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Kang M, Oh J, Kim M, Byeon SH, Kim SS, Shin JY. Extracellular fluid excess linked to reduced choroidal vascularity index in patients with chronic kidney disease. Sci Rep 2024; 14:12769. [PMID: 38834727 DOI: 10.1038/s41598-024-63444-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
Extracellular fluid (ECF) excess is common in patients with chronic kidney disease (CKD). This study (involving 284 patients with CKD) explored the association between choroidal vascularity index (CVI) and ECF excess. We categorised patients into three groups based on extracellular water/total body water: normal, mildly overhydrated, and severely overhydrated. The more severe ECF status was associated with a lower CVI after adjustment (B = - 0.902, p = 0.001). In non-diabetic patients, both vascular luminal (LA, p < 0.001) and stromal areas (SA, p = 0.003) were significantly reduced in patients with severe ECF excess compared to others, whereas diabetic patients showed no significant differences in LA (p = 0.96) and SA (p = 0.86) based on ECF excess status. These findings suggest that ECF status may influence CVI in patients with CKD, underscoring the need for further research to clarify its direct impact on choroidal changes.
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Affiliation(s)
- Minjae Kang
- Department of Ophthalmology, Institute of Vision Research, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Jongrok Oh
- Department of Ophthalmology, Institute of Vision Research, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joo Youn Shin
- Department of Ophthalmology, Institute of Vision Research, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
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Duan S, Ma Y, Lu F, Zhang C, Guo H, Zeng M, Sun B, Yuan Y, Xing C, Mao H, Zhang B. High sodium intake and fluid overhydration predict cardiac structural and functional impairments in chronic kidney disease. Front Nutr 2024; 11:1388591. [PMID: 38860161 PMCID: PMC11164051 DOI: 10.3389/fnut.2024.1388591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/14/2024] [Indexed: 06/12/2024] Open
Abstract
Background High sodium intake and fluid overhydration are common factors of and strongly associated with adverse outcomes in chronic kidney disease (CKD) patients. Yet, their effects on cardiac dysfunction remain unclear. Aims The study aimed to explore the impact of salt and volume overload on cardiac alterations in non-dialysis CKD. Methods In all, 409 patients with CKD stages 1-4 (G1-G4) were enrolled. Daily salt intake (DSI) was estimated by 24-h urinary sodium excretion. Volume status was evaluated by the ratio of extracellular water (ECW) to total body water (TBW) measured by body composition monitor. Recruited patients were categorized into four groups according to DSI (6 g/day) and median ECW/TBW (0.439). Echocardiographic and body composition parameters and clinical indicators were compared. Associations between echocardiographic findings and basic characteristics were performed by Spearman's correlations. Univariate and multivariate binary logistic regression analysis were used to determine the associations between DSI and ECW/TBW in the study groups and the incidence of left ventricular hypertrophy (LVH) and elevated left ventricular filling pressure (ELVFP). In addition, the subgroup effects of DSI and ECW/TBW on cardiac abnormalities were estimated using Cox regression. Results Of the enrolled patients with CKD, the median urinary protein was 0.94 (0.28-3.14) g/d and estimated glomerular filtration rate (eGFR) was 92.05 (IQR: 64.52-110.99) mL/min/1.73 m2. The distributions of CKD stages G1-G4 in the four groups was significantly different (p = 0.020). Furthermore, compared to group 1 (low DSI and low ECW/TBW), group 4 (high DSI and high ECW/TBW) showed a 2.396-fold (95%CI: 1.171-4.902; p = 0.017) excess risk of LVH and/or ELVFP incidence after adjusting for important CKD and cardiovascular disease risk factors. Moreover, combined with eGFR, DSI and ECW/TBW could identify patients with higher cardiac dysfunction risk estimates with an AUC of 0.704 (sensitivity: 75.2%, specificity: 61.0%). The specificity increased to 85.7% in those with nephrotic proteinuria (AUC = 0.713). The magnitude of these associations was consistent across subgroups analyses. Conclusion The combination of high DSI (>6 g/d) and high ECW/TBW (>0.439) independently predicted a greater risk of LVH or ELVFP incidence in non-dialysis CKD patients. Moreover, the inclusion of eGFR and proteinuria improved the risk stratification ability of DSI and ECW/TBW in cardiac impairments in CKD.
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Yang L, Ni Y, Jiang C, Liu L, Zhang S, Liu J, Sun L, Xu W. A neuromorphic device mimicking synaptic plasticity under different body fluid K + homeostasis for artificial reflex path construction and pattern recognition. FUNDAMENTAL RESEARCH 2024; 4:353-361. [PMID: 38933504 PMCID: PMC11197765 DOI: 10.1016/j.fmre.2022.03.024] [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: 12/14/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/22/2022] Open
Abstract
The ionic environment of body fluids influences nervous functions for maintaining homeostasis in organisms and ensures normal perceptual abilities and reflex activities. Neural reflex activities, such as limb movements, are closely associated with potassium ions (K+). In this study, we developed artificial synaptic devices based on ion concentration-adjustable gels for emulating various synaptic plasticities under different K+ concentrations in body fluids. In addition to performing essential synaptic functions, potential applications in information processing and associative learning using short- and long-term plasticity realized using ion concentration-adjustable gels are presented. Artificial synaptic devices can be used for constructing an artificial neural pathway that controls artificial muscle reflex activities and can be used for image pattern recognition. All tests show a strong relationship with ion homeostasis. These devices could be applied to neuromorphic robots and human-machine interfaces.
