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Sittihakote N, Danvirutai P, Anutrakulchai S, Tuantranont A, Srichan C. Empowering an Acute Kidney Injury 3D Graphene-Based Sensor Using Extreme Learning Machine. ACS Omega 2024; 9:21276-21286. [PMID: 38764614 PMCID: PMC11097169 DOI: 10.1021/acsomega.4c01315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/21/2024]
Abstract
This study reports on the application of an extreme learning machine (ELM) in near-real-time kidney monitoring via urine neutrophil gelatinase-associated lipocalin (NGAL) detection with a 3D graphene electrode. This integration marks the first instance of combining a graphene-based electrode with machine learning to enhance the NGAL detection accuracy, building on our group's 2020 research. The methodology involves two key components: a graphene electrode functionalized with a lipocalin-2 antibody for NGAL detection and the ELM application for improved prediction accuracy by using urine analysis data. The results show a significant 15% increase in the area under the curve (AUC) for NGAL determination, with error reduction from ±6 to 0.54 ng/mL within a linear range of 2.7-140 ng/mL. The ELM also lowered the detection limit from 14.8 to 0.89 ng/mL and increased accuracy, precision, sensitivity, specificity, and F1 score for AKI prediction by 8.89, 30.69, 6.78, 9.94, and 19.07%, respectively. These findings underscore the efficacy of simple neural networks in enhancing graphene-based electrochemical sensors for AKI biomarkers. ELM was chosen for its optimal performance-resource balance, with a comparative analysis of ELM, support vector machines, multilayer perceptron, and random forest algorithms also included. This research suggests the potential for miniaturizing AI-enhanced sensors for practical applications.
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Affiliation(s)
- Netnapa Sittihakote
- Faculty
of Engineering, Biomedical Engineering, Khon Kaen University, Nai Mueang 40002, Khon Kaen, Thailand
| | - Pobporn Danvirutai
- Faculty
of Engineering, Computer Engineering, Khon
Kaen University, Nai Mueang 40002, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Faculty
of Medicine, Khon Kaen University, Nai Mueang 40002, Khon Kaen, Thailand
- Chronic
Kidney Disease Prevention in the Northeast of Thailand, Khon Kaen University, 123 Khon Kaen University, Nai Mueang 40002, Khon Kaen, Thailand
| | - Adisorn Tuantranont
- National
Science and Technology Development Agency, 111 Thailand Science Park, Khlong Luang 12120, Pathum Thani, Thailand
| | - Chavis Srichan
- Faculty
of Engineering, Biomedical Engineering, Khon Kaen University, Nai Mueang 40002, Khon Kaen, Thailand
- Faculty
of Engineering, Computer Engineering, Khon
Kaen University, Nai Mueang 40002, Khon Kaen, Thailand
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Yingklang M, Chaidee A, Dangtakot R, Jantawong C, Haonon O, Sitthirach C, Hai NT, Cha'on U, Anutrakulchai S, Kamsa-Ard S, Pinlaor S. Correction: Association of Strongyloides stercoralis infection and type 2 diabetes mellitus in northeastern Thailand: Impact on diabetic complication-related renal biochemical parameters. PLoS One 2024; 19:e0303774. [PMID: 38723010 PMCID: PMC11081342 DOI: 10.1371/journal.pone.0303774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0269080.].
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Theeranut A, Methakanjanasak N, Lertsinudom S, Surit P, Panyaek N, Leeladapattarakul S, Nilpetch P, Kessomboon P, Chalermwat C, Rintara W, Khongtong W, Paktipat P, Banchonhattakit P, Chunlertrith D, Sharma A, Cha’on U, Anutrakulchai S. Integrated Care Model by the Village Health Volunteers to Prevent and Slow down Progression of Chronic Kidney Disease in a Rural Community, Thailand. J Prim Care Community Health 2024; 15:21501319241240355. [PMID: 38554000 PMCID: PMC10981849 DOI: 10.1177/21501319241240355] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/24/2024] [Accepted: 03/01/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is a major health problem in Thailand and health behaviors are central to its risk and progression. Because of the shortage of healthcare personnel, village health volunteers (VHVs) have been collaborating in the primary health care system. However, the contribution of VHVs to CKD reduction has not been evaluated yet. This study aimed to evaluate the efficacy of the VHV-integrated model in preventing and slowing down CKD and its risk factors. METHODS The population-based cohort study was conducted in a rural community of Thailand between 2017 and 2019. Baseline clinical and behavioral characteristics including CKD, diabetes, hypertension, and other high-risk factors of the participants were collected. The integrated care model was initiated by the multidisciplinary care team that facilitated, empowered, and trained VHVs targeting risk factors of CKD, health literacy, and health promotion. Then the participants were educated and trained for lifestyle modification and were monitored continuously for 18 months by VHVs. Changes in the CKD risk factors, and kidney functions before and after the application of integrated care model were compared. RESULTS A total of 831 subjects participated in the study with an average age of 57.5 years, and 69.5% were female. Among them, 222 participants (26.7%) were diagnosed as having CKD, the vast majority (95%) of which were in the early stages (G1-G3 and A1-A2). CKD risk factors such as high salt intake, smoking, alcohol consumption, self-NSAID (non-steroidal anti-inflammatory drugs) use were significantly decreased after application of the care model. Also, hemoglobin A1c was significantly reduced in diabetic patients, and blood pressure was controlled better than before in the hypertensive patients. Most importantly, a decline of estimated glomerular filtration rate of the CKD group was improved and lower than the non-CKD group. CONCLUSION The integrated care model through VHV significantly attenuated the risk factors associated with CKD in the general and high-risk population and effectively slowed down the progression of CKD.
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Affiliation(s)
| | | | | | - Pattama Surit
- Guangxi University of Chinese Medicine, Nanning, Guangxi, China
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Pinrod V, Chawjiraphan W, Segkhoonthod K, Hanchaisri K, Tantiwathanapong P, Pinpradup P, Putnin T, Pimalai D, Treerattrakoon K, Cha’on U, Anutrakulchai S, Japrung D. Development of a High-Accuracy, Low-Cost, and Portable Fluorometer with Smartphone Application for the Detection of Urinary Albumin towards the Early Screening of Chronic Kidney and Renal Diseases. Biosensors (Basel) 2023; 13:876. [PMID: 37754110 PMCID: PMC10526137 DOI: 10.3390/bios13090876] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
This study presents the development of a portable fluorometer with a smartphone application designed to facilitate the early screening of chronic kidney and renal diseases by enabling the sensitive detection of urinary albumin. Utilizing a fluorescence-based aptasensor, the device achieved a linear calibration curve (0.001-1.5 mg/mL) with a linearity of up to 0.98022 and a detection limit of 0.203 µg/mL for human serum albumin (HSA). The analysis of 130 urine samples demonstrated comparable performance between this study's fluorometer, a commercial fluorometer, and the standard automated method. These findings validate the feasibility of the portable fluorometer and aptasensor combination as a reliable instrument for the sensitive and specific measurement of HSA in urine samples. Moreover, the fluorometer's portability offers potential applications in portable point-of-care testing, enhancing its utility in clinical settings for early disease screening.
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Affiliation(s)
- Visarute Pinrod
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Wireeya Chawjiraphan
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Khoonsake Segkhoonthod
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Kriangkai Hanchaisri
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Phornpol Tantiwathanapong
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Preedee Pinpradup
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Thitirat Putnin
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Dechnarong Pimalai
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Kiatnida Treerattrakoon
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
- Department of Pure and Applied Chemistry, Technology and Innovation Centre, University of Strathclyde, Glasgow G1 1RD, UK
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand;
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Deanpen Japrung
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
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Tran NT, Chaidee A, Surapinit A, Yingklang M, Roytrakul S, Charoenlappanit S, Pinlaor P, Hongsrichan N, Nguyen Thi H, Anutrakulchai S, Cha'on U, Pinlaor S. Strongyloides stercoralis infection reduces Fusicatenibacter and Anaerostipes in the gut and increases bacterial amino-acid metabolism in early-stage chronic kidney disease. Heliyon 2023; 9:e19859. [PMID: 37809389 PMCID: PMC10559256 DOI: 10.1016/j.heliyon.2023.e19859] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Understanding gut bacterial composition and proteome changes in patients with early-stage chronic kidney disease (CKD) could lead to better methods of controlling the disease progression. Here, we investigated the gut microbiome and microbial functions in patients with S. stercoralis infection (strongyloidiasis) and early-stage CKD. Thirty-five patients with early stages (1-3) of CKD were placed in two groups matched for population characteristics and biochemical parameters, 12 patients with strongyloidiasis in one group and 23 uninfected patients in the other. From every individual, a sample of their feces was obtained and processed for 16S rRNA sequencing and metaproteomic analysis using tandem liquid chromatography-mass spectrometry (LC-MS/MS). Strongyloides stercoralis infection per se did not significantly alter gut microbial diversity. However, certain genera (Bacteroides, Faecalibacterium, Fusicatenibacter, Sarcina, and Anaerostipes) were significantly more abundant in infection-free CKD patients than in infected individuals. The genera Peptoclostridium and Catenibacterium were enriched in infected patients. Among the significantly altered genera, Fusicatenibacter and Anaerostipes were the most correlated with renal parameters. The relative abundance of members of the genus Fusicatenibacter was moderately positively correlated with estimated glomerular filtration rate (eGFR) (r = 0.335, p = 0.049) and negatively with serum creatinine (r = -0.35, p = 0.039). Anaerostipes, on the other hand, showed a near-significant positive correlation with eGFR (r = 0.296, p = 0.084). Individuals with S. stercoralis infection had higher levels of bacterial proteins involved in amino-acid metabolism. Analysis using STITCH predicted that bacterial amino-acid metabolism may also be involved in the production of colon-derived uremic toxin (indole), a toxic substance known to promote CKD. Strongyloides stercoralis infection is, therefore, associated with reduced abundance of Fusicatenibacter and Anaerostipes (two genera possibly beneficial for kidney function) and with increased bacterial amino-acid metabolism in the early-stages of CKD, potentially producing uremic toxin. This study provides useful information for prevention of progression of CKD beyond the early stages.
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Affiliation(s)
- Na T.D. Tran
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Medical Laboratory Science, Danang University of Medical Technology and Pharmacy, Danang, Viet Nam
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, Thailand
| | - Apisit Chaidee
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, Thailand
| | - Achirawit Surapinit
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Sitiruk Roytrakul
- Functional Proteomics Technology Laboratory, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Sawanya Charoenlappanit
- Functional Proteomics Technology Laboratory, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Porntip Pinlaor
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, Thailand
| | - Nuttanan Hongsrichan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, Thailand
| | - Hai Nguyen Thi
- Department of Parasitology, Faculty of Basic Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Viet Nam
| | - Sirirat Anutrakulchai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, Thailand
| | - Ubon Cha'on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, Thailand
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, Thailand
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Pisprasert V, Phocharoen J, Anutrakulchai S, Rattanachaiwong S, Hongsprabhas P. Mid-Upper Arm Circumference Can Predict Malnutrition In Ckd Patients Better Than Handgrip Strength. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Tran NTD, Chaidee A, Surapinit A, Yingklang M, Roytrakul S, Charoenlappanit S, Pinlaor P, Hongsrichan N, Anutrakulchai S, Cha'on U, Pinlaor S. Chronic Strongyloides stercoralis infection increases presence of the Ruminococcus torques group in the gut and alters the microbial proteome. Sci Rep 2023; 13:4216. [PMID: 36918707 PMCID: PMC10012286 DOI: 10.1038/s41598-023-31118-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/07/2023] [Indexed: 03/15/2023] Open
Abstract
We explored the impact of chronic Strongyloides stercoralis infection on the gut microbiome and microbial activity in a longitudinal study. At baseline (time-point T0), 42 fecal samples from matched individuals (21 positive for strongyloidiasis and 21 negative) were subjected to microbiome 16S-rRNA sequencing. Those positive at T0 (untreated then because of COVID19 lockdowns) were retested one year later (T1). Persistent infection in these individuals indicated chronic strongyloidiasis: they were treated with ivermectin and retested four months later (T2). Fecal samples at T1 and T2 were subjected to 16S-rRNA sequencing and LC-MS/MS to determine microbial diversity and proteomes. No significant alteration of indices of gut microbial diversity was found in chronic strongyloidiasis. However, the Ruminococcus torques group was highly over-represented in chronic infection. Metaproteome data revealed enrichment of Ruminococcus torques mucin-degrader enzymes in infection, possibly influencing the ability of the host to expel parasites. Metaproteomics indicated an increase in carbohydrate metabolism and Bacteroidaceae accounted for this change in chronic infection. STITCH interaction networks explored highly expressed microbial proteins before treatment and short-chain fatty acids involved in the synthesis of acetate. In conclusion, our data indicate that chronic S. stercoralis infection increases Ruminococcus torques group and alters the microbial proteome.
