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Wu YT, Hu LM, Lee CW, Lee WC, Lin JR, Tsai HI, Yu HP. Low preoperative serum uric acid is associated with early acute kidney injury after living donor liver transplantation. J Chin Med Assoc 2024; 87:635-642. [PMID: 38690873 DOI: 10.1097/jcma.0000000000001103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Liver transplantation is treatment option for patients with end-stage liver disease and hepatocellular carcinoma. Renal function deterioration significantly impacts the survival rates of liver recipients, and serum uric acid (SUA) is associated with both acute and chronic renal function disorders. Thus, our study aimed to assess the relationship and predictive value of preoperative SUA level and postoperative acute kidney injury (AKI) in living donor liver transplantation (LDLT). METHODS We conducted a prospective observational study on 87 patients undergoing LDLT. Blood samples were collected immediately before LDLT, and renal function status was followed up for 3 consecutive days postoperatively. RESULTS Low SUA levels (cutoff value 4.15 mg/dL) were associated with a high risk of early posttransplantation AKI. The area under the curve was 0.73 (sensitivity, 79.2%; specificity, 59.4%). Although not statistically significant, there were no deaths in the non-AKI group but two in the early AKI group secondary to liver graft dysfunction in addition to early AKI within the first month after LDLT. CONCLUSION AKI after liver transplantation may lead to a deterioration of patient status and increased mortality rates. We determined low preoperative SUA levels as a possible risk factor for early postoperative AKI.
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Affiliation(s)
- Yueh-Tse Wu
- Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Li-Min Hu
- Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
- Division of Medical Education, Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chao-Wei Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Wei-Chen Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC
- Department of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
- Department of Liver and Transplant Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Jr-Rung Lin
- Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
- Clinical Informatics and Medical Statistics Research Center and Graduate Institute of Clinical Medical Sciences, Department of Biomedical Sciences, Gung Gung University, Taoyuan, Taiwan, ROC
| | - Hsin-I Tsai
- Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Huang-Ping Yu
- Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC
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Yin J, Zhang X, Wang Z, Qu Z, Sun X, Song Y, Zhang H. Application of exercise therapy in patients with chronic kidney disease-induced muscle atrophy: a scoping review. BMC Sports Sci Med Rehabil 2024; 16:100. [PMID: 38689329 PMCID: PMC11061900 DOI: 10.1186/s13102-024-00876-8] [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: 12/02/2023] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The prevalence of muscle atrophy in patients suffering from chronic kidney disease (CKD) presents a significant challenge to healthcare providers, necessitating innovative approaches to management and care. Against this backdrop, this study embarks on a comprehensive review of literature concerning the application of exercise interventions in the nursing care of these patients. Such interventions are critical in addressing the debilitating effects of the condition, which include progressive loss of muscle mass and strength, adversely affecting patient mobility, quality of life, and overall survival. This review aims to identify the specific exercise modalities, contents, outcome indicators, and application effects associated with this intervention, in the context of the complex interplay of metabolic, inflammatory, and hormonal factors contributing to muscle wasting in CKD patients. By examining the efficacy of various exercise interventions, this study seeks to elucidate optimal strategies for mitigating the impact of CKD-induced muscle atrophy, thereby informing clinical practices and improving patient outcomes. METHODS According to the method of a scoping review, nine databases (Cochrane, PubMed, EMBASE, Web of Science, ProQuest, Ovid, CNKI, Wanfang Data, and VIP) were searched until September 28, 2023. The included literature was screened, summarized, and analyzed. RESULTS A total of 20 pieces of literature were included. Some types include aerobic exercise, resistance exercise, and aerobic combined resistance exercise. The exercise intensity primarily falls within the mild to moderate range, with a recommended frequency of 2 - 3 times a week, lasting 30 - 60 min each time. The types of outcomes encompassed in this study include body composition, functional testing, strength measurements, laboratory examinations, cardiopulmonary function assessments, and patient-reported outcomes. To varying degrees, exercise intervention positively impacts the subjects' physical activity ability, body composition, and skeletal muscle status. Currently, resistance training is the primary type of intervention used for preventing and treating CKD patients induced by muscle atrophy. CONCLUSION Exercise intervention can improve muscle strength, physical function, and quality of life in patients with CKD muscle atrophy. Therefore, patients should be fully informed of the effect of exercise intervention in the treatment of chronic kidney disease-induced muscle atrophy in future, so as to promote the standardized implementation of exercise intervention.
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Affiliation(s)
- Jiawei Yin
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Xiaotu Zhang
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Zilin Wang
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Zihan Qu
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Xuefeng Sun
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Yuqing Song
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Hongshi Zhang
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China.
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Tamura H. Acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise. World J Nephrol 2023; 12:56-65. [PMID: 37476010 PMCID: PMC10354565 DOI: 10.5527/wjn.v12.i3.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/20/2023] [Accepted: 03/22/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND There are two known types of exercise-induced acute renal failure. One is the long-known myoglobinuria-induced acute renal failure due to severe rhabdomyolysis, and the other is the recently recognized non-myoglobinuria-induced acute renal failure with mild rhabdomyolysis. Exercise-induced acute renal failure was first reported in 1982. Non-myoglobinuria-induced acute renal failure is associated with severe low back pain and patchy renal vasoconstriction, and it is termed post-exercise acute renal failure because it usually occurs hours after exercise. It is also called acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE).
AIM To makes a significant contribution to medical literature as it presents a study that investigated a not-widely-known type of exercise-induced acute renal failure known as ALPE.