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Affiliation(s)
- Lu Yang
- Institute of Photoelectronic Thin Film Devices and Technology, Key Laboratory of Optoelectronic Thin Film Devices and Technology of Tianjin, Engineering Research Center of Thin Film Photoelectronic Technology, Ministry of Education, Nankai University, Tianjin 300350, China
- Shenzhen Research Institute of Nankai University, Shenzhen 518000, China
| | - Yao Ni
- Institute of Photoelectronic Thin Film Devices and Technology, Key Laboratory of Optoelectronic Thin Film Devices and Technology of Tianjin, Engineering Research Center of Thin Film Photoelectronic Technology, Ministry of Education, Nankai University, Tianjin 300350, China
- Shenzhen Research Institute of Nankai University, Shenzhen 518000, China
| | - Chengpeng Jiang
- Institute of Photoelectronic Thin Film Devices and Technology, Key Laboratory of Optoelectronic Thin Film Devices and Technology of Tianjin, Engineering Research Center of Thin Film Photoelectronic Technology, Ministry of Education, Nankai University, Tianjin 300350, China
- Shenzhen Research Institute of Nankai University, Shenzhen 518000, China
| | - Lu Liu
- Institute of Photoelectronic Thin Film Devices and Technology, Key Laboratory of Optoelectronic Thin Film Devices and Technology of Tianjin, Engineering Research Center of Thin Film Photoelectronic Technology, Ministry of Education, Nankai University, Tianjin 300350, China
- Shenzhen Research Institute of Nankai University, Shenzhen 518000, China
| | - Song Zhang
- Institute of Photoelectronic Thin Film Devices and Technology, Key Laboratory of Optoelectronic Thin Film Devices and Technology of Tianjin, Engineering Research Center of Thin Film Photoelectronic Technology, Ministry of Education, Nankai University, Tianjin 300350, China
- Shenzhen Research Institute of Nankai University, Shenzhen 518000, China
| | - Jiaqi Liu
- Institute of Photoelectronic Thin Film Devices and Technology, Key Laboratory of Optoelectronic Thin Film Devices and Technology of Tianjin, Engineering Research Center of Thin Film Photoelectronic Technology, Ministry of Education, Nankai University, Tianjin 300350, China
- Shenzhen Research Institute of Nankai University, Shenzhen 518000, China
| | - Lin Sun
- Institute of Photoelectronic Thin Film Devices and Technology, Key Laboratory of Optoelectronic Thin Film Devices and Technology of Tianjin, Engineering Research Center of Thin Film Photoelectronic Technology, Ministry of Education, Nankai University, Tianjin 300350, China
- Shenzhen Research Institute of Nankai University, Shenzhen 518000, China
| | - Wentao Xu
- Institute of Photoelectronic Thin Film Devices and Technology, Key Laboratory of Optoelectronic Thin Film Devices and Technology of Tianjin, Engineering Research Center of Thin Film Photoelectronic Technology, Ministry of Education, Nankai University, Tianjin 300350, China
- Shenzhen Research Institute of Nankai University, Shenzhen 518000, China
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Andreev VP, Helmuth ME, Smith AR, Zisman A, Cameron AP, DeLancey JOL, Bushman WA. Dynamic analysis of the individual patterns of intakes, voids, and bladder sensations reported in bladder diaries collected in the LURN study. PLoS One 2023; 18:e0284544. [PMID: 37983243 PMCID: PMC10659201 DOI: 10.1371/journal.pone.0284544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023] Open
Abstract
The goal of this study was to develop the novel analytical approach and to perform an in-depth dynamic analysis of individual bladder diaries to inform which behavioral modifications would best reduce lower urinary tract symptoms, such as frequency and urgency. Three-day bladder diaries containing data on timing, volumes, and types of fluid intake, as well as timing, volumes, and bladder sensation at voids were analyzed for 197 participants with lower urinary tract symptoms. A novel dynamic analytic approach to bladder diary time series data was proposed and developed, including intra-subject correlations between time-varying variables: rates of intake, bladder filling rate, and urge growth rate. Grey-box models of bladder filling rate and multivariable linear regression models of urge growth rate were developed for individual diaries. These models revealed that bladder filling rate, rather than urine volume, was the primary determinant of urinary frequency and urgency growth rate in the majority of participants. Simulations performed with the developed models predicted that the most beneficial behavioral modifications to reduce the number of urgency episodes are those that smooth profiles of bladder filling rate, which might include behaviors such as exclusion of caffeine and alcohol and/or other measures, e.g., increasing number and decreasing volumes of intakes.