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Affiliation(s)
- Na T D Tran
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Apisit Chaidee
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Achirawit Surapinit
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | | | - Sitiruk Roytrakul
- Functional Proteomics Technology Laboratory, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Sawanya Charoenlappanit
- Functional Proteomics Technology Laboratory, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Porntip Pinlaor
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Nuttanan Hongsrichan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Sirirat Anutrakulchai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Ubon Cha'on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, 40002, Thailand.
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Kosuvun M, Danvirutai P, Hormdee D, Chaosakul A, Tanboonchuy V, Siritaratiwat A, Anutrakulchai S, Sharma A, Tuantranont A, Srichan C. Nanoflowers on Microporous Graphene Electrodes as a Highly Sensitive and Low-Cost As(III) Electrochemical Sensor for Water Quality Monitoring. Sensors (Basel) 2023; 23:3099. [PMID: 36991809 PMCID: PMC10053495 DOI: 10.3390/s23063099] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
In this work, we report a low-cost and highly sensitive electrochemical sensor for detecting As(III) in water. The sensor uses a 3D microporous graphene electrode with nanoflowers, which enriches the reactive surface area and thus enhances its sensitivity. The detection range achieved was 1-50 ppb, meeting the US-EPA cutoff criteria of 10 ppb. The sensor works by trapping As(III) ions using the interlayer dipole between Ni and graphene, reducing As(III), and transferring electrons to the nanoflowers. The nanoflowers then exchange charges with the graphene layer, producing a measurable current. Interference by other ions, such as Pb(II) and Cd(II), was found to be negligible. The proposed method has potential for use as a portable field sensor for monitoring water quality to control hazardous As(III) in human life.
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Affiliation(s)
- Mahatthanah Kosuvun
- Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand; (M.K.); (P.D.); (D.H.); (A.C.); (V.T.); (A.S.)
| | - Pobporn Danvirutai
- Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand; (M.K.); (P.D.); (D.H.); (A.C.); (V.T.); (A.S.)
- Research and Development Division, T. Robotics, Co., Ltd., Khon Kaen 40000, Thailand
| | - Daranee Hormdee
- Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand; (M.K.); (P.D.); (D.H.); (A.C.); (V.T.); (A.S.)
| | - Arnut Chaosakul
- Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand; (M.K.); (P.D.); (D.H.); (A.C.); (V.T.); (A.S.)
| | - Visanu Tanboonchuy
- Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand; (M.K.); (P.D.); (D.H.); (A.C.); (V.T.); (A.S.)
- Research Center for Environmental and Hazardous Substance Management (EHSM), Khon Kaen University, Khon Kaen 40002, Thailand
| | - Apirat Siritaratiwat
- Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand; (M.K.); (P.D.); (D.H.); (A.C.); (V.T.); (A.S.)
| | - Sirirat Anutrakulchai
- Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (S.A.); (A.S.)
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
| | - Amod Sharma
- Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (S.A.); (A.S.)
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
| | - Adisorn Tuantranont
- Graphene and Printed Electronics for Dual-Use Applications Research Division (GPERD), National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand;
| | - Chavis Srichan
- Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand; (M.K.); (P.D.); (D.H.); (A.C.); (V.T.); (A.S.)
- Research Center for Environmental and Hazardous Substance Management (EHSM), Khon Kaen University, Khon Kaen 40002, Thailand
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Foocharoen C, Tonsawan P, Pongkulkiat P, Anutrakulchai S, Mahakkanukrauh A, Suwannaroj S. Management review of scleroderma renal crisis: An update with practical pointers. Mod Rheumatol 2023; 33:12-20. [PMID: 35349704 DOI: 10.1093/mr/roac028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/20/2022] [Accepted: 03/14/2022] [Indexed: 01/05/2023]
Abstract
Scleroderma renal crisis (SRC) represents severe, fatal internal organ involvement brought on by systemic sclerosis. A high rate of renal replacement therapy and mortality persists despite various treatments. Depending on the stage of SRC, a vasodilator called angiotensin-converting enzyme inhibitor is the treatment of choice. The efficacy of various other vasodilators (i.e. endothelin-1 receptor antagonist) and complement cascade blocker for SRC have been investigated; however, no randomized control trial has been conducted. A new approach has been proposed for the management of SRC, categorized by specific clinical features of narrowly defined SRC and systemic sclerosis-thrombotic microangiopathy. SRC prophylaxis using angiotensin-converting enzyme inhibitor might be harmful, leading to a poor renal outcome, so the pathogenesis of SRC needs to be clarified in order to identify other possible preventions or therapies.
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Affiliation(s)
- Chingching Foocharoen
- Department of Medicine, Division of Rheumatology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pantipa Tonsawan
- Department of Medicine, Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Patnarin Pongkulkiat
- Department of Medicine, Division of Rheumatology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Department of Medicine, Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ajanee Mahakkanukrauh
- Department of Medicine, Division of Rheumatology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Siraphop Suwannaroj
- Department of Medicine, Division of Rheumatology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Banjong D, Pongking T, Tran NTD, Pinlaor S, Dangtakot R, Intuyod K, Anutrakulchai S, Cha’on U, Pinlaor P. Slight Changes in the Gut Microbiome in Early-stage Chronic Kidney Disease of Unknown Etiology. Microbes Environ 2023; 38:ME22097. [PMID: 37635077 PMCID: PMC10522841 DOI: 10.1264/jsme2.me22097] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/23/2023] [Indexed: 08/29/2023] Open
Abstract
Gut dysbiosis and changes in short-chain fatty acids (SCFAs) occur in end-stage chronic kidney disease (CKD); however, the degree of these changes in the gut microbiome and serum SCFA profiles in the early stages of CKD, particularly in CKD of unknown etiology (CKDu), is unclear. We herein investigated the gut microbiome and SCFA profiles of early-stage CKD patients (CKD stages 1-3) in a community in Khon Kaen Province, Thailand. Seventy-two parasite-free participants were distributed among a healthy control group (HC, n=18) and three patient groups (an underlying disease group [UD, n=18], early-stage CKD with underlying disease [CKD-UD, n=18], and early-stage CKD of unknown etiology, [CKDu, n=18]). Fecal DNA was individually extracted and pooled for groups of six individuals (three pools in each group) to examine the composition of the gut microbiome using next-generation sequencing. A SCFA ana-lysis was performed on serum samples from each individual using gas chromatography-mass spectrometry. The results revealed that microbial abundance differed between the healthy group and all patient groups (UD, CKD-UD, and CKDu). [Eubacterium]_coprostanoligenes_group was more abundant in the CKDu group than in the HC and CKD-UD groups. Furthermore, serum concentrations of acetate, a major SCFA component, were significantly lower in all patient groups than in the HC group. The present results indicate that minor changes in the gut microbiome and a significant decrease in serum acetate concentrations occur in early-stage CKDu, which may be important for the development of prevention strategies for CKD patients.
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Affiliation(s)
- Ditsayathan Banjong
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Thatsanapong Pongking
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Na T. D. Tran
- Faculty of Medical Laboratory Science, Danang University of Medical Technology and Pharmacy, Danang, Vietnam
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Rungtiwa Dangtakot
- Faculty of Medical Technology, Nakhonratchasima College, Nakhon Ratchasima, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Kitti Intuyod
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Porntip Pinlaor
- Center for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
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11
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Trirattanapikul A, Kongpetch S, Lukkanalikitkul E, Ahooja A, Seesuk P, Sharma A, Anutrakulchai S. Lung Ultrasound Estimates the Overhydration and Benefits Blood Pressure Control in Normal or Mild Symptomatic Hemodialysis Patients. Int J Nephrol Renovasc Dis 2022; 15:383-395. [PMID: 36570492 PMCID: PMC9784469 DOI: 10.2147/ijnrd.s374569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Lung ultrasound (LUS) is used for dry weight guidance by assessment of pulmonary congestion in hemodialysis (HD) patients. The aim of this study was to estimate amounts of accumulated fluid by total LUS scores (TLUSS), which were scarcely reported in HD patients who were normal or had a mild functional abnormality. In addition, the correlations between the LUS score of each area and TLUSS were determined to suggest fewer specific areas valuable to shorten the examination time of LUS. Methods This cohort study was conducted in adult HD patients who have New York Heart Association Classes I-II. LUS and multifrequency bioimpedance (BIA) were performed at baseline and the individual prescribed dry weight was set. Then each LUS was conducted at 28 areas of bilateral intercostal spaces and calculated as TLUSS weekly for eight weeks in which dry weight was adjusted. The second BIA was also measured at week eight. The difference of pre-HD weight and target weight (weight gain; WG) represented the amount of fluid accumulation. Results Twenty patients with a mean age of 62.2±14.0 years were enrolled. One hundred and sixty-six LUS were performed in which forty episodes of them were simultaneously measured with BIA. Optimum dry weight adjusted by TLUSS which benefited in mean reductions of blood pressure, and cardiothoracic ratios. WG amounts were significantly correlated with TLUSS (r=0.38), and with extracellular fluid (r=0.35) and overhydration fluid (r=0.39) assessed by BIA. Estimations of mean fluid overload were 2.18 (TLUSS ≤15), 2.72 (TLUSS 16-24), 3.17 (TLUSS 25-33), 3.65 (TLUSS 34-38) and 5.03 (TLUSS ≥39) in liters. The cut-off points of sum scores of 12 specific lung areas represented the none-mild were <8, moderate at 8-16, and severe pulmonary congestions were >16. Conclusion TLUSS estimated accumulated fluid useful for volume and blood pressure controls. Performance of LUS in 12 specific lung areas may reduce spending time and support routine uses of LUS in clinical practice.
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Affiliation(s)
| | - Sawinee Kongpetch
- Deparment of Medicine, Khon Kaen University, Khon Kaen, Thailand,Center of Excellence in Kidney Diseases, Khon Kaen University, Khon Kaen, Thailand
| | - Eakalak Lukkanalikitkul
- Deparment of Medicine, Khon Kaen University, Khon Kaen, Thailand,Center of Excellence in Kidney Diseases, Khon Kaen University, Khon Kaen, Thailand
| | - Anucha Ahooja
- Department of Radiology, Khon Kaen University, Khon Kaen, Thailand
| | - Patamapon Seesuk
- Center of Excellence in Kidney Diseases, Khon Kaen University, Khon Kaen, Thailand
| | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET) Project, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Deparment of Medicine, Khon Kaen University, Khon Kaen, Thailand,Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET) Project, Khon Kaen University, Khon Kaen, Thailand,Correspondence: Sirirat Anutrakulchai, Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand, Email ;
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12
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Kyaw TS, Sukmak M, Nahok K, Sharma A, Silsirivanit A, Lert-Itthiporn W, Sansurin N, Senthong V, Anutrakulchai S, Sangkhamanon S, Pinlaor S, Selmi C, Hammock BD, Cha'on U. Monosodium glutamate consumption reduces the renal excretion of trimethylamine N-oxide and the abundance of Akkermansia muciniphila in the gut. Biochem Biophys Res Commun 2022; 630:158-166. [PMID: 36155062 PMCID: PMC9851609 DOI: 10.1016/j.bbrc.2022.09.038] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 09/09/2022] [Indexed: 01/21/2023]
Abstract
We previously demonstrated that monosodium glutamate (MSG) consumption increases trimethylamine (TMA) level in the renal tissue as well as dimethylamine and methylamine levels in urine of rats, suggesting the effects of MSG on humans. To better define the findings, we investigated whether MSG consumption alters serum trimethylamine N-oxide (TMAO) level, and as a consequence, induces kidney injury in the rat model. Adult male Wistar rats (n = 40) were randomized to be fed with a standard diet (control group) or a standard diet with 0.5, 1.5 or 3.0 g% MSG corresponding to 7, 21, or 42 g/day in 60 kg man, respectively in drinking water (MSG-treated groups), or a standard diet with 3.0 g% MSG in drinking water which was withdrawn after 4 weeks (MSG-withdrawal group). Blood and urine samples were collected to analyze the TMAO levels using 1H NMR and markers of kidney injury. Fecal samples were also collected for gut microbiota analysis. We found serum TMAO levels increased and urinary TMAO excretion decreased during MSG consumption, in parallel with the increase of the neutrophil gelatinase-associated lipocalin (NGAL) excretion which subsided with the withdrawal of MSG. The fecal 16 S rRNA analysis during MSG consumption showed gut microbiota changes with a consistent suppression of Akkermansia muciniphila, a mucin producing bacteria, but not of TMA-producing bacteria. In conclusions, our findings suggested that prolonged high dose MSG consumption may cause TMAO accumulation in the blood via reduction of renal excretion associated with acute kidney injury. The mechanisms by which MSG reduced TMAO excretion require further investigation.
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Affiliation(s)
- Thin Su Kyaw
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Manatsaphon Sukmak
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Kanokwan Nahok
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Atit Silsirivanit
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Worachart Lert-Itthiporn
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Nichapa Sansurin
- Northeast Laboratory Animal Center, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Vichai Senthong
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand; Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Sakkarn Sangkhamanon
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Carlo Selmi
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center IRCCS, Rozzano, 20089, Milan, Italy; Department of Clinical Biosciences, Humanitas University, Pieve Emanuele, 20090, Milan, Italy.
| | - Bruce D Hammock
- Department of Entomology & Nematology and the UC Davis Comprehensive Cancer Research Center, University of California, Davis, CA, 95616, USA
| | - Ubon Cha'on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand; Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, 40002, Thailand.