METHODS We performed a database search selecting papers published in the English or Japanese language. A database search was lastly accessed on September 1, 2022. The results of this study were compared with those reported in other case series.
RESULTS The study evaluated renal hypouricemia as a key risk factor of ALPE. The development of ALPE is due to the sum of risk factors such as exercise, hypouricemia, nonsteroidal anti-inflammatory drugs, vasopressors, and dehydration.
CONCLUSION In conclusion, hypouricemia plays a key role in the development of ALPE and is often associated with anaerobic exercise. The development of ALPE is a result of the cumulative effects of risk factors such as exercise, hypouricemia, NSAIDs, vasopressors, and dehydration.
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Affiliation(s)
- Hiroshi Tamura
- Department of Pediatrics, Kumamoto University, Kumamoto 8608556, Japan
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Kim HY, Lee JD, Lee YH, Seo SW, Lee HS, Kim S, Kim KB. Urinary Metabolomics in Young Soccer Players after Winter Training Season. Metabolites 2022; 12:metabo12121283. [PMID: 36557321 PMCID: PMC9784126 DOI: 10.3390/metabo12121283] [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: 11/07/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
During the off-season, soccer players in Korea attend the winter training season (WTS) to build running stamina for the next season. For young soccer players, proper recovery time is needed to prevent injury or muscle damage. In this study, urinary metabolites in young players after 1, 5, and 10 days of the WTS were analyzed using nuclear magnetic resonance spectroscopy (NMR) combined with multivariate analysis to suggest appropriate recovery times for improving their soccer skills. After NMR analysis of the urine samples obtained from young players, 79 metabolites were identified, and each group (1, 5, or 10 days after WTS) was separated from the before the WTS group in the target profiling analysis using partial least squares-discriminant analysis (PLS-DA). Of these, 15 metabolites, including 1-methylnicotinamide, 3-indoxylsulfate, galactarate, glutamate, glycerol, histamine, methylmalonate, maltose, N-phenylacetylglycine, trimethylamine, urea, 2-hydroxybutyrate, adenine, alanine, and lactate, were significantly different than those from before the WTS and were mainly involved in the urea, purine nucleotide, and glucose-alanine cycles. In this study, most selected metabolites increased 1 day after the WTS and then returned to normal levels. However, 4 metabolites, adenine, 2-hydroxybutyrate, alanine, and lactate, increased during the 5 days of recovery time following the WTS. Based on excess ammonia, adenine, and lactate levels in the urine, at least 5 days of recovery time can be considered appropriate.
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Affiliation(s)
- Hyang-Yeon Kim
- College of Pharmacy, Dankook University, 119 Dandae-ro, Cheonan 31116, Republic of Korea
- Center for Human Risk Assessment, Dankook University, 119 Dandae-ro, Cheonan 31116, Republic of Korea
| | - Jung-Dae Lee
- College of Pharmacy, Dankook University, 119 Dandae-ro, Cheonan 31116, Republic of Korea
- Center for Human Risk Assessment, Dankook University, 119 Dandae-ro, Cheonan 31116, Republic of Korea
| | - Yun-Hwan Lee
- Department of Exercise and Medical Science, Graduate School, Dankook University, 119 Dandae-ro, Cheonan 31116, Republic of Korea
| | - Sang-Won Seo
- Department of Sports Science, Gwangju University, Gwangju 61743, Republic of Korea
| | - Ho-Seong Lee
- Department of Exercise and Medical Science, Graduate School, Dankook University, 119 Dandae-ro, Cheonan 31116, Republic of Korea
- Correspondence: (H.-S.L.); (K.-B.K.)
| | - Suhkmann Kim
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan Daehak-ro 63 beon-gil 2, Busan 46241, Republic of Korea
| | - Kyu-Bong Kim
- Center for Human Risk Assessment, Dankook University, 119 Dandae-ro, Cheonan 31116, Republic of Korea
- Correspondence: (H.-S.L.); (K.-B.K.)
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Wu Y, Guo X, Peng Y, Fang Z, Zhang X. Roles and Molecular Mechanisms of Physical Exercise in Sepsis Treatment. Front Physiol 2022; 13:879430. [PMID: 35845992 PMCID: PMC9277456 DOI: 10.3389/fphys.2022.879430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
Physical exercise is a planned, purposeful action to keep a healthy lifestyle and improve physical fitness. Physical exercise has been widely used as a non-pharmacological approach to preventing and improving a wide range of diseases, including cardiovascular disease, cancer, metabolic disease, and neurodegenerative disease. However, the effects of physical exercise on sepsis have not been summarized until now. In this review, we discuss the effects of physical exercise on multiple organ functions and the short- and long-time outcomes of sepsis. Furthermore, the molecular mechanisms underlying the protective effects of physical exercise on sepsis are discussed. In conclusion, we consider that physical exercise may be a beneficial and non-pharmacological alternative for the treatment of sepsis.
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Affiliation(s)
- You Wu
- Department of Intensive Care Unit, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Xiaofeng Guo
- Department of Intensive Care Unit, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
- Department of Intensive Care Unit, Joint Logistics Force No. 988 Hospital, Zhengzhou, China
| | - Yuliang Peng
- Department of Intensive Care Unit, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Zongping Fang
- Department of Intensive Care Unit, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
- *Correspondence: Zongping Fang, ; Xijing Zhang,
| | - Xijing Zhang
- Department of Intensive Care Unit, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
- *Correspondence: Zongping Fang, ; Xijing Zhang,
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