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Affiliation(s)
- Victor P. Andreev
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
| | - Margaret E. Helmuth
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
| | - Abigail R. Smith
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
| | - Anna Zisman
- Section of Nephrology, University of Chicago, Chicago, IL, United States of America
| | - Anne P. Cameron
- Department of Urology, University of Michigan, Ann Arbor, MI, United States of America
| | - John O. L. DeLancey
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States of America
| | - Wade A. Bushman
- Department of Urology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States of America
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Andreev VP, Helmuth ME, Smith AR, Zisman A, Cameron AP, DeLancey JOL, Bushman WA. Dynamic analysis of the individual patterns of intakes, voids, and bladder sensations reported in bladder diaries collected in the LURN study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.05.23288100. [PMID: 37066258 PMCID: PMC10104230 DOI: 10.1101/2023.04.05.23288100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
The goal of this study was to perform an in-depth dynamic analysis of individual bladder diaries to inform which behavioral modifications would best reduce lower urinary tract symptoms, such as frequency and urgency. Three-day bladder diaries containing data on timing, volumes, and types of fluid intake, as well as timing, volumes, and bladder sensation at voids were analyzed for 197 participants with lower urinary tract symptoms. A novel dynamic analytic approach to bladder diary time series data was proposed and developed, including intra-subject correlations between time-varying variables: rates of intake, bladder filling rate, and urge growth rate. Grey-box models of bladder filling rate and multivariable linear regression models of urge growth rate were developed for individual diaries. These models revealed that bladder filling rate, rather than urine volume, was the primary determinant of urinary frequency and urgency growth rate in the majority of participants. Simulations performed with the developed models predicted that the most beneficial behavioral modifications to reduce the number of urgency episodes are those that smooth profiles of bladder filling rate, which might include behaviors such as exclusion of caffeine and alcohol and/or other measures, e.g., increasing number and decreasing volumes of intakes.
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Affiliation(s)
| | | | | | - Anna Zisman
- Section of Nephrology, University of Chicago, Chicago IL, US
| | - Anne P. Cameron
- Department of Urology, University of Michigan, Ann Arbor MI, US
| | - John O. L. DeLancey
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor MI, US
| | - Wade A. Bushman
- Department of Urology, School of Medicine and Public Health, University of Wisconsin, Madison WI, US
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Park S, Lee CJ, Jhee JH, Yun HR, Kim H, Jung SY, Kee YK, Yoon CY, Park JT, Kim HC, Han SH, Kang SW, Park S, Yoo TH. Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease. J Am Heart Assoc 2018; 7:e008935. [PMID: 29960990 PMCID: PMC6064889 DOI: 10.1161/jaha.118.008935] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/21/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Extracellular fluid (ECF) excess is an independent predictor of cardiovascular morbidity in patients undergoing dialysis. This study aimed to investigate the relationship between ECF status, which is affected by renal function, and coronary artery calcification (CAC), which is a marker of cardiovascular disease, in patients with chronic kidney disease (CKD). METHODS AND RESULTS A total of 1741 patients at all stages of pre-dialysis CKD from the prospective observational cohort of CMERC-HI (Cardiovascular and Metabolic Disease Etiology Research Center-High Risk) were analyzed for the association between ECF status and CAC. ECF status was defined as extracellular water-to-total body water ratio (ECW/TBW) measured using bioelectrical impedance analysis. ECF excess was defined as ECW/TBW ≥0.390 or ≥0.400 depending on its severity. To define CAC, Agatston coronary artery calcium scores were measured. A total coronary artery calcium score of ≥400 was defined as CAC. The CKD stages were defined according to estimated glomerular filtration rate calculated using the CKD Epidemiology Collaboration equation. ECW/TBW and the proportion of ECF excess increased with progressing CKD stages. Multivariable logistic regression analyses showed that ECW/TBW was independently associated with CAC (per 0.01 increase of ECW/TBW, odds ratio 1.168, 95% confidence interval, 1.079-1.264, P<0.001). The adjusted R2 for predicting higher coronary artery calcium scores and CAC significantly improved after ECW/TBW was added to conventional factors. This association was further confirmed by net reclassification and integrated discriminant improvements, sensitivity analysis, and subgroup analysis. CONCLUSIONS ECF status is independently associated with a high risk of CAC in patients with CKD. STUDY REGISTRATION URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02003781.
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Affiliation(s)
- Seohyun Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Joo Lee
- Division of Cardiology, Cardiovascular Hospital, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hyun Jhee
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Hae-Ryong Yun
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoungnae Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Su-Young Jung
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Youn Kyung Kee
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chang-Yun Yoon
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
| | - Sungha Park
- Division of Cardiology, Cardiovascular Hospital, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
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Ježek F, Kulhánek T, Kalecký K, Kofránek J. Lumped models of the cardiovascular system of various complexity. Biocybern Biomed Eng 2017. [DOI: 10.1016/j.bbe.2017.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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