Does the Administration of Sevelamer or Nicotinamide Modify Uremic Toxins or Endotoxemia in Chronic Hemodialysis Patients?

AbstractBackgroundHyperphosphatemia control is a major issue in hemodialysis patients. Both sevelamer and nicotinamide are prescribed for this purpose. In addition, they exert pleiotropic effects such as an improvement of inflammatory status and potentially enhanced clearance of uremic toxins. In the present secondary analysis of the NICOREN trial, we investigated the impact of sevelamer and nicotinamide on uremic toxins, toxin precursors, and endotoxemia in chronic hemodialysis patients.MethodsCirculating uremic toxins (including phenylacetylglutamine, trimethylamine-N-oxide, p-cresyl sulfate, indoxyl sulfate, kynurenine, hippuric acid, indole-3-acetic acid, 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid, kynurenic acid, and p-cresyl glucuronide) and precursors were measured by ultra-performance liquid chromatography-tandem mass spectrometry, and urea, uric acid, phosphate, C-reactive protein, and intact parathyroid hormone by routine biochemistry methods. Serum endotoxin (evaluated by lipopolysaccharide levels) and C-terminal fibroblast growth factor-23 levels were measured using enzyme-linked immunosorbent assay kits.ResultsOne hundred hemodialysis patients were randomized to receive either nicotinamide or sevelamer treatment. Among them, 63% were male, mean ( ± standard deviation) age was 65 ± 14 years, 47% had diabetes mellitus, and 51% had a history of cardiovascular disease. In the sevelamer group, but not the nicotinamide gro...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research

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Source: BMJ Comments - Category: General Medicine Source Type: forums
Two Clinical Nurse Specialist opportunities are available to contribute towards the provision of excellent patient care within our Endocrinology and Diabetes Service.One post will be for our Queen Elizabeth Hospital (QEHB) site and the other for our Heartlands, Good Hope and Solihull Hospital site (HGS). Successful candidates will join a team of experienced specialist nurses in a tertiary Endocrine referral centre and will be given full structured training and supervision to develop their skills in Endocrinology.Application deadline is2 February 2020. Visit www.jobs.nhs.uk for full details and to apply. 
Source: Society for Endocrinology - Category: Endocrinology Source Type: news
Researchers reports an over 50% drop in overall death rates among people with diabetes living in Hong Kong from 2001-2016; younger people with diabetes less likely to experience improvement in survival, however.Medscape Medical News
Source: Medscape Diabetes Headlines - Category: Endocrinology Tags: Diabetes & Endocrinology News Source Type: news
CONCLUSIONS Our results highlight that interaction of Nr4a1 and LKB1 can mitigate T2DM by activating the AMPK/SIRT1 signaling pathway and inhibiting NF-kappaB activation. This may offer new insight for T2DM treatment. PMID: 31939452 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
This study reported a simple and inexpensive method for determination of 10-hydroxy-2-decenoic acid (10-HDA) and free amino acids in different royal jelly based dietary supplement samples using a purpose-made dual-channeled capillary electrophoresis (CE) system with capacitively coupled contactless conductivity detection (C4D). The objective of the work is to propose a tool for food / quality control activities that can be realizable even with a modest infrastructure. 10-HDA and free amino acids were analyzed using the background electrolyte (BGE) solutions composed of 20 mM Tris(hydroxymethyl)aminomethane adjusted ...
Source: Journal of Food Composition and Analysis - Category: Food Science Source Type: research
Authors: Saritas T, Floege J Abstract Patients with chronic kidney disease (CKD) are at increased risk for kidney failure, cardiovascular disease (CVD), and death. In fact, the likelihood of dying from CVD is markedly higher than that for reaching end-stage renal disease. Evidence-based management of comorbidities such as CVD remains challenging in patients with advanced CKD, as they were usually excluded from randomized controlled trials. This review focuses on the epidemiology, risk factors, and clinical manifestations of CVD in patients with advanced CKD. Specific topics of interest include diagnostic and therap...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
Publication date: Available online 16 January 2020Source: Life SciencesAuthor(s): Milad Ashrafizadeh, Zahra Ahmadi, Saeed Samarghandian, Reza Mohammadinejad, Habib Yaribeygi, Thozhukat Sathyapalan, Amirhossein SahebkarAbstractMicroRNAs (miRs) are small non-coding pieces of RNA that are involved in a variety of physiologic processes such as apoptosis, cell proliferation, cell differentiation, cell cycle and cell survival. These multifunctional nucleotides are also capable of preventing oxidative damages by modulating antioxidant defense systems in a variety of milieu, such as in diabetes. Although the exact molecular mechan...
Source: Life Sciences - Category: Biology Source Type: research
Driving blood glycaemia from hyperglycaemia to euglycaemia as fast as possible while avoiding hypoglycaemia is a major problem for decades for type-1 diabetes and is solved in this study. A control algorithm is designed that guaranties hypoglycaemia avoidance for the first time both from the theory of positive systems point of view and from the most pragmatic clinical practice. The solution consists of a state feedback control law that computes the required hyperglycaemia correction bolus in real-time to safely steer glycaemia to the target. A rigorous proof is given that shows that the control-law respects the positivity ...
Source: IET Systems Biology - Category: Biology Source Type: research
In this study, a multiple-model strategy is evaluated as an alternative closed-loop method for subcutaneous insulin delivery in type 1 diabetes. Non-linearities of the glucose–insulin regulatory system are considered by modelling the system around five different operating points. After conducting some identification experiments in the UVA/Padova metabolic simulator (accepted simulator by the US Food and Drug Administration (FDA)), five transfer functions are obtained for these operating points. Paying attention to some physiological facts, the control objectives such as the required settling time and permissible boun...
Source: IET Systems Biology - Category: Biology Source Type: research
Abstract Significant interest in recent years has focused on gut microbiota-host interaction because accumulating evidence has revealed that intestinal microbiota play an important role in human health and disease, including cardiovascular diseases. Changes in the composition of gut microbiota associated with disease, referred to as dysbiosis, have been linked to pathologies such as atherosclerosis, hypertension, heart failure, chronic kidney disease, obesity, and type 2 diabetes mellitus. In addition to alterations in gut microbiota composition, the metabolic potential of gut microbiota has been identified as a c...
Source: Circulation Research - Category: Cardiology Authors: Tags: Circ Res Source Type: research
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