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13
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Sompark C, Chawjiraphan W, Sukmak M, Cha’on U, Anutrakulchai S, Pongprayoon P, Putnin T, Pimalai D, Pinrod V, Japrung D. Effects of Boric Acid and Storage Temperature on the Analysis of Microalbumin Using Aptasensor-Based Fluorescent Detection. Biosensors (Basel) 2022; 12:915. [PMID: 36354425 PMCID: PMC9687920 DOI: 10.3390/bios12110915] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/07/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
The instability of human serum albumin (HSA) in urine samples makes fresh urine a requirement for microalbumin analyses using immunoturbidimetry. Here, we determined the ability of an aptasensor-based fluorescent platform to detect microalbumin in old, boric acid-preserved urine samples. Our results show that the cleavage site of protease enzymes on urine albumin protein differed from the binding position of the aptamer on HSA protein, suggesting the aptasensor may be effective for albumin detection in non-fresh urine. Furthermore, the addition of boric acid in urine samples over a short term (at ambient temperature (Ta) and 4 °C), long term (-20 and -80 °C), and following freeze-thawing (1-3 cycles) did not significantly affect albumin stability, as analyzed using the aptasensor. Therefore, boric acid stabilized has in urine stored over a short- and long-term. Thus, the aptasensor developed by us is applicable for HSA detection in boric acid-preserved urine that has been stored for 7-d at Ta and 4 °C, and in the long-term at -80 °C.
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Affiliation(s)
- Chalermwoot Sompark
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand
- Postharvest and Processing Research and Development Division, Department of Agriculture, Bangkok 10900, Thailand
| | - Wireeya Chawjiraphan
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand
| | - Manatsaphon Sukmak
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Prapasiri Pongprayoon
- Faculty of Science, Department of Chemistry, Kasetsart University, Chatuchak, Bangkok 10900, Thailand
- Center for Advance Studies in Nanotechnology for Chemical, Food and Agricultural Industries, KU Institute for Advance Studies, Kasetsart University, Bangkok 10900, Thailand
| | - Thitirat Putnin
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand
| | - Dechnarong Pimalai
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand
| | - Visarute Pinrod
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand
| | - Deanpen Japrung
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand
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14
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Nahok K, Selmi C, Sukmak M, Phetcharaburanin J, Li JV, Silsirivanit A, Thanan R, Sharma A, Anutrakulchai S, Hammock BD, Cha’on U. Reply to Chao et al. Comment on “Nahok et al. Monosodium Glutamate Induces Changes in Hepatic and Renal Metabolic Profiles and Gut Microbiome of Wistar Rats. Nutrients 2021, 13, 1865”. Nutrients 2022; 14:nu14204387. [PMID: 36297071 PMCID: PMC9611631 DOI: 10.3390/nu14204387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/05/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Kanokwan Nahok
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
| | - Carlo Selmi
- Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Manatsaphon Sukmak
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
| | - Jutarop Phetcharaburanin
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Jia V. Li
- Department of Metabolism, Digestive Disease and Reproduction, Faculty of Medicine, Imperial College London, South Kensington, London SW7 2AZ, UK
| | - Atit Silsirivanit
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Raynoo Thanan
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Bruce D. Hammock
- Department of Entomology and Comprehensive Cancer Research Center, University of California, Davis, CA 95616, USA
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand
- Correspondence: ; Tel.: +66-43-363265
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15
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Sangthawan P, Klyprayong P, Geater SL, Tanvejsilp P, Anutrakulchai S, Boongird S, Gojaseni P, Kuhiran C, Lorvinitnun P, Noppakun K, Parapiboon W, Sirilak S, Tankee P, Taruangsri P, Sangsupawanich P, Sritara P, Chaiyakunapruk N, Kitiyakara C. The hidden financial catastrophe of chronic kidney disease under universal coverage and Thai "Peritoneal Dialysis First Policy". Front Public Health 2022; 10:965808. [PMID: 36311589 PMCID: PMC9606783 DOI: 10.3389/fpubh.2022.965808] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/26/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Universal health coverage can decrease the magnitude of the individual patient's financial burden of chronic kidney disease (CKD), but the residual financial hardship from the patients' perspective has not been well-studied in low and middle-income countries (LMICs). This study aimed to evaluate the residual financial burden in patients with CKD stage 3 to dialysis in the "PD First Policy" under Universal Coverage Scheme (UCS) in Thailand. Methods This multicenter nationwide cross-sectional study in Thailand enrolled 1,224 patients with pre-dialysis CKD, hemodialysis (HD), and peritoneal dialysis (PD) covered by UCS and other health schemes for employees and civil servants. We interviewed patients to estimate the proportion with catastrophic health expenditure (CHE) and medical impoverishment. The risk factors associated with CHE were analyzed by multivariable logistic regression. Results Under UCS, the total out-of-pocket expenditure in HD was over two times higher than PD and nearly six times higher than CKD stages 3-4. HD suffered significantly more CHE and medical impoverishment than PD and pre-dialysis CKD [CHE: 8.5, 9.3, 19.5, 50.0% (p < 0.001) and medical impoverishment: 8.0, 3.1, 11.5, 31.6% (p < 0.001) for CKD Stages 3-4, Stage 5, PD, and HD, respectively]. In the poorest quintile of UCS, medical impoverishment was present in all HD and two-thirds of PD patients. Travel cost was the main driver of CHE in HD. In UCS, the adjusted risk of CHE increased in PD and HD (OR: 3.5 and 16.3, respectively) compared to CKD stage 3. Conclusions Despite universal coverage, the residual financial burden remained high in patients with kidney failure. CHE was considerably lower in PD than HD, although the rates remained alarmingly high in the poor. The "PD First' program" could serve as a model for other LMICs. However, strategies to minimize financial distress should be further developed, especially for the poor.
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Affiliation(s)
- Pornpen Sangthawan
- Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pinkaew Klyprayong
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sarayut L. Geater
- Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pimwara Tanvejsilp
- Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Sirirat Anutrakulchai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sarinya Boongird
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pongsathorn Gojaseni
- Department of Medicine, Bhumibol Adulyadej Hospital, Directorate of Medical Services, Royal Thai Air Force, Bangkok, Thailand
| | - Charan Kuhiran
- Department of Medicine, Somdej Pranangchao Sirikit Hospital, Chonburi, Thailand
| | - Pichet Lorvinitnun
- Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Kajohnsak Noppakun
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Watanyu Parapiboon
- Department of Medicine, Maharat Nakhonratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Supinda Sirilak
- Department of Internal Medicine, Naresuan University Hospital, Naresuan University, Phitsanulok, Thailand
| | - Pluemjit Tankee
- Department of Medicine, Vachiraphuket Hospital, Phuket, Thailand
| | | | - Pasuree Sangsupawanich
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Piyamitr Sritara
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States,IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, United States,*Correspondence: Nathorn Chaiyakunapruk
| | - Chagriya Kitiyakara
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand,Chagriya Kitiyakara
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16
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Lukkanalikitkul E, Kongpetch S, Chotmongkol W, Morley MG, Anutrakulchai S, Srichan C, Thinkhamrop B, Chunghom T, Wiangnon P, Thinkhamrop W, Morley KE. Optimization of the Chronic Kidney Disease-Peritoneal Dialysis App to Improve Care for Patients on Peritoneal Dialysis in Northeast Thailand: User-Centered Design Study. JMIR Form Res 2022; 6:e37291. [PMID: 35793137 PMCID: PMC9301552 DOI: 10.2196/37291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 02/06/2023] Open
Abstract
Background The prevalence of peritoneal dialysis (PD) in Thailand is increasing rapidly in part because of Thailand’s Peritoneal Dialysis First policy. PD is a home-based renal replacement therapy in which patients with chronic kidney disease perform up to 4 exchanges of dialysate fluid per day in the peritoneal cavity. Overhydration is one of the most common complications in patients on PD and is associated with increased morbidity and mortality. To monitor hydration status, patients collect hydration metrics, including body weight, blood pressure, urine output, and ultrafiltration volume, from each dialysis cycle and enter this information into a PD logbook. This information is reviewed bimonthly at PD clinic appointments. The chronic kidney disease-PD (CKD-PD) app with near-field communication (NFC) and optical character recognition (OCR) was developed to automate hydration metric collection. The information was displayed in the app for self-monitoring and uploaded to a database for real-time monitoring by the PD clinic staff. Early detection and treatment of overhydration could potentially reduce the morbidity and mortality related to overhydration. Objective This study aims to identify usability issues and technology adoption barriers for the CKD-PD app with NFC and OCR and a monitoring system and to use this information to make rapid cycle improvements. Methods A multidisciplinary team of nephrologists, PD clinic nurses, computer programmers, and engineers trained and observed 2 groups of 5 participants in the use of the CKD-PD app with NFC and OCR and a monitoring system. The participants were observed using technology in their homes in 3 phases. The data collected included the Unified Theory of Acceptance and Use of Technology questionnaire, think-aloud observation, user ratings, completion of hydration metrics, and upload of hydration metrics to the central database. These results were used by the team between phases to improve the functionality and usefulness of the app. Results The CKD-PD app with NFC and OCR and a monitoring system underwent 3 rapid improvement cycles. Issues were identified regarding the usability of the NFC and OCR data collection, app stability, user interface, hydration metric calculation, and display. NFC and OCR improved hydration metric capture; however, issues remained with their usability. App stability and user interface issues were corrected, and hydration metrics were successfully uploaded by the end of phase 3. Participants’ scores on technology adoption decreased but were still high, and there was enthusiasm for the self-monitoring and clinical communication features. Conclusions Our rapid cycle process improvement methodology identified and resolved key barriers and usability issues for the CKD-PD app with NFC and OCR and a monitoring system. We believe that this methodology can be accomplished with limited training in data collection, statistical analysis, and funding.
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Affiliation(s)
- Eakalak Lukkanalikitkul
- Center of Excellence in Kidney Diseases, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sawinee Kongpetch
- Center of Excellence in Kidney Diseases, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wijittra Chotmongkol
- Center of Excellence in Kidney Diseases, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Michael G Morley
- Ophthalmic Consultants of Boston, Harvard Medical School, Boston, MA, United States
| | - Sirirat Anutrakulchai
- Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chavis Srichan
- Department of Computer Engineering, Faculty of Engineering, Khon Kaen University, Khon Kaen, Thailand
| | - Bandit Thinkhamrop
- Data Management and Statistical Analysis Center, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Theenatchar Chunghom
- Kidney Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pongsai Wiangnon
- Kidney Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wilaiphorn Thinkhamrop
- Data Management and Statistical Analysis Center, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Katharine E Morley
- Massachusetts General Hospital Center for Global Health, Harvard Medical School, Boston, MA, United States
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17
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Panaput T, Domrongkitchaiporn S, Thinkhamrop B, Sirivongs D, Praderm L, Anukulanantachai J, Kanokkantapong C, Tungkasereerak P, Pongskul C, Anutrakulchai S, Keobounma T, Narenpitak S, Intarawongchot P, Suwattanasin A, Tatiyanupanwong S, Niwattayakul K. Early as compared to late initiation of twice-weekly hemodialysis and short-term survival among end-stage renal disease patients. Hemodial Int 2022; 26:509-518. [PMID: 35726582 DOI: 10.1111/hdi.13031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 04/21/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The impact of timing of hemodialysis (HD) for end-stage renal disease (ESRD) patients treated with twice-weekly HD remains unclear. We aimed to determine the effects of late initiation of HD on short-term mortality and hospitalization. METHODS A multicenter cohort study was conducted in 11 HD centers in Northeastern Thailand (HEmodialysis Network of the NorthEastern Thailand study group). We recruited adult ESRD patients who were treated with twice-weekly HD for more than 3 months and had data on eGFR at HD initiation. Clinical and laboratory values at the time of recruitment were recorded. Late and early (eGFR at start <5 and >5 ml/min/1.73 m2 ) initiations were defined. Outcomes were disease-related death (excluding any accidental deaths) and first hospitalization. Data analysis was performed by multivariable cox-regression analysis. FINDINGS A total of 407 patients who had data on eGFR at HD initiation (303 in late group and 104 in early group) were included for analysis. There were 56.8% male with a mean age of 55 years. During the 15.1 months of follow-up, there were 27 (6.6%) disease-related deaths. The 1-year survival rate was similar among late and early initiation groups. The incidence density of first hospitalization in the late group was significantly lower than those in the early group (HR adjusted, 0.63; 95% CI, 0.40-0.99, p = 0.047). Among 303 patients who were in the late start group, patients with diabetes had a higher mortality rate (HR, 3.49; 95% CI, 1.40-8.70, p = 0.007) when compared to non-diabetic patients. DISCUSSION Early initiation of HD at eGFR >5 ml/min/1.73 m2 had no short-term survival benefit compared to the late group in ESRD patients treated with twice-weekly HD for at least 3 months in a resource-limited setting. A survival benefit from an early start of HD was found among diabetic patients.
