicians should be aware of the consequences of prescribing multiple and certain xerogenic medications in reducing UWSFR, especially in patients physiologically at risk of hyposalivation such as those suffering from GERD and/or glossodynia.
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LIMITED EVIDENCE SUGGESTS THAT END STAGE KIDNEY DISEASE AND HEMODIALYSIS MAY IMPACT SALIVARY FLOW RATE AND COMPOSITION. J Evid Based Dent Pract 2022; 22:101757. [DOI: 10.1016/j.jebdp.2022.101757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bal Ozkaptan B, Aydin Sayilan A, Unver V, Ozen N. The reliability and validity of the Turkish version of the Shortened Xerostomia Inventory in hemodialysis patients. Ther Apher Dial 2022; 26:797-805. [PMID: 35438251 DOI: 10.1111/1744-9987.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to translate, linguistically validate and evaluate the psychometric properties of the Shortened Xerostomia Inventory (SXI) among Turkish patients undergoing hemodialysis. METHODS The study was conducted with 81 chronic hemodialysis patients in the hemodialysis units of two state hospitals between June and August 2020. Explanatory Factor Analysis (EFA) were implemented to test the construct validity. In addition, the test-retest method was performed to test the reliability and consistency of the scale over time. RESULTS A total of 81 patients participated in the study. The Cronbach's alpha coefficient of SXI was 0.788. The mean values for the test was 12.84±6.78 and re-test scores was 11.03±6.88. ICC value calculated as 0.992 and accordingly a statistically significant relationship between the test and retest scores (p<0.001). CONCLUSIONS Our study showed that the SXI is a valid and reliable measurement tool for Turkish hemodialysis patients.
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Affiliation(s)
- Bilge Bal Ozkaptan
- Sinop University Faculty of Health Sciences, Nursing Department, Sinop, Turkey
| | - Aylin Aydin Sayilan
- Kırklareli University Faculty of Health Science, Nursing Department, Kırklareli, Turkey
| | - Vesile Unver
- Acıbadem Mehmet Ali Aydınlar University, Faculty of Health Sciences, Nursing Department, Istanbul, Turkey
| | - Nurten Ozen
- Demiroglu Bilim University Florence Nightingale Hospital School of Nursing, Istanbul, Turkey
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Xie H, Zheng X, Huang Y, Li W, Wang W, Li Q, Hou J, Luo L, Kuang X, Lin CQ. Diurnal pattern of salivary alpha-amylase and cortisol under citric acid stimulation in young adults. PeerJ 2022; 10:e13178. [PMID: 35433126 PMCID: PMC9012170 DOI: 10.7717/peerj.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/07/2022] [Indexed: 01/12/2023] Open
Abstract
Background Saliva composition has diurnal variations. Citric acid stimulation plays a major role in the change of salivary flow rate and salivary composition. However, diurnal variations and sex differences in salivary alpha-amylase (sAA), pH, salivary flow rate (SFR), and salivary cortisol before and after citric acid stimulation remain unclear. Methods We recruited 30 healthy volunteers, including 15 women (24.7 ± 1.0 years old) and 15 men (25.3 ± 1.3 years old). At four time points (T1, 7:00; T2, 10:00; T3, 16:00; and T4, 20:00), saliva was collected from healthy volunteers before and after citric acid stimulation; and sAA, pH, SFR and salivary cortisol were measured and compared between men and women. Results There were circadian fluctuations in sAA activity, SFR, pH, and cortisol level both before and after citric acid stimulation, and the diurnal fluctuations of these indexes were not affected by citric acid stimulation. There were significant differences in salivary cortisol between men and women before and after acid stimulation in T1. Neither SFR nor pH showed sex-related differences before or after acid stimulation. The variation trend of sAA activity was contrary to that of cortisol, with a significant negative correlation. Conclusions Our data suggest that sAA and cortisol showed diurnal fluctuation, and the variation characteristics of male and female under resting state and acid stimulation were basically the same. The variation trend of salivary alpha-amylase activity was opposite to that of cortisol, with significant negative correlation. Our findings may enable the selection of the correct sampling time for research and the selection of appropriate sampling strategies in studies investigating chronic psychosocial conditions.
