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Tseng CY, Wu TT, Lai CW, Lin HJ, Chou CY, Chang CT, Chen HC. Vegetarian diet may ameliorate uremic pruritus in hemodialysis patients. Ren Fail 2018; 40:514-519. [PMID: 30396306 PMCID: PMC7012008 DOI: 10.1080/0886022x.2018.1512871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives: Systemic inflammation has been reported to be associated with uremic pruritus (UP). Although a vegetarian diet can reduce systemic inflammation in hemodialysis patients, the effect of vegetarian diet on UP is not clear. The purpose of the study was to know the possible effects of vegetarian diet on UP. Methods: A cross-sectional study was done to compare the severity of UP and blood levels of systemic inflammatory markers between vegetarian and non-vegetarian hemodialysis patients. Six non-vegetarian patients with uremic pruritus changed their non-vegetarian diet to vegetarian diet for 2 months. Visual Analogue Scale (VAS) and pruritus score (PS) were used to measure the UP severity. The serum high-sensitivity C-reactive protein (hs-CRP), and interleukin-2 (IL-2) were used as markers of inflammation. Results: Both the median VAS scores (p = .043) and the median PS scores (p < .001) were lower in the Vegetarian than in the non-vegetarian group. The median values of hs-CRP in Vegetarian were lower than that for the non-vegetarian (p = .020). The median value of IL-2 was also lower in Vegetarian than that of the non-vegetarian (p = .016). There were 6 non-vegetarian patients shift to vegetarian for 2 months. The pruritus score improved and IL-2 level decreased after change to vegetarian diet. Conclusion: We concluded that vegetarian diet might be associated with the amelioration of the uremic pruritus severity in hemodialysis patients.
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Affiliation(s)
- Chun-Yang Tseng
- a Kidney Institute and Division of Nephrology , China Medical University Hospital , Taichung , Taiwan
| | - Tai-Te Wu
- b Department of Health Care Management , Chang Gung University , Taoyuan , Taiwan
| | - Chia-Wen Lai
- c Division of Nephrology , Asia University Hospital , Taichung , Taiwan
| | - Hsuan-Jen Lin
- d Division of Nephrology , Asia University Hospital , Taichung , Taiwan
| | - Che-Yi Chou
- e Division of Nephrology , Asia University Hospital , Taichung , Taiwan
| | - Chiz-Tzung Chang
- f Kidney Institute and Division of Nephrology , China Medical University Hospital , Taichung , Taiwan
| | - Hung-Chih Chen
- g Division of Nephrology , Asia University Hospital , Taichung , Taiwan
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Souberbielle JC, Massart C, Brailly-Tabard S, Cormier C, Cavalier E, Delanaye P, Chanson P. Serum PTH reference values established by an automated third-generation assay in vitamin D-replete subjects with normal renal function: consequences of diagnosing primary hyperparathyroidism and the classification of dialysis patients. Eur J Endocrinol 2016; 174:315-23. [PMID: 26628583 DOI: 10.1530/eje-15-0595] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 12/01/2015] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To determine parathyroid hormone (PTH) reference values in French healthy adults, taking into account serum 25-hydroxyvitamin D (25OHD), renal function, age, gender, and BMI. PARTICIPANTS AND MAIN BIOLOGICAL MEASUREMENTS We studied 898 healthy subjects (432 women) aged 18-89 years with a normal BMI and estimated glomerular filtration rate (eGFR), 81 patients with surgically proven primary hyperparathyroidism (PHPT), and 264 dialysis patients. 25OHD and third-generation PTH assays were implemented on the LIAISON XL platform. RESULTS Median PTH and 25OHD values in the 898 healthy subjects were 18.8 ng/l and 23.6 ng/ml respectively. PTH was lower in subjects with 25OHD ≥30 ng/ml than in those with lower values. Among the 183 subjects with 25OHD ≥30 ng/ml, those aged ≥60 years (n=31) had higher PTH values than younger subjects, independent of 25OHD, BMI, and eGFR (P<0.001). Given the small number of subjects aged ≥60 years, we adopted the 95% CI of PTH values for the entire group of 183 vitamin D-replete subjects (9.4-28.9 ng/l) as our reference values. With 28.9 ng/l as the upper limit of normal (ULN) rather than the manufacturer's ULN of 38.4 ng/l, the percentage of PHPT patients with 'high' PTH values rose to 90.1% from 66.6% (P<0.001), and 18.6% of the dialysis patients were classified differently in view of the KDIGO target range (two to nine times the ULN). CONCLUSION When only subjects with 25OHD ≥30 ng/ml were included in the reference population, the PTH ULN fell by 22.4%, diagnostic sensitivity for PHPT improved, and the classification of dialysis patients was modified.
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Affiliation(s)
| | - Catherine Massart
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France
| | - Sylvie Brailly-Tabard
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpita
| | - Catherine Cormier
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France
| | - Etienne Cavalier
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France
| | - Pierre Delanaye
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France
| | - Philippe Chanson
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpita
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Salas P, Pinto V, Rodriguez J, Zambrano MJ, Mericq V. Growth retardation in children with kidney disease. Int J Endocrinol 2013; 2013:970946. [PMID: 24187550 PMCID: PMC3800635 DOI: 10.1155/2013/970946] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 08/23/2013] [Indexed: 11/18/2022] Open
Abstract
Growth failure is almost inextricably linked with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Growth failure in CKD has been associated with both increased morbidity and mortality. Growth failure in the setting of kidney disease is multifactorial and is related to poor nutritional status as well as comorbidities, such as anemia, bone and mineral disorders, and alterations in hormonal responses, as well as to aspects of treatment such as steroid exposure. This review covers updated management of growth failure in these children including adequate nutrition, treatment of metabolic alterations, and early administration of recombinant human growth hormone (GH).
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Affiliation(s)
- Paulina Salas
- Pediatric Nephrology Unit, Hospital Exequiel Gonzalez Cortes, Ramón Barros Luco 3301, Santiago, Chile
| | - Viola Pinto
- Pediatric Nephrology Unit, Hospital Exequiel Gonzalez Cortes, Ramón Barros Luco 3301, Santiago, Chile
| | - Josefina Rodriguez
- Faculty of Medicine, University of Chile, Av. Independencia 1027, Santiago, Chile
| | - Maria Jose Zambrano
- Faculty of Medicine, Catholic University, Av Libertador Bernardo O Higgins 340, Santiago, Chile
| | - Veronica Mericq
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Casilla 226-3, Santiago, Chile
- *Veronica Mericq:
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