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Affiliation(s)
| | | | | | - Dhavee Sirivongs
- Department of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | | | | | | | | | - Cholatip Pongskul
- Department of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Department of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
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18
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Lukkanalikitkul E, Pussadhamma B, Ahooja A, Ungprasert P, Toparkngam P, Nawapun S, Takong W, Toimamueang U, Anutrakulchai S. Effect and correlation of patent vascular access flow on left ventricular hypertrophy in kidney transplant patients. IJC Heart & Vasculature 2022; 40:101048. [PMID: 35586170 PMCID: PMC9108726 DOI: 10.1016/j.ijcha.2022.101048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 11/30/2022]
Abstract
Background Patency of vascular accesses (VA) is associated with left ventricular hypertrophy (LVH) in kidney transplant recipients (KTR). This level of VA flow (VAF) as related to LVH was assessed and an upward level of VA flow recommended for VA closure determined. This recommendation has not been previously reported. Methods 123 KTR cohort patients were enrolled between August 2016 and December 2017 and their LVH and LV mass index (LVMI) by echocardiography and VAF by Doppler ultrasound were evaluated at baseline and for a 24-month follow-up period. Associations between VAF and LVH were adjusted for other factors. Results Patients with patent VA (55.3%) had significantly greater LVH (47.1 vs. 29.1%, an adjusted odds ratio 2.44, p = 0.03) and LVMI (112.15 ± 34.4 vs. 97.55 ± 23.55 g/m2, p = 0.009) when compared with the non-VA group. A positive correlation between VAF rate and LVM was noted (r = 0.40, p < 0.001). Subgroup analysis revealed the VAF ≥ 900 ml/min had risks of LVH 3.61, and 2.86 times compared with the non-VA group and the VAF < 900 ml/min group. After a 24-month follow up, there was no significantly individual change in LVMI in patients with or without VA except 6 patients who lost their VA patency during follow-up time had a significant reduction of LVMI (120.17 ± 52.13 to 80.89 ± 22.72 g/m2, p = 0.046). Conclusions Patency of VA in post-KT patients was associated with LVH. There was a significant reduction of LMVI after loss of VA patency. Patients with stable kidney graft function should be considered for VA closure especially if VAF is ≥ 900 ml/min.
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19
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Yingklang M, Chaidee A, Dangtakot R, Jantawong C, Haonon O, Sitthirach C, Hai NT, Cha’on U, Anutrakulchai S, Kamsa-ard S, Pinlaor S. Association of Strongyloides stercoralis infection and type 2 diabetes mellitus in northeastern Thailand: Impact on diabetic complication-related renal biochemical parameters. PLoS One 2022; 17:e0269080. [PMID: 35639713 PMCID: PMC9154194 DOI: 10.1371/journal.pone.0269080] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/13/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Several studies have demonstrated that helminth infections provide a degree of protection against Type 2 diabetes mellitus (T2DM). However, the relationship between Strongyloides stercoralis infection and T2DM has scarcely been investigated and the protective effect of infection against development of diabetic complications is unclear. In this study, we aimed to investigate the relationship between S. stercoralis infection and T2DM in a rural area of Khon Kaen Province, Thailand. The impact of S. stercoralis infection on diabetic complication-related kidney function biochemical parameters and body-mass index (BMI) was also assessed. METHODOLOGY Using a cross-sectional study design, S. stercoralis infection and T2DM assessments were conducted between October 2020 and May 2021. Associations between S. stercoralis infection, T2DM, and socioeconomic factors were analyzed using multivariable logistic regression analyses. Diabetic complication-related biochemical parameters relating largely to kidney function (estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), serum creatinine, uric acid, alanine transaminase (ALT), and low-density lipoprotein cholesterol (LDL-C)) and BMI of participants with and without T2DM were compared between groups with or without S. stercoralis infection. RESULTS One hundred and seven out of 704 individuals (15.20%) were positive for S. stercoralis, and 283 people were diagnosed with T2DM. Of those with T2DM, 11.31% (32/283) were infected with S. stercoralis and of those without T2DM, 17.82% (75/421) were infected with S. stercoralis. Multivariate analysis revealed that T2DM was inversely correlated with S. stercoralis infection (Adjusted OR = 0.49; 95% CI: 0.30, 0.78; p = 0.003), while male, increasing age, lower education level, and alcohol intake were positively associated with infection. Those infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels than those in the uninfected group. CONCLUSION This finding indicates that S. stercoralis infection was inversely associated with T2DM in northeastern Thailand, but participants infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels. Infection with S. stercoralis might lead to worse complication-related renal biochemical parameters.
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Affiliation(s)
- Manachai Yingklang
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Apisit Chaidee
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Rungtiwa Dangtakot
- Department of Medical Technology, Faculty of Allied Health Science, Nakhon Ratchasima College, Nakhon Ratchasima, Thailand
| | - Chanakan Jantawong
- Department of Medical Technology, Faculty of Allied Health Science, Nakhon Ratchasima College, Nakhon Ratchasima, Thailand
| | - Ornuma Haonon
- Department of Medical Technology, Faculty of Allied Health Science, Nakhon Ratchasima College, Nakhon Ratchasima, Thailand
| | - Chutima Sitthirach
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nguyen Thi Hai
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Ubon Cha’on
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Supot Kamsa-ard
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Somchai Pinlaor
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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20
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Sasai F, Rogers K, Orlicky DJ, Stem A, Schaeffer J, Garcia G, Fox J, Ray MS, Butler-Dawson J, Gonzalez-Quiroz M, Leiva R, Taduri G, Anutrakulchai S, Venugopal V, Madero M, Glaser J, Wijkstrom J, Wernerson A, Brown J, Roncal-Jimenez CA, Johnson RJ. Inhaled Silica Nanoparticles Causes Chronic Kidney Disease in Rats. Am J Physiol Renal Physiol 2022; 323:F48-F58. [PMID: 35635324 DOI: 10.1152/ajprenal.00021.2022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Silica nanoparticles (SiNPs) released during the burning of sugarcane have been postulated to have a role in chronic kidney disease of unknown etiology. We tested the hypothesis that pristine SiNPs of the size present in sugarcane might cause chronic kidney injury when administered through the lung in rats. METHODS We administered 200 nm or 300 nm amorphous SiNPs twice weekly (4 mg/dose) or vehicle by oropharyngeal aspiration for 13 weeks to rats followed by sacrifice after an additional 13 weeks (26 weeks total). Tissues were evaluated for presence of SiNPs and evidence of histologic injury. RESULTS Both sizes of SiNPs caused kidney damage, with early tubular injury and inflammation (at week 13) that continued to inflammation and chronic fibrosis at week 26 despite discontinuing the SiNP administration. Both sizes of SiNPs caused local inflammation in the lung and kidney and were detected in the serum and urine at week 13, and the 200 nm particles also localized to the kidney with no evidence of retention of the 300 nm particles. At week 26 there was some clearance of the 200 nm silica from the kidneys, and urinary levels of SiNPs were reduced but still significant in both the 200 and 300 nm exposed rats. CONCLUSIONS Inhaled SiNPs causes chronic kidney injury that progresses despite stopping the SiNP administration. These findings are consistent with the hypothesis that human exposure to amorphous silica nanoparticles found in burned sugarcane fields could have a participatory role in chronic kidney disease of unknown etiology.
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Affiliation(s)
- Fumihiko Sasai
- Division of Renal Disease, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Keegan Rogers
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - David J Orlicky
- Department of Pathology, University of Colorado School of Medicine, Denver, Colorado, United States
| | - Arthur Stem
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Joshua Schaeffer
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States.,Center for Health, Work and Environment, Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Gabriela Garcia
- Division of Renal Disease, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Jacob Fox
- Division of Renal Disease, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Matthew S Ray
- Division of Renal Disease, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Jaime Butler-Dawson
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States
| | - Marvin Gonzalez-Quiroz
- Research Centre on Health, Work and Environment (CISTA), National Autonomous University of Nicaragua, León, Nicaragua
| | - Ricardo Leiva
- Division of Kidney Diseases, Hospital Rosales, San Salvador, El Salvador
| | | | | | - Vidhya Venugopal
- School of Public Health, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Magdalena Madero
- Division of Kidney Diseases, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | | | - Julia Wijkstrom
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Annika Wernerson
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Jared Brown
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Carlos A Roncal-Jimenez
- Division of Renal Disease, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Richard J Johnson
- Division of Renal Disease, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
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21
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Chariyavilaskul P, Phaisal W, Kittanamongkolchai W, Rukrung C, Anutrakulchai S, Avihingsanon Y. Pharmacokinetics and pharmacodynamics profiles of enteric-coated mycophenolate sodium in female patients with difficult-to-treat lupus nephritis. Clin Transl Sci 2022; 15:1776-1786. [PMID: 35570339 PMCID: PMC9283741 DOI: 10.1111/cts.13295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/11/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022] Open
Abstract
Relapsed or resistant lupus nephritis (LN) is considered a difficult-to-treat type of LN, and enteric-coated mycophenolate sodium (EC-MPS) has been used in this condition. Therapeutic drug monitoring using the area under the plasma mycophenolic acid concentration from 0 to 12 h postdose (MPA-AUC0-12h ) ≥45 μg.h/ml is a useful approach to achieve the highest efficiency. This study assessed EC-MPS's pharmacokinetic (PK) and pharmacodynamic (PD) profiles and investigated an optimal level of the single time point of plasma MPA concentration. Nineteen biopsy-proven patients with class III/IV LN received 1440 mg/day of EC-MPS for 24 weeks. PK (maximum plasma MPA concentration [Cmax ], time to Cmax , and MPA-AUC0-12h ) and PD (activity of inosine-5'-monophosphate dehydrogenase [IMPDH]) parameters were measured at weeks 2, 8, 16, and 24. We found that IMPDH activity decreased from baseline by 31-42% within 2-4 h after dosing, coinciding with the increased plasma MPA concentration. MPA-AUC0-12h ≥45 μg.h/ml was best predicted by a single time point MPA concentration at C0.5, C2, C3, C4, and C8 (r2 = 0.516, 0.514, 0.540, 0.611, and 0.719, respectively), independent of dose, albumin, urine protein/creatinine ratio, and urinalysis. The MPA-C0.5 cutoff of 2.03 g/ml yielded the highest overall sensitivity of 85% and specificity of 88.2% in predicting MPA-AUC0-12h ≥45 μg.h/ml. A single timepoint of plasma MPA-C0.5 ≥2.03 μg/ml may help guide EC-MPS adjustment to achieve adequate drug exposure. Further study of EC-MPS used to validate this cutoff is warranted.
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Affiliation(s)
- Pajaree Chariyavilaskul
- Clinical Pharmacokinetics and Pharmacogenomics Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Weeraya Phaisal
- Clinical Pharmacokinetics and Pharmacogenomics Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wonngarm Kittanamongkolchai
- Maha Chakri Sirindhorn Clinical Research Center Under the Royal Patronage, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Renal Immunology and Transplantation Research Unit, Chulalongkorn University, Bangkok, Thailand.,Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chutima Rukrung
- Maha Chakri Sirindhorn Clinical Research Center Under the Royal Patronage, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sirirat Anutrakulchai
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Knon Kaen, Thailand
| | - Yingyos Avihingsanon
- Renal Immunology and Transplantation Research Unit, Chulalongkorn University, Bangkok, Thailand.,Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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22
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Tonsawan P, Intarak S, Sripa B, Puapairoj A, Sripa M, Sithithaworn P, Anutrakulchai S. Association between Opisthorchis viverrini Infection and Glomerular Disease in Thailand. Am J Nephrol 2022; 53:199-206. [PMID: 35168235 DOI: 10.1159/000521780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/27/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Opisthorchis viverrini (OV) is a major cause of infection in Southeast Asia. Previous studies in mouse models have shown that OV infection can contribute to immune-complex glomerulonephritis (GN). However, OV infection in human kidney tissue has never been demonstrated. Herein, we evaluated the association of OV infection with biopsy-proven glomerular disease. METHODS This study was performed in adult patients who underwent kidney biopsy between July 2016 and February 2017. All kidney tissue samples were processed using the standard techniques for renal pathological diagnoses and immunohistochemistry techniques to detect OV antigen. Pre-implanted donor kidney tissue samples were used as controls. The participants were also assessed for OV infection by serum OV immunoglobulin G antibody (Ab) levels and/or presence of OV eggs in stool. RESULTS Forty-three renal tissue samples from glomerular disease patients and 50 from transplant donors were included in the study. Mean age in the GN group was 41.7 ± 15.9 years, estimated glomerular filtration rate (eGFR) was 70.65 ± 36.61 mL/min/1.73 m2, and median proteinuria was 3.17 (1.70-4.95) g/day. Lupus nephritis (LN) was the most common diagnosis (32.6%), followed by IgA nephropathy (23.3%), IgM nephropathy (18.6%), and primary membranous nephropathy (MN; 7%). The OV antigen was observed in kidney tissue from patients with IgA nephropathy, LN, primary MN, focal segmental glomerulosclerosis, and IgM nephropathy. By contrast, no OV antigen was detected in tissue samples from the control group. The presence of OV antigens was observed in glomerular endothelial cells, mesangial cells, tubular cells, and peritubular capillaries. The odds ratio of positive serum OV Ab to predict the presence of OV antigen in kidney tissues was 4.47 (p = 0.057), and there was a negative correlation between levels of serum OV Ab and eGFR (r = -0.31, p = 0.04). DISCUSSION/CONCLUSION This is the first study to demonstrate the presence of OV antigen in human kidney tissue, which indicates that OV infection may be associated with biopsy-proven glomerular diseases.