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Affiliation(s)
- Haimei Xie
- Guangzhou University of Traditional Chinese Medicine, Science and Technology Innovation Center, Guangzhou, Guangdong, China,Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaomei Zheng
- Guangzhou University of Traditional Chinese Medicine, Science and Technology Innovation Center, Guangzhou, Guangdong, China,Guangzhou University of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ye Huang
- Guangzhou University of Traditional Chinese Medicine, Science and Technology Innovation Center, Guangzhou, Guangdong, China
| | - Weihao Li
- Guangzhou University of Traditional Chinese Medicine, Science and Technology Innovation Center, Guangzhou, Guangdong, China
| | - Wenkai Wang
- Guangzhou University of Traditional Chinese Medicine, Science and Technology Innovation Center, Guangzhou, Guangdong, China
| | - Qiao Li
- Guangzhou University of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiangtao Hou
- Guangzhou University of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Lulu Luo
- Guangzhou University of Traditional Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiuying Kuang
- Guangzhou University of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chuan-quan Lin
- Guangzhou University of Traditional Chinese Medicine, Science and Technology Innovation Center, Guangzhou, Guangdong, China
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Rodrigues RPCB, Vidigal MTC, Vieira WA, Nascimento GG, Sabino-Silva R, Blumenberg C, Siqueira MF, Siqueira WL, Paranhos LR. Salivary changes in chronic kidney disease and in patients undergoing hemodialysis: a systematic review and meta-analysis. J Nephrol 2022; 35:1339-1367. [PMID: 35235185 DOI: 10.1007/s40620-022-01274-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/06/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study is aimed at describing changes in salivary flow rate and ionic composition present in the saliva of chronic kidney disease (CKD) patients by assessing the pH, calcium, phosphate, and phosphorus concentrations and comparing them to healthy individuals, along with exploring the influence of hemodialysis on these parameters. METHODS The bibliographical search was performed in nine databases to find all types of studies, including observational clinical studies, without restrictions regarding publication year or language. Two reviewers selected the studies, extracted the data, and assessed the risk of bias using JBI tools. Random-effect meta-analysis was performed with the standardized mean difference (SMD) as effect estimate, at a 95% confidence interval. RESULTS Thirty-three studies were included in the qualitative synthesis and 31 studies were included in the meta-analysis. Chronic kidney disease patients presented lower salivary flow rate (SMD: - 1.73; 95% CI = - 2.14; - 1.31), higher pH (SMD: 1.57; 95% CI = 1.11; 2.03), and higher phosphorus concentration (SMD: 0.86; 95% CI = 0.63; 1.09) in saliva. Concurrently, salivary flow rate and pH presented significant changes after hemodialysis, with higher salivary flow rate (SMD: 0.53; 95% CI = 0.25; 0.81) and lower pH (SMD: - 0.53; 95% CI = - 0.88; - 0.19) in patients on hemodialysis treatment. CONCLUSION Chronic kidney disease patients present reduced salivary flow rate and increased pH and phosphorus concentration in saliva. Hemodialysis can increase the salivary flow rate of these patients.
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Affiliation(s)
- Renata Prata Cunha Bernardes Rodrigues
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Campus Umuarama, Av. Pará, 1720, Bloco 2G, sala 1, Uberlândia, Minas Gerais, 38405-320, Brazil
| | | | - Walbert A Vieira
- Endodontics Division, Department of Restorative Dentistry, School of Dentistry of Piracicaba, State University of Campinas, UNICAMP, Piracicaba, Brazil
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Robinson Sabino-Silva
- Innovation Center in Salivary Diagnostics and Nanotheranostics, Department of Physiology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Cauane Blumenberg
- Department of Social Medicine, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Walter L Siqueira
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Campus Umuarama, Av. Pará, 1720, Bloco 2G, sala 1, Uberlândia, Minas Gerais, 38405-320, Brazil.
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