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Borire AA, Arnold R, Pussell BA, Kwai NC, Visser LH, Simon NG, Kiernan MC, Krishnan AV. Effects of hemodialysis on intraneural blood flow in end-stage kidney disease. Muscle Nerve 2017; 57:287-293. [PMID: 28556350 DOI: 10.1002/mus.25704] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/17/2017] [Accepted: 05/23/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION We quantified intraneural blood flow (INBF) in 18 patients with end-stage kidney disease (ESKD) and examined its relationship with nerve size, neuropathy severity, and nerve excitability parameters. METHODS Sonographic measurements of the median nerve were performed at the same site before and after hemodialysis. INBF was quantified by analyzing power Doppler sonograms to obtain the vessel score (VSc) and maximum perfusion intensity (MPI). Corresponding median motor nerve excitability studies were performed. Neuropathy severity was assessed using Total Neuropathy Score. RESULTS A total of 39% of ESKD patients had detectable INBF compared with none in the control group (P < 0.0001). Patients with detectable INBF had larger nerves and more severe neuropathy (P < 0.01). INBF parameters were significantly reduced after a session of dialysis (VSc: P < 0.01; MPI: P < 0.01). A significant relationship was found between interdialytic change in INBF and changes in nerve excitability. CONCLUSIONS Increased INBF is a potential marker for neuropathy severity in ESKD patients. Muscle Nerve 57: 287-293, 2018.
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Affiliation(s)
- Adeniyi A Borire
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Ria Arnold
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Bruce A Pussell
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Natalie C Kwai
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Leo H Visser
- Elisabeth-Tweesteden Hospital, Department of Neurology, Tilburg, the Netherlands
| | - Neil G Simon
- St Vincent's Clinical School, University of New South Wales, Sydney, Australia.,Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - Arun V Krishnan
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
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Senemar S, Saffari B, Sharifkazemi MB, Bahari M, Jooyan N, Dehaghani ED, Yavarian M. 5,10-methylene tetrahydrofolate reductase C677T gene polymorphism, homocysteine concentration and the extent of premature coronary artery disease in southern Iran. EXCLI J 2013; 12:437-48. [PMID: 26417236 PMCID: PMC4566917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 04/16/2013] [Indexed: 11/29/2022]
Abstract
Elevated level of plasma homocysteine (Hcy) has been identified as an independent risk factor for coronary artery disease (CAD). Furthermore, numerous studies have documented the influences of a common polymorphism (C677T) of methylenetetrahydrofolate reductase (MTHFR) on homocysteine levels. However the relationship between this mutation and cardiovascular diseases (CVD) has remained as a controversial issue. The present study was undertaken to investigate the relationship between C677T polymorphism of MTHFR gene, plasma total Hcy levels and the number of affected vessels as a criterion for the extent of CAD. MTHFR genotypes and plasma homocysteine (HCY) concentrations were examined in 231 patients and 300 healthy subjects who underwent diagnostic coronary angiography. A multiple linear regression analysis was performed to identify the predictors of Hcy levels whereas logistic regression model was built to determine the association of Hcy quartiles with the risk of CAD adjusted for risk factors. The prevalence of MTHFR genotypes was similar between CAD patients and non-CAD individuals while the geometric mean of Hcy values was significantly higher in patient group (14.13 ± 4.11 μmol/l) than in control group (10.19 ± 3.52 μmol/l) (P < 0.001). Moreover, unlike the MTHFR polymorphism, Hcy concentration increased with increasing number of stenosed vessels and the CAD risk increased about 2 folds in the top two Hcy quartiles (≥ 17.03 and 13.20-17.02 μmol/l) compared with the lowest quartile (≤ 9.92 μmol/l) after controlling for conventional risk factors (P<0.001 for both). Our data suggest that hyperhomocysteinaemia (HHcy) is significantly associated to CAD risk increase as well as to the extent of coronary atherosclerosis.
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Affiliation(s)
- Sara Senemar
- Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Province Branch, Shiraz 71347, Iran
| | - Babak Saffari
- Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Province Branch, Shiraz 71347, Iran,School of Biology, College of Sciences, University of Tehran, Tehran 14155-6455, Iran,*To whom correspondence should be addressed: Babak Saffari, Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Province Branch, Shiraz 71347, Iran. Tel: +98 711 2303662; Fax: +98 711 2337851, E-mail:
| | | | - Marzieh Bahari
- Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Province Branch, Shiraz 71347, Iran
| | - Najmeh Jooyan
- Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Province Branch, Shiraz 71347, Iran,Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran 13145-1384, Iran
| | - Elham Davoudi Dehaghani
- Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Province Branch, Shiraz 71347, Iran,Medical Genetics Department, Tehran University of Medical Sciences, Tehran 14155-6447, Iran
| | - Majid Yavarian
- Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937, Iran
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