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Affiliation(s)
- Pantipa Tonsawan
- Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sompote Intarak
- Department of Medicine, Mahasarakham Hospital, Mahasarakham, Thailand
| | - Banchob Sripa
- Tropical Disease Research Center, Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Anucha Puapairoj
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Manop Sripa
- Tropical Disease Research Center, Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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23
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Srichan C, Srichan W, Danvirutai P, Ritsongmuang C, Sharma A, Anutrakulchai S. Non-invasively accuracy enhanced blood glucose sensor using shallow dense neural networks with NIR monitoring and medical features. Sci Rep 2022; 12:1769. [PMID: 35110583 PMCID: PMC8810809 DOI: 10.1038/s41598-022-05570-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/12/2022] [Indexed: 11/24/2022] Open
Abstract
Non-invasive and accurate method for continuous blood glucose monitoring, the self-testing of blood glucose is in quest for better diagnosis, control and the management of diabetes mellitus (DM). Therefore, this study reports a multiple photonic band near-infrared (mbNIR) sensor augmented with personalized medical features (PMF) in Shallow Dense Neural Networks (SDNN) for the precise, inexpensive and pain free blood glucose determination. Datasets collected from 401 blood samples were randomized and trained with ten-fold validation. Additionally, a cohort of 234 individuals not included in the model training set were investigated to evaluate the performance of the model. The model achieved the accuracy of 97.8% along with 96.0% precision, 94.8% sensitivity and 98.7% specificity for DM classification based on a diagnosis threshold of 126 mg/dL for diabetes in fasting blood glucose. For non-invasive real-time blood glucose monitoring, the model exhibited ± 15% error with 95% confidence interval and the detection limit of 60–400 mg/dL, as validated with the standard hexokinase enzymatic method for glucose estimation. In conclusion, this proposed mbNIR based SDNN model with PMF is highly accurate and computationally cheaper compared to similar previous works using complex neural network. Some groups proposed using complicated mixed types of sensors to improve noninvasive glucose prediction accuracy; however, the accuracy gain over the complexity and costs of the systems harvested is still in questioned (Geng et al. in Sci Rep 7:12650, 2017). None of previous works report on accuracy enhancement of NIR/NN using PMF. Therefore, the proposed SDNN over PMF/mbNIR is an extremely promising candidate for the non-invasive real-time blood glucose monitoring with less complexity and pain-free.
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Affiliation(s)
- Chavis Srichan
- Faculty of Engineering, Khon Kaen University, Khon Kaen, Thailand.
| | | | | | | | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand.,Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand. .,Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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24
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Kovitangkoon K, Lukkanalikitkul E, Wiangnon P, Chunghom T, Anutrakulchai S, Blaine J, Tonsawan P. Cefazolin Plus Ceftazidime versus Cefazolin Monotherapy in the Treatment of Culture-Negative Peritonitis: A Retrospective Cohort Study. Int J Nephrol Renovasc Dis 2022; 15:17-25. [PMID: 35177925 PMCID: PMC8846620 DOI: 10.2147/ijnrd.s346427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Based on current ISPD guidelines, it is unclear as to whether ceftazidime should be discontinued in subsequent management of culture-negative peritonitis if it is used as empirical gram-negative coverage. Herein, we aim to compare the clinical outcomes of cefazolin plus ceftazidime versus cefazolin alone. Methods This was a retrospective cohort study. Adult peritoneal dialysis (PD) patients who were diagnosed with culture-negative peritonitis between 2014 and 2020 were included. Patients were categorized into two groups according to treatment regimen. Primary response rate, peritonitis relapse rate, and time to primary response were compared. Factors that predicted primary response were determined using Cox regression analysis. Results A total of 58 patients were included in the study. Of these, 42 received cefazolin plus ceftazidime and 16 received cefazolin monotherapy. Overall, the mean age was 65.7±10.4 years. Most of the patients (81.3%) were prescribed continuous ambulatory peritoneal dialysis. Initial effluent WBC was 4211±10357 in the combination group and 3833±6931 cell/mm3 in the monotherapy group (p=0.89). There was no significant difference in primary response at day 5 between the two groups (95.2% in the combination group vs93.7% in the monotherapy group, p=0.82). However, cumulative probability of primary response by the Kaplan–Meier analysis in the combination group was higher than in the monotherapy group (p=0.02). Adjusted HR of serum potassium level to predict a primary response was 1.83 according to multivariate analysis (p=0.03). There was no difference between the two groups in terms of peritonitis relapse or catheter removal. Conclusion This is the first study to compare clinical outcomes between cefazolin plus ceftazidime versus cefazolin monotherapy in culture-negative peritonitis. Our results suggest that if peritonitis is resolving at day 3, discontinuation of ceftazidime could yield favorable treatment outcomes and might be appropriate for subsequent management. However, the risk of not having gram-negative coverage should be considered.
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Affiliation(s)
- Krit Kovitangkoon
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Eakalak Lukkanalikitkul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pongsai Wiangnon
- Kidney Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Theenatchar Chunghom
- Kidney Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Judith Blaine
- Division of Renal Disease and Hypertension, University of Colorado School of Medicine, Aurora, CO, USA
| | - Pantipa Tonsawan
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Correspondence: Pantipa Tonsawan, Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand, Email
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25
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Theerakulpisut D, Thinkhamrop B, Anutrakulchai S. Comparison between Tc-99 m DTPA and Tc-99 m MAG3 Renal Scintigraphy for Prediction of Early Adverse Outcome After Kidney Transplantation. Nucl Med Mol Imaging 2021; 55:302-310. [PMID: 34868379 DOI: 10.1007/s13139-021-00716-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/15/2021] [Revised: 08/28/2021] [Accepted: 09/23/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Renal scintigraphy (RS) with either technetium-99 m diethylene-triamine-pentaacetate (Tc-99 m DTPA) or technetium-99 m mercaptoacetyltriglycine (Tc-99 m MAG3) has both been used to evaluate early allograft function after kidney transplantation (KT). This study was done to compare the predictive performance of RS using these two radiopharmaceuticals for prediction of outcomes during first 3 months of KT. Methods This retrospective study included patients who received KT then underwent both Tc-99 m DTPA and Tc-99 m MAG3 RS, successively. Receiver operating characteristic (ROC) curve analysis was used to determine the predictiveness of RS parameters on early clinical adverse outcomes of either (1) graft-related death, (2) need for graft resection, (3) delayed graft function requiring temporary dialysis, or (4) a serum creatinine level of ≥ 2.0 mg/dL at three months post-KT, as well as to predict biopsy-confirmed acute tubular necrosis and acute rejection. Results Of 187 patients included, 77 (41.2%) had at least one early adverse clinical outcome. Tc-99 m MAG3 RS was more predictive than Tc-99 m DTPA RS, in terms of AUCROC, in three parameters including time to peak (0.754 vs. 0.516, p-value 0.0001), 20-min to peak ratio (0.762 vs. 0.651, p-value 0.006), and 20-min to 3-min ratio (0.823 vs. 0.699, p-value 0.0005). Acute tubular necrosis was better predicted by Tc-99 m MAG3 RS while both were at best only modest in predicting acute rejection. Conclusion Three parameters which, when obtained from Tc-99 m MAG3 RS, had superior predictiveness compared with Tc-99 m DTPA RS, including time to peak, 20-min to peak ratio, and 20-min to 3-min ratio.
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Affiliation(s)
- Daris Theerakulpisut
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Bandit Thinkhamrop
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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26
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Sengthong C, Yingklang M, Intuyod K, Haonon O, Pinlaor P, Jantawong C, Hongsrichan N, Laha T, Anutrakulchai S, Cha'on U, Sithithaworn P, Pinlaor S. Repeated Ivermectin Treatment Induces Ivermectin Resistance in Strongyloides ratti by Upregulating the Expression of ATP-Binding Cassette Transporter Genes. Am J Trop Med Hyg 2021; 105:1117-1123. [PMID: 34339389 DOI: 10.4269/ajtmh.21-0377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/06/2021] [Indexed: 11/07/2022] Open
Abstract
Ivermectin (IVM) is a widely used anthelmintic. However, with widespread use comes the risk of the emergence of IVM resistance, particularly in strongyloidiasis. Adenosine triphosphate (ATP)-binding cassette (ABC) transporter genes play an important role in the IVM-resistance mechanism. Here, we aimed to establish an animal experimental model of IVM resistance by frequent treatment of Strongyloides ratti with subtherapeutic doses of IVM, resistance being evaluated by the expression levels of ABC transporter genes. Rats infected with S. ratti were placed in experimental groups as follows: 1) untreated control (control); 2) treated with the mutagen ethyl methanesulfonate (EMS); 3) injected with 100 µg/kg body weight of IVM (IVM); 4) treated with a combination of EMS and IVM (IVM+EMS). Parasites were evaluated after four generations. Extent of IVM resistance was assessed using IVM sensitivity, larval development, and expression of ABC genes. By the F4 generation, S. ratti in the IVM group exhibited significantly higher levels of IVM resistance than did other groups according to in vitro drug-sensitivity tests and inhibition of larval development (IC50 = 36.60 ng/mL; 95% CI: 31.6, 42.01). Expression levels of ABC isoform genes (ABCA, ABCF, and ABCG) were statistically significantly higher in the IVM-resistant line compared with the susceptible line. In conclusion, IVM subtherapeutic doses induced IVM resistance in S. ratti by the F4 generation with corresponding upregulation of some ABC isoform genes. The study provides a model for inducing and assessing drug resistance in Strongyloides.
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Affiliation(s)
- Chatchawan Sengthong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Medical Technology Unit of Bangkatum Hospital, Phitsanulok, Thailand.,Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand
| | - Manachai Yingklang
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand
| | - Kitti Intuyod
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.,Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ornuma Haonon
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.,Faculty of Medical Technology, Nakhonratchasima College, Nakhon Ratchasima, Thailand
| | - Porntip Pinlaor
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.,Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Chanakan Jantawong
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.,Science Program in Biomedical Science, Khon Kaen University, Khon Kaen, Thailand
| | - Nuttanan Hongsrichan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand
| | - Thewarach Laha
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.,Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ubon Cha'on
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand.,Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand
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27
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Nahok K, Phetcharaburanin J, Li JV, Silsirivanit A, Thanan R, Boonnate P, Joonhuathon J, Sharma A, Anutrakulchai S, Selmi C, Cha’on U. Monosodium Glutamate Induces Changes in Hepatic and Renal Metabolic Profiles and Gut Microbiome of Wistar Rats. Nutrients 2021; 13:1865. [PMID: 34070818 PMCID: PMC8229789 DOI: 10.3390/nu13061865] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 01/14/2023] Open
Abstract
The short- and long-term consumption of monosodium glutamate (MSG) increases urinary pH but the effects on the metabolic pathways in the liver, kidney and the gut microbiota remain unknown. To address this issue, we investigated adult male Wistar rats allocated to receive drinking water with or without 1 g% MSG for 2 weeks (n = 10, each). We performed a Nuclear Magnetic Resonance (NMR) spectroscopy-based metabolomic study of the jejunum, liver, and kidneys, while faecal samples were collected for bacterial DNA extraction to investigate the gut microbiota using 16S rRNA gene sequencing. We observed significant changes in the liver of MSG-treated rats compared to controls in the levels of glucose, pyridoxine, leucine, isoleucine, valine, alanine, kynurenate, and nicotinamide. Among kidney metabolites, the level of trimethylamine (TMA) was increased, and pyridoxine was decreased after MSG-treatment. Sequencing of the 16S rRNA gene revealed that MSG-treated rats had increased Firmicutes, the gut bacteria associated with TMA metabolism, along with decreased Bifidobacterium species. Our data support the impact of MSG consumption on liver and kidney metabolism. Based on the gut microbiome changes, we speculate that TMA and its metabolites such as trimethylamine-N-oxide (TMAO) may be mediators of the effects of MSG on the kidney health.
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Affiliation(s)
- Kanokwan Nahok
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (K.N.); (J.P.); (A.S.); (R.T.); (P.B.)
