Mucociliary clearance in patients with continuous ambulatory peritoneal dialysis

The effect of autosomal dominant polycystic kidney disease on mucociliary clearance

PURPOSE

Autosomal dominant polycystic kidney disease (ADPKD) is a renal disease with genetic transmisson. Mutations in the PKD1 and PKD2 genes, which encode integral membrane proteins of the cilia of primary renal tubule epithelial cells, are seen in ADPKD. The aim of this study was to evaluate the sinonasal epithelium, which is epithelium with cilia, by measuring the nasal mucociliary clearance time, and to investigate the effect of ADPKD on nasal mucociliary clearance.

METHODS

The study included 34 patients, selected from patients followed up in the Nephrology Clinic, and 34 age and gender-matched control group subjects. The nasal mucociliary clearance time (NMCT) was measured with the saccharin test.

RESULTS

The mean age of the study subjects was 47.15 ± 14.16 years in the patient group and 47.65 ± 13.85 years in the control group. The eGFR rate was determined as mean 72.06 ± 34.26 mL/min in the patient group and 99.79 ± 17.22 mL/min in the control group (p < 0.001). The NMCT was determined to be statistically significantly longer in the patient group (903.6 ± 487.8 s) than in the control group (580 ± 259 s) (p = 0.006).

CONCLUSIONS

The study results showed that the NMCT was statistically significantly longer in patients with ADPKD compared to the control group, but in the linear regression analysis results, no correlation was determined between eGFR and NMCT.

Evaluation of Nasal Mucociliary Clearance Using Saccharin Test Versus Charcoal Test Among Filipinos in a Tertiary Government Hospital

Background: Nasal mucociliary clearance is mainly measured using the saccharin test because it is inexpensive, readily available, and non-toxic. However, in the local setting, the authors had difficulty procuring saccharin, and this prompted the authors to look for an alternative. Upon an expansive review of the literature, the authors came to know about the use of charcoal that has the same properties as saccharin plus it is inert and easily traceable. The objectives of this study were to (1) establish the normal nasal mucociliary clearance time (MCT) using the saccharin test (ST) and charcoal test (CT) among Filipinos, (2) determine if CT can be used to determine nasal mucociliary clearance and (3) determine if the age, sex, land of dwelling, and comorbidities can prolong MCT.

Methods: This is a cross-sectional study involving 50 subjects. ST and CT were performed by placing a particle of sodium saccharine and 10μg of charcoal on the medial surface and at least 1 cm behind the head of the inferior turbinate. All STs were done on the right nostril while CTs were done on the left. A 0- to 20-minute MCT was considered normal while MCT of more than 30 minutes was considered prolonged clearance. Lastly, a transit time of more than 60 minutes was considered a failed mucociliary clearance test.

Results: The mean mucociliary transit time for the saccharin group was 14.48 minutes while for the charcoal group was 14.78 minutes (p=0.531). When grouped into subcategories, CT results showed a higher mucociliary clearance mean time among males, provincial residents, and those without comorbidities while ST had a higher mean mucociliary clearance time among females, Metro Manila residents, and those with comorbidities. All were noted to be not statistically significant.

Conclusion: This study showed that CT is comparable with ST. Also, it can be used as an alternative to ST because the tester directly observes the charcoal transit in the oropharynx while ST relies on the patient's perception of taste that could result in false results.

Evaluation of nasal mucociliary clearance by saccharine test in rheumatoid arthritis

OBJECTIVE

We aimed to reveal whether there is nasal involvement by examining the Nasal Mucociliary Clearance (NMC) and the relationship between this activity and disease severity in Rheumatoid Arthritis (RA) patients.

METHODS

In this prospective study, NMC time, disease activity (Disease Activity Score 28) and blood parameters of RA patients (n = 87) were investigated and compared with the healthy control group (n = 50). In addition, the relationship between DAS 28 and NMC was investigated.

RESULTS

The mean NMC of the RA group was 9.51 ± 3.54 min, the mean NMC of the control group was 8.69 ± 2.85 min, and there was no significant difference between the two groups. There was no correlation between NMC and disease duration, and DAS 28. The mean NMC of the RA patients with Anti Cyclic Citrulled Peptide (Anti-CCP) positive was significantly higher than the negative ones.

CONCLUSION

Although there was no significant difference in NMC values between the RA and control group, the NMC of the Anti-CCP positive patients was higher.

LEVEL OF EVIDENCE

Level 2.