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand; (A.S.); (S.A.)
| | - Jutarop Phetcharaburanin
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (K.N.); (J.P.); (A.S.); (R.T.); (P.B.)
| | - Jia V. Li
- Department of Metabolism, Digestive Disease and Reproduction, Faculty of Medicine, Imperial College London, South Kensington, London SW7 2AZ, UK;
| | - Atit Silsirivanit
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (K.N.); (J.P.); (A.S.); (R.T.); (P.B.)
| | - Raynoo Thanan
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (K.N.); (J.P.); (A.S.); (R.T.); (P.B.)
| | - Piyanard Boonnate
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (K.N.); (J.P.); (A.S.); (R.T.); (P.B.)
| | - Jarus Joonhuathon
- Northeast Laboratory Animal Center, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand; (A.S.); (S.A.)
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand; (A.S.); (S.A.)
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Carlo Selmi
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center IRCCS, Rozzano, 20089 Milan, Italy
- Department of Clinical Biosciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (K.N.); (J.P.); (A.S.); (R.T.); (P.B.)
- Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand; (A.S.); (S.A.)
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Danvirutai P, Ekpanyapong M, Tuantranont A, Bohez E, Anutrakulchai S, Wisitsoraat A, Srichan C. Ultra-sensitive and label-free neutrophil gelatinase-associated lipocalin electrochemical sensor using gold nanoparticles decorated 3D Graphene foam towards acute kidney injury detection. Sensing and Bio-Sensing Research 2020. [DOI: 10.1016/j.sbsr.2020.100380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Pundee R, Kongtip P, Nankongnab N, Anutrakulchai S, Robson MG, Woskie S. Cross-shift change of acute kidney injury biomarkers in sugarcane farmers and cutters. Hum Ecol Risk Assess 2020; 27:1170-1187. [PMID: 34290492 PMCID: PMC8291722 DOI: 10.1080/10807039.2020.1812049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 06/04/2023]
Abstract
Sugarcane farmers and cutters have been reported to be at high risk of acute kidney injury. This cross-sectional study aimed to assess acute kidney injury biomarkers, and cross-shift change among 150 sugarcane cutters and 98 sugarcane farmers in Thailand. Physical health examination, environmental measurements, and measured urinary neutrophil gelatinase-associated lipocalin (NGAL) were assessed. Cross-shift change of urine creatinine (uCr), albumin creatinine ratio (ACR), and NGAL between sugarcane farmers and cutters was compared. Factors influencing abnormal post-shift ACR and NGAL were analyzed by binary logistic regression adjusted with covariates. Sugarcane cutters were significantly more likely to take nonsteroidal anti-inflammatory drugs (NSAID) and herbs to relieve pain than sugarcane farmers. Males were more likely to be current smokers and drinkers although 62% of cutters and 56% of farmers were female. Sugarcane farmers and cutters had similar post-shift estimated glomerular filtration rate (eGFR) and ACR levels. Cross-shift measurements showed that both sugarcane cutters and sugarcane farmers had significantly higher post-shift geometric mean (GM) urinary NGAL, but that the cross-shift changes of NGAL were significantly higher for sugarcane cutters (182%) vs. sugarcane farmers (112%). Water intake less than recommendation of subjects was a significant predictor of a higher risk for an abnormal post-shift ACR after controlling for covariates, while being a sugarcane cutter was a predictor of a lower risk of an abnormal risk of a post-shift NGAL after controlling for covariates. Measurements of heat stress (WBGT plus workload) found that sugarcane cutters exceeded recommended exposures while sugarcane farmers were compliance to the TLV. These findings suggest that to protect sugarcane farmers and cutters, preventative measures are needed.
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Affiliation(s)
- Ritthirong Pundee
- Mahidol University Faculty of Public Health, Department of Occupational Health and Safety, Bangkok, Thailand
| | - Pornpimol Kongtip
- Mahidol University Faculty of Public Health, Department of Occupational Health and Safety, Bangkok, Thailand
- Center of Excellence on Environmental Health and Toxicology, Bangkok, Thailand
| | - Noppanun Nankongnab
- Mahidol University Faculty of Public Health, Department of Occupational Health and Safety, Bangkok, Thailand
| | - Sirirat Anutrakulchai
- Khon Kaen University Faculty of Medicine, Department of Medicine, Khon Kaen, Thailand
| | - Mark Gregory Robson
- Rutgers, School of Environmental and Biological Sciences, New Brunswick, USA
| | - Susan Woskie
- Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Department of Public Health, Lowell, USA
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Cha'on U, Wongtrangan K, Thinkhamrop B, Tatiyanupanwong S, Limwattananon C, Pongskul C, Panaput T, Chalermwat C, Lert-Itthiporn W, Sharma A, Anutrakulchai S. CKDNET, a quality improvement project for prevention and reduction of chronic kidney disease in the Northeast Thailand. BMC Public Health 2020; 20:1299. [PMID: 32854662 PMCID: PMC7450931 DOI: 10.1186/s12889-020-09387-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of chronic kidney disease (CKD) is high in the Northeast Thailand compared to other parts of the country. Therefore, a broad program applying all levels of care is inevitable. This paper describes the results of the first year trial of the Chronic Kidney Disease Prevention in the Northeast Thailand (CKDNET), a quality improvement project collaboratively established to curb CKD. METHODS We have covered general population, high risk persons and all stages of CKD patients with expansive strategies such as early screening, effective CKD registry, prevention and CKD comprehensive care models including cost effectiveness analysis. RESULTS The preliminary results from CKD screening in general population of two rural sub-districts show that 26.8% of the screened population has CKD and 28.9% of CKD patients are of unknown etiology. We have established the CKD registry that has enlisted a total of 10.4 million individuals till date, of which 0.13 million are confirmed to have CKD. Pamphlets, posters, brochures and other media of 94 different types in the total number of 478,450 has been distributed for CKD education and awareness at the community level. A CKD guideline that suits for local situation has been formulated to deal the problem effectively and improve care. Moreover, our multidisciplinary intervention and self-management supports were effective in improving glomerular filtration rate (49.57 versus 46.23 ml/min/1.73 m2; p < 0.05), blood pressure (129.6/76.1 versus 135.8/83.6 mmHg) and quality of life of CKD patients included in the program compared to those of the patients under conventional care. The cost effectiveness analysis revealed that lifetime cost for the comprehensive health services under the CKDNET program was 486,898 Baht compared to that of the usual care of 479,386 Baht, resulting in an incremental-cost effectiveness ratio of 18,702 Baht per quality-adjusted life years gained. CONCLUSION CKDNET, a quality improvement project of the holistic approach is currently applying to the population in the Northeast Thailand which will facilitate curtailing of CKD burden in the region.
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Affiliation(s)
- Ubon Cha'on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Kanok Wongtrangan
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Bandit Thinkhamrop
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Data Management and Statistical Analysis Center, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Sajja Tatiyanupanwong
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Chaiyaphum Hospital, Chaiyaphum, Thailand
| | - Chulaporn Limwattananon
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Faculty of Pharmaceutical Science, Khon Kaen University, Khon Kaen, Thailand
| | - Cholatip Pongskul
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thanachai Panaput
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
- Khon Kaen Hospital, Khon Kaen, Thailand
| | - Chalongchai Chalermwat
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Worachart Lert-Itthiporn
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen, Thailand.
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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Pongking T, Haonon O, Dangtakot R, Onsurathum S, Jusakul A, Intuyod K, Sangka A, Anutrakulchai S, Cha’on U, Pinlaor S, Pinlaor P. A combination of monosodium glutamate and high-fat and high-fructose diets increases the risk of kidney injury, gut dysbiosis and host-microbial co-metabolism. PLoS One 2020; 15:e0231237. [PMID: 32267892 PMCID: PMC7141667 DOI: 10.1371/journal.pone.0231237] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 03/19/2020] [Indexed: 12/15/2022] Open
Abstract
Consumption of either monosodium glutamate (MSG) or high-fat and high-fructose (HFF) diets changes the gut microbiome and hence contributes to development of several diseases. In this study, with an emphasis on kidney injury, hamsters were divided into 4 groups as follows: (1) hamsters fed with standard diet (control); (2) hamsters fed with standard diet and MSG in drinking water (MSG); (3) hamsters fed with high-fat and high-fructose diets (HFF), and (4) animals fed MSG+HFF. After 8 months, the animals were used for the study. Despite showing normal kidney function, hamsters fed with MSG+HFF exhibited signs of kidney damage as demonstrated by the highest expression levels of high-mobility group box-1 and kidney injury molecule-1 in kidney tissues, while slight changes of histopathological features in H&E-stained sections and normal levels of creatinine were observed, indicating possible early stages of kidney injury. Sequencing of the microbial 16S rRNA gene revealed that animals fed with the MSG+HFF diet had a higher ratio of gut Firmicutes/Bacteroidetes along with marked changes in abundance and diversity of gut microbiome compared to hamsters fed with MSG or HFF alone. In addition, 1H Nuclear magnetic resonance spectroscopy showed an elevation of urine p-cresol sulfate levels in the MSG+HFF group. These results indicate that consumption of both MSG and HFF increases the risk of kidney injury, induces gut dysbiosis and an increase in the amount of p-cresol sulfate in hamsters.
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Affiliation(s)
- Thatsanapong Pongking
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ornuma Haonon
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Rungtiwa Dangtakot
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sudarat Onsurathum
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand
| | - Apinya Jusakul
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kitti Intuyod
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Arunnee Sangka
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Porntip Pinlaor
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeast of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- * E-mail:
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Cha’on U, Pongskul C, Thinkhamrop B, Limwattananon C, Sharma A, Anutrakulchai S. CKDNET: a program for fighting with chronic kidney disease in the Northeast Thailand. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.08939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University
| | | | - Bandit Thinkhamrop
- Data Management and Statistical Analysis Center, Faculty of Public Health, Khon Kaen University
| | | | - Amod Sharma
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET)
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Thancharoen O, Waleekhachonloet O, Limwattananon C, Anutrakulchai S. Cognitive impairment, quality of life and healthcare utilization in patients with chronic kidney disease stages 3 to 5. Nephrology (Carlton) 2020; 25:625-633. [DOI: 10.1111/nep.13705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/05/2020] [Accepted: 02/14/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | - Onanong Waleekhachonloet
- Department of Clinical Pharmacy, Faculty of PharmacyMahasarakham University Mahasarakham Thailand
| | - Chulaporn Limwattananon
- Division of Clinical Pharmacy, Faculty of Pharmaceutical SciencesKhon Kaen University Khon Kaen Thailand
| | - Sirirat Anutrakulchai
- Department of Internal Medicine, Faculty of MedicineKhon Kaen University Khon Kaen Thailand
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Kaewrat W, Sengthong C, Yingklang M, Intuyod K, Haonon O, Onsurathum S, Dangtakot R, Saisud P, Sangka A, Anutrakulchai S, Pinlaor S, Cha'on U, Pinlaor P. Improved agar plate culture conditions for diagnosis of Strongyloides stercoralis. Acta Trop 2020; 203:105291. [PMID: 31816322 DOI: 10.1016/j.actatropica.2019.105291] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 10/09/2019] [Accepted: 12/04/2019] [Indexed: 01/29/2023]
Abstract
Strongyloides stercoralis infection causes gastrointestinal symptoms and can lead to severe disease in immunocompromised hosts. Live larvae are passed in feces, encouraging the common use of diagnosis by cultivation methods including agar plate culture (APC), the gold-standard technique. Nevertheless, APC has limitations, especially since there can be considerable day-to-day fluctuations in numbers of larvae produced. Herein, we collected stool samples from heavily infected subjects with strongyloidiasis in Khon Kaen Province, Thailand, to evaluate modifications (temperature, pH, nutrition source and salinity) to APC conditions to maximize the number of S. stercoralis worms counted. Best results were obtained using a modified APC with the following conditions: pH 6.0, 0.5% of NaCl, addition of yeast extract for nutrition and incubation at 29-30 °C. This modified APC was more sensitive for detection of S. stercoralis than was standard APC or the formalin-ethyl acetate concentration technique. In brief, this finding suggests that a modification of standard APC conditions increases the counts of S. stercoralis.
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Sae-lim O, Doungngern T, Jaisue S, Cheewatanakornkul S, Arunmanakul P, Anutrakulchai S, Kanjanavanit R, Wongpoowarak W. Prediction Of Serum Digoxin Concentration Using Estimated Glomerular Filtration Rate In Thai Population. Int J Gen Med 2019; 12:455-463. [PMID: 31819596 PMCID: PMC6896919 DOI: 10.2147/ijgm.s218393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/05/2019] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Serum digoxin concentration (SDC) monitoring may be unavailable in some healthcare settings. Predicted SDC comes into play in the efficacy and toxicity monitoring of digoxin. Renal function is the important parameter for predicting SDC. This study was conducted to compare measured and predicted SDC when using creatinine clearance (CrCl) from Cockcroft-Gault (CG) equation and estimated glomerular filtration rate (eGFR) calculated from CKD-Epidemiology Collaboration (CKD-EPI), re-expressed Modification of Diet in Renal Disease (Re-MDRD4), Thai-MDRD4, and Thai-eGFR equations in Sheiner's and Konishi's pharmacokinetic models. PATIENTS AND METHODS In this retrospective study, patients with cardiovascular disease with a steady-state of SDC within 0.5-2.0 mcg/L were enrolled. CrCl and studied eGFR adjusted for body surface area (BSA) were used in the models to determine the predicted SDC. The discrepancies of the measured and the predicted SDC were analyzed and compared. RESULTS One hundred and twenty-four patients ranging in age from 22 to 88 years (median 60 years, IQR 50.2, 69.2) were studied. Their serum creatinine ranged from 0.40 to 1.80 mg/dL (median 0.90 mg/dL, IQR 0.79, 1.10). The mean±SD of measured SDC was 1.12±0.34 mcg/L. In the Sheiner's model, the mean predicted SDC was calculated by using the CG and the BSA adjusted CKD-EPI equations and was not different when compared with the measured levels (1.10±0.36 mcg/L (p=0.669) and 1.08±0.42 mcg/L (p=0.374), respectively). The CG, CKD-EPI, and Re-MDRD4 equations were a better fit for patients with creatinine ≥0.9 mg/dL for prediction with minimal errors. In the Konishi's model, the predicted SDC using the CG and the studied eGFR equation was lower than the measured SDC (p<0.05). CONCLUSION In Sheiner's model, the CG and the BSA adjusted CKD-EPI equations should be used for predicting SDC, especially in patients with serum creatinine ≥0.9 mg/dL. The other studied eGFRs underestimated SDC in both Sheiner's and Konishi's model.
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Affiliation(s)
- Orawan Sae-lim
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Thitima Doungngern
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Siriluk Jaisue
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Sirichai Cheewatanakornkul
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Poukwan Arunmanakul
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Sirirat Anutrakulchai
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Rungsrit Kanjanavanit
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chaing Mai University, Chiang Mai, Thailand
| | - Wibul Wongpoowarak
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
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Anutrakulchai S, Pongskul C, Kritmetapak K, Limwattananon C, Vannaprasaht S. Therapeutic concentration achievement and allograft survival comparing usage of conventional tacrolimus doses and CYP3A5 genotype-guided doses in renal transplantation patients. Br J Clin Pharmacol 2019; 85:1964-1973. [PMID: 31077425 DOI: 10.1111/bcp.13980] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 11/04/2018] [Revised: 04/04/2019] [Accepted: 04/27/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS Although cytochromeP450(CYP)3A5 gene polymorphism affects personalized tacrolimus doses, there is no consensus as to whether CYP3A5 genotypes should be determined to adjust the doses. The aims were to compare the therapeutic ranges and clinical outcomes between the conventional and genotype-guided tacrolimus doses. METHODS This randomized controlled study compared 63 cases of the conventional tacrolimus dose group (0.1 mg/kg/day) with 62 cases of the genotype-guided doses group of 0.125, 0.1 and 0.08 mg/kg for CYP3A5*1/*1, *1/*3, and *3/*3 genotypes for the initial 3 days of kidney transplantation. After day 3, dose adjustment occurred in both groups to achieve therapeutic concentrations. RESULTS The genotype-guided group had an increased proportion of patients with tacrolimus concentrations in the therapeutic range at the steady state on day 3 (40.3 vs 23.8%, P = .048). A lower proportion of over-therapeutic concentration patients was noted in the genotype-guided group in the CYP3A5*3/*3 genotype (9.7 vs 27%, P = .013). Unexpectedly, more delayed graft functions (DGFs) were in the genotype-guided group (41.9 vs 22.2%, P = .018) especially in the CYP3A5*1/*1 participants who might have had an aggravated DGF by a longer ischaemic time and higher serum donor creatinine levels than in the control group. There were no significant differences of glomerular filtration rates or graft or patient survivals over a median 37-month follow-up period. CONCLUSIONS Determination of the CYP3A5 genotype improved therapeutic range achievement. CYP3A5*1/*1 patients who have high risks of DGF should be closely monitored because of an increased risk of DGF and reduced glomerular filtration rate with high tacrolimus doses.
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Affiliation(s)
- Sirirat Anutrakulchai
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Cholatip Pongskul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kittrawee Kritmetapak
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chulaporn Limwattananon
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Thailand
| | - Suda Vannaprasaht
- Department of Pharmacology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Kateyam L, Sae-Ung N, Anutrakulchai S, Cha'on U, Boonlakron S. Microalbuminuria detection: comparisons of two differently semiquantitative urine strip tests with a quantitative automated chemistry analyzer. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kuaha K, Arwae A, Janthamala S, Pinlaor P, Tavichakorntrakool R, Cha'on U, Anutrakulchai S. Distribution of ABO blood groups in chronic kidney disease. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sae-Ung N, Srisukkho P, Archwichaiudom S, Sairos K, Jungtrakul Y, Anutrakulchai S. Advantage of acanthocyte flag message of UriSed 3 pro automated microscopy urine analyzer. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Suttichet TB, Kittanamongkolchai W, Phromjeen C, Anutrakulchai S, Panaput T, Ingsathit A, Kamanamool N, Ophascharoensuk V, Sumethakul V, Avihingsanon Y. Urine TWEAK level as a biomarker for early response to treatment in active lupus nephritis: a prospective multicentre study. Lupus Sci Med 2019; 6:e000298. [PMID: 31168397 PMCID: PMC6519400 DOI: 10.1136/lupus-2018-000298] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/22/2018] [Accepted: 12/31/2018] [Indexed: 11/25/2022]
Abstract
Background TNF-like weak inducer of apoptosis (TWEAK) is a proinflammatory molecule that plays a key role in active inflammation of lupus nephritis (LN). Urine TWEAK (uTWEAK) levels were found to be associated with renal disease activity among patients with LN. Here, we determined whether serial measurements of uTWEAK during induction therapy could predict treatment response or not. Methods Spot urine samples were collected from patients with biopsy-proven active LN at time of flare, and 3 and 6 months after flare to assess the uTWEAK levels. All patients received standard immunosuppressive therapy and treatment response was evaluated at 6 months. The performance of uTWEAK as a predictor for treatment response was compared with clinically used biomarkers for patients with LN. Results Among 110 patients with LN, there were 29% complete responders (CR), 34% partial responders (PR) and 37% non-responders (NR). On average, uTWEAK level was consistently low in CR, trended down by 3 months in PR and persistently elevated in NR. uTWEAK levels at month 3 were able to predict complete response at month 6 (OR adjusted for age, sex and creatinine=0.34 [95% CI 0.15 to 0.80], the area under the receiver operating characteristic curve [ROC-AUC]=0.68, p=0.02). The optimal threshold for uTWEAK level at month 3 was 0.46 pg/mgCr, discriminating complete response with 70% sensitivity and 63% specificity. Combining uTWEAK and urine protein at month 3 improved predictive performance for complete response at 6 months (ROC-AUC 0.83, p<0.001). Conclusions In addition to urine protein, uTWEAK level at 3 months after flare can improve the accuracy in predicting complete response at 6 months of induction therapy.
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Affiliation(s)
- Thitima Benjachat Suttichet
- Department of Medicine, Faculty of Medicine, Center of Excellence in Immunology and Immune-mediated Diseases, Chulalongkorn University, Bangkok, Thailand
| | - Wonngarm Kittanamongkolchai
- Chula Clinical Research Center and Renal Immunology and Transplantation Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chutipha Phromjeen
- Chula Clinical Research Center and Renal Immunology and Transplantation Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Thanachai Panaput
- Department of Medicine, Khon Kaen Regional Hospital, Khon Kaen, Thailand
| | - Atiporn Ingsathit
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nanticha Kamanamool
- Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | | | - Vasant Sumethakul
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yingyos Avihingsanon
- Department of Medicine, Faculty of Medicine, Center of Excellence in Immunology and Immune-mediated Diseases, Chulalongkorn University, Bangkok, Thailand
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Benjachat Suttichet T, Chewcharat A, Kittanamongkolchai W, Phromjeen C, Anutrakulchai S, Panaput T, Ingsathit A, Kamanamool N, Ophascharoensuk V, Sumethakul V, Avihingsanon Y. FP160URINE TWEAK AS A BIOMARKER FOR EARLY RESPONSE TO TREATMENT IN ACTIVE LUPUS NEPHRITIS: A PROSPECTIVE MULTI-CENTER STUDY. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Thitima Benjachat Suttichet
- Center of Excellence in Immunology and Immune-mediated diseases, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Api Chewcharat
- Renal Immunology and Therapeutic Apheresis Research Unit and Chula Clinical Research Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Wonngarm Kittanamongkolchai
- Renal Immunology and Therapeutic Apheresis Research Unit and Chula Clinical Research Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Chutipha Phromjeen
- Renal Immunology and Therapeutic Apheresis Research Unit and Chula Clinical Research Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Sirirat Anutrakulchai
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thanachai Panaput
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Atiporn Ingsathit
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nanticha Kamanamool
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | | | - Vasant Sumethakul
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yingyos Avihingsanon
- Renal Immunology and Therapeutic Apheresis Research Unit and Chula Clinical Research Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Kamanamool N, Ingsathit A, Rattanasiri S, Ngamjanyaporn P, Kasitanont N, Chawanasuntorapoj R, Pichaiwong W, Anutrakulchai S, Sangthawan P, Ophascharoensuk V, Avihingsanon Y, Sumethkul V. Comparison of disease activity between tacrolimus and mycophenolate mofetil in lupus nephritis: a randomized controlled trial. Lupus 2018; 27:647-656. [PMID: 29105558 DOI: 10.1177/0961203317739131] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We conducted a prospective multicenter, opened-label, parallel, randomized, controlled trial to compare tacrolimus (TAC) and mycophenolate mofetil (MMF) for induction and maintenance therapy in lupus nephritis (LN). Adult patients with biopsy-proven LN International Society of Nephrology/Renal Pathology Society classes III-V and active nephritis were to receive prednisolone (0.7-1.0 mg/kg/day for four weeks of run-in period and tapered) and randomly assigned to receive TAC (0.1 mg/kg/day) or MMF (1.5-2 g/day) as induction therapy for six months. All patients who had remission received azathioprine (AZA) 1-2 mg/kg/day as standard treatment in the maintenance phase. The primary outcome was Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) at six and 12 months, and the secondary outcomes included renal SLEDAI, non-renal SLEDAI, modified SLEDAI-2K, immunity SLEDAI, and disease activity remission. Eighty-four patients were randomized. One patient who was randomized to the TAC group withdrew from the study immediately after randomization. Therefore, 42 patients received MMF and 41 patients received TAC. Disease activity remission rate and time to disease activity remission were similar in both groups. Twelve patients (28.57%) in the MMF group and 10 patients (24.39%) in the TAC group achieved disease activity remission. For disease activity scores, both regimens significantly improved SLEDAI-2K during induction and maintenance therapy. Overall, SLEDAI-2K score in the MMF group decreased more compared with the TAC group. In the MMF group, mean SLEDAI-2K decreased from 11.6 ± 4.8 to 6.3 ± 3.9 after induction therapy and to 5.4 ± 4.4 after maintenance therapy. In the TAC group, mean SLEDAI-2K decreased from 9.0 ± 3.7 to 6.3 ± 5.1 after induction therapy and to 7.1 ± 5.4 after maintenance therapy. Renal SLEDAI and modified SLEDAI-2K showed a similar pattern with SLEDAI-2K. In non-renal SLEDAI and immunity SLEDAI, both regimens also resulted in decreased disease activity scores during the first two months. After that the scores were slightly increased. In the MMF group, the scores were still lower than baseline but in the TAC group were not. In conclusion, disease activity remission rate was similar in the MMF and TAC groups. For disease activity score as measured by SLEDAI-2K, TAC was comparable with MMF during induction but MMF was more effective on disease activity of active LN classes III and IV at 12 months, especially in the renal system.
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Affiliation(s)
- N Kamanamool
- 1 Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- 2 Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - A Ingsathit
- 1 Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - S Rattanasiri
- 1 Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - P Ngamjanyaporn
- 3 Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - N Kasitanont
- 4 Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - R Chawanasuntorapoj
- 5 Department of Medicine, 65106 Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok, Thailand
| | - W Pichaiwong
- 6 Department of Internal Medicine, 54781 Rajavithi Hospital , Bangkok, Thailand
| | - S Anutrakulchai
- 7 Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - P Sangthawan
- 8 Department of Medicine, 37689 Faculty of Medicine, Prince of Songkla University , Hat Yai, Thailand
| | - V Ophascharoensuk
- 4 Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Y Avihingsanon
- 9 37690 Division of Nephrology , Department of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - V Sumethkul
- 3 Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Kritmetapak K, Anutrakulchai S, Pongchaiyakul C, Puapairoj A. Clinical and pathological characteristics of non-diabetic renal disease in type 2 diabetes patients. Clin Kidney J 2017; 11:342-347. [PMID: 29942497 PMCID: PMC6007236 DOI: 10.1093/ckj/sfx111] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 08/17/2017] [Indexed: 12/19/2022] Open
Abstract
Background Renal involvement in type 2 diabetes is mainly due to diabetic nephropathy (DN). Nevertheless, a sizable proportion of diabetic patients could actually have nondiabetic renal diseases (NDRDs) or DN plus NDRDs. This study aimed to explore the pathological features of NDRD in diabetic patients and to assess the predictability of diagnosing NDRD (±DN) versus isolated DN on the basis of clinical parameters. Methods Medical records of type 2 diabetes patients who underwent renal biopsy under suspicion of NDRD from January 2011 through November 2015 were analyzed retrospectively. Results A total of 101 patients were enrolled in this study. The most frequent indication for renal biopsy was recent onset of nephrotic syndrome (41%), followed by rapidly progressive renal failure (29%) and active urinary sediment (21%). On renal biopsy, 51% of patients had isolated DN, 20% had isolated NDRD and 29% had DN plus NDRD. IgA nephropathy was the most common cause of isolated NDRD, whereas acute tubular necrosis (39%) and acute interstitial nephritis (33%) were the main causes of NDRD superimposed on DN. Male gender, short-duration diabetes (<8 years), lower glycated hemoglobin and active urinary sediment (≥10 red and white blood cells per high-power field) were independent predictors of NDRD according to multiple logistic regression analysis. Conclusions Judicious use of renal biopsy revealed NDRD (±DN) in nearly half of type 2 diabetes patients with atypical renal presentation, especially in male patients with well-controlled diabetes, those who have had diabetes for a short duration and those with active urinary sediment.
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Affiliation(s)
- Kittrawee Kritmetapak
- Division of Nephrology, Department of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Division of Nephrology, Department of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chatlert Pongchaiyakul
- Division of Endocrinology and Metabolism, Department of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Anucha Puapairoj
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Anutrakulchai S, Mairiang P, Pongskul C, Thepsuthammarat K, Chan-on C, Thinkhamrop B. Erratum to: Mortality and treatment costs of hospitalized chronic kidney disease patients between the three major health insurance schemes in Thailand. BMC Health Serv Res 2016; 16:614. [PMID: 27782835 PMCID: PMC5080797 DOI: 10.1186/s12913-016-1874-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 10/21/2016] [Indexed: 11/16/2022] Open
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Anutrakulchai S, Mairiang P, Pongskul C, Thepsuthammarat K, Chan-On C, Thinkhamrop B. Mortality and treatment costs of hospitalized chronic kidney disease patients between the three major health insurance schemes in Thailand. BMC Health Serv Res 2016; 16:528. [PMID: 27686066 PMCID: PMC5043539 DOI: 10.1186/s12913-016-1792-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 09/24/2016] [Indexed: 11/10/2022] Open
Abstract
Background Thailand has reformed its healthcare to ensure fairness and universality. Previous reports comparing the fairness among the 3 main healthcare schemes, including the Universal Coverage Scheme (UCS), the Civil Servant Medical Benefit Scheme (CSMBS) and the Social Health Insurance (SHI) have been published. They focused mainly on provision of medication for cancers and human immunodeficiency virus infection. Since chronic kidney disease (CKD) patients have a high rate of hospitalization and high risk of death, they also require special care and need more than access to medicine. We, therefore, performed a 1-year, nationwide, evaluation on the clinical outcomes (i.e., mortality rates and complication rates) and treatment costs for hospitalized CKD patients across the 3 main health insurance schemes. Methods All adult in-patient CKD medical expense forms in fiscal 2010 were analyzed. The outcomes focused on were clinical outcomes, access to special care and equipment (especially dialysis), and expenses on CKD patients. Factors influencing mortality rates were evaluated by multiple logistic regression. Results There were 128,338 CKD patients, accounting for 236,439 admissions. The CSMBS group was older on average, had the most severe co-morbidities, and had the highest hospital charges, while the UCS group had the highest rate of complications. The mortality rates differed among the 3 insurance schemes; the crude odds ratio (OR) for mortality was highest in the CSMBS scheme. After adjustment for biological, economic, and geographic variables, the UCS group had the highest risk of in-hospital death (OR 1.13;95 % confidence interval (CI) 1.07–1.20; p < 0.001) while the SHI group had lowest mortality (OR 0.87; 95 % CI 0.76–0.99; p = 0.038). The circumscribed healthcare benefits and limited access to specialists and dialysis care in the UCS may account for less favorable comparison with the CSMBS and SHI groups. Conclusions Significant differences are observed in mortality rates among CKD patients from among the 3 main healthcare schemes. Improvements in equity of care might minimize the differences. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1792-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sirirat Anutrakulchai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, 40002, Thailand.
| | - Pisaln Mairiang
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, 40002, Thailand
| | - Cholatip Pongskul
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, 40002, Thailand
| | - Kaewjai Thepsuthammarat
- Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, 40002, Thailand
| | - Chitranon Chan-On
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, 40002, Thailand
| | - Bandit Thinkhamrop
- Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen Province, 40002, Thailand.
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Glaser J, Lemery J, Rajagopalan B, Diaz HF, García-Trabanino R, Taduri G, Madero M, Amarasinghe M, Abraham G, Anutrakulchai S, Jha V, Stenvinkel P, Roncal-Jimenez C, Lanaspa MA, Correa-Rotter R, Sheikh-Hamad D, Burdmann EA, Andres-Hernando A, Milagres T, Weiss I, Kanbay M, Wesseling C, Sánchez-Lozada LG, Johnson RJ. Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy. Clin J Am Soc Nephrol 2016; 11:1472-1483. [PMID: 27151892 PMCID: PMC4974898 DOI: 10.2215/cjn.13841215] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Climate change has led to significant rise of 0.8°C-0.9°C in global mean temperature over the last century and has been linked with significant increases in the frequency and severity of heat waves (extreme heat events). Climate change has also been increasingly connected to detrimental human health. One of the consequences of climate-related extreme heat exposure is dehydration and volume loss, leading to acute mortality from exacerbations of pre-existing chronic disease, as well as from outright heat exhaustion and heat stroke. Recent studies have also shown that recurrent heat exposure with physical exertion and inadequate hydration can lead to CKD that is distinct from that caused by diabetes, hypertension, or GN. Epidemics of CKD consistent with heat stress nephropathy are now occurring across the world. Here, we describe this disease, discuss the locations where it appears to be manifesting, link it with increasing temperatures, and discuss ongoing attempts to prevent the disease. Heat stress nephropathy may represent one of the first epidemics due to global warming. Government, industry, and health policy makers in the impacted regions should place greater emphasis on occupational and community interventions.
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Affiliation(s)
- Jason Glaser
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
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Abstract
Background Sleep problem is a common geriatric condition that can result in various outcomes, both physical and mental, that reduce quality of life. The studies regarding the prevalence and impact of insomnia on daily activities in Thailand in pre-elderly and elderly adults are few. Objectives The primary objective of this study was to determine the prevalence of insomnia among pre-elderly and elderly populations and the secondary objective was to study the impact of insomnia on their daily lives. Methods This study included the participants from the urban middle class in the pre-retirement age of 50 years or older adults who worked for Khon Kaen University (KKU), Khon Kaen, Thailand, and their elderly relatives. Information on baseline characteristics, sleep problems, and outcomes were collected. Descriptive analytical statistics were used to analyze baseline data. Multivariate analysis was used to analyze associated factors of the impact of insomnia. Results A total of 491 participants were recruited. The prevalence of insomnia was 60%. The significant consequences related to insomnia were feeling unrefreshed (adjusted odds ratio (AOD) 2.22, 95% confidence interval (CI) 1.44-3.04), daytime sleepiness (AOD 2.04, 95% CI 1.29-3.22), need for a sedative drug (AOD 4.23, 95% CI 2.09-8.55), depression (AOD 4.74, 95% CI 1.73-13), and impaired attention (AOD 2.29, 95% CI 1.52-3.45). Conclusions Insomnia was found in the majority of pre-elderly and elderly participants and resulted in several poor outcomes. Early detection of insomnia may prevent some inevitable outcomes.
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Affiliation(s)
- Manchumad Manjavong
- 1 Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand
| | - Panita Limpawattana
- 1 Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand.,2 Non-communicable Disease Research Group, Khon Kaen University, Thailand
| | - Pisaln Mairiang
- 3 Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand
| | - Sirirat Anutrakulchai
- 4 Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand
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Anutrakulchai S, Panaput T, Wongchinsri J, Chaishayanon S, Satirapoj B, Traitanon O, Pima W, Rukrung C, Thinkhamrop B, Avihingsanon Y. A multicentre, randomised controlled study of enteric-coated mycophenolate sodium for the treatment of relapsed or resistant proliferative lupus nephritis: an Asian experience. Lupus Sci Med 2016; 3:e000120. [PMID: 26835147 PMCID: PMC4716419 DOI: 10.1136/lupus-2015-000120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/26/2015] [Accepted: 12/13/2015] [Indexed: 01/06/2023]
Abstract
Objective The optimal treatment of relapse or resistant lupus nephritis (LN) is still unclear. Mycophenolate might be an alternative therapy to avoid toxicities of cyclophosphamide (CYC). This study was aimed to compare enteric-coated mycophenolate sodium (EC-MPS) versus intravenous CYC as an induction therapy. Methods The study was a 12-month period of multicentre, open-labelled randomised controlled trial. Fifty-nine patients who had relapsed (36%) or who were resistant to previous CYC treatment (64%) and all who were biopsy-proven class III/IV, were randomised into CYC (n=32) and EC-MPS groups (n=27). The CYC group received intravenous CYC 0.5–1 g/m2 monthly and the EC-MPS group was treated with EC-MPS 1440 mg/day for first 6 months. After induction therapy, both groups received EC-MPS 720 mg/day until the end of study at 12 months. Results The study was prematurely terminated due to high rate of serious adverse events in CYC arm. Death and serious infections were observed more in the CYC group (15.6% in CYC and 3.5% in EC-MPS; p=0.04). The early discontinuation rates, mainly from serious infections, were significantly higher in CYC group (percentage differences of 16.9; 95% CI 1.3 to 32.4). At the 12th month, both arms were comparable in terms of complete and partial remission rates (68% CYC and 71% EC-MPS) and times to remission (96 days CYC and 97 days EC-MPS). Composites of unfavourable outcomes (death, doubling of serum creatinine, non-remission and intolerance to treatment) were 46.9% and 37% in CYC and EC-MPS (risk difference=9.84; p=0.44). Conclusions EC-MPS may have comparable efficacy, but was better tolerated than CYC. EC-MPS should be an alternative choice of treatment for difficult-to-treat LN, particularly in CYC-experienced LN patients. Due to an early termination of the study, further clinical implementation could be cautiously used. Trial registration number Clinicaltrials.gov ID#NCT01015456.
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Affiliation(s)
| | - Thanachai Panaput
- Department of Medicine , Khon Kaen Regional Hospital , Khon Kaen , Thailand
| | | | | | - Bancha Satirapoj
- Department of Medicine , Phramongkutklao Hospital , Bangkok , Thailand
| | - Opas Traitanon
- Department of Medicine , Thammasart University , Pathumthani , Thailand
| | - Warabhorn Pima
- Medical University Research Network of the Consortium of Thai Medical Schools (MedResNet) , Thailand
| | - Chutima Rukrung
- Chulalongkorn Clinical Research Center (ChulaCRC) , Chulalongkorn University , Bangkok , Thailand
| | - Bandit Thinkhamrop
- Department of Biostatistics and Demography, Faculty of Public Health , Khon Kaen University , Khon Kaen , Thailand
| | - Yingyos Avihingsanon
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok,Thailand; Center of Excellence in Immunology and Immune-mediated Diseases, Chulalongkorn University, Bangkok, Thailand
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Panaput T, Domrongkitchaiporn S, Sirivongs D, Thinkhamrop B, Pongskul C, Anutrakulchai S, Narenpitak S, Intarawongchot P, Tatiyanuphanwong S, Tungkasereerak P, Kanokkantapong C, Suwattanasin A, Praderm L, Keonounma T, Niwattayakul K. SP752ESTIMATED GLOMERULAR FILTRATION RATE AT INITIATION OF DIALYSIS AND OUTCOMES AMONG PATIENTS WITH END-STAGE RENAL DISEASE TREATED WITH TWICE-WEEKLY HEMODIALYSIS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv200.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Panaput T, Thinkhamrop B, Domrongkitchaiporn S, Sirivongs D, Praderm L, Anukulanantachai J, Kanokkantapong C, Tungkasereerak P, Pongskul C, Anutrakulchai S, Keobounma T, Narenpitak S, Intarawongchot P, Suwattanasin A, Tatiyanupanwong S, Niwattayakul K. Dialysis Dose and Risk Factors for Death Among ESRD Patients Treated with Twice-Weekly Hemodialysis: A Prospective Cohort Study. Blood Purif 2015; 38:253-62. [DOI: 10.1159/000368885] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/04/2014] [Indexed: 11/19/2022]
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