Burning occipital headache with Palpebral edema during acute Covid phase may lead to persistent headache

With limited understanding of the clinical spectrum and influencing factors, persistent headaches are becoming a prevalent symptom post-COVID-19. A recent cross-sectional study published in the BMC Infectious Diseases focused on a subset of patients suffering with new daily persistent headache (NDPH).

This comprehensive survey involved a total of 421 participants from 11 Latin American countries that explored the characteristics of persistent headaches following SARS-CoV-2 infection. Importantly, one in four participants met the diagnostic criteria for NDPH which revealed a substantial incidence of this debilitating condition. 

The study was conducted on individuals over 18 who were tested positive for SARS-CoV-2 and reported persistent headaches through an online survey. The results indicated that most participants were female (82%), with an average age of 40 years. Over 90% reported mild to moderate COVID-19 symptoms and 58% had a history of headaches, primarily of migraine-type.

Distinct clinical characteristics emerged, including occipital location, severe intensity, burning character, and radiating pain in individuals who were diagnosed with NDPH. Also, the higher proportions of anxiety symptoms, sleep problems, myalgia, mental fog, and various other symptoms were reported in NDPH patients.

The most significant contribution of the study lies in the identification of risk factors associated with NDPH. Palpebral edema during the acute phase of COVID-19, occipital location, and a burning character of the headache were revealed as potential risk factors. This crucial information provides clinicians with important insights for the early identification and customized management of patients with persistent headaches following COVID-19.

Reference:

Carrión-Nessi, F. S., Ascanio, L. C., Pineda-Arapé, A. G., Omaña-Ávila, Ó. D., Mendoza-Millán, D. L., Romero, S. R., Almao-Rivero, A. B., Camejo-Ávila, N. A., Gebran-Chedid, K. J., Rodriguez-Saavedra, C. M., Freitas-De Nobrega, D. C., Castañeda, S. A., Forero-Peña, J. L., Delgado-Noguera, L. A., Meneses-Ramírez, L. K., Cotuá, J. C., Rodriguez-Morales, A. J., Forero-Peña, D. A., & Paniz-Mondolfi, A. E. (2023). New daily persistent headache after SARS-CoV-2 infection in Latin America: a cross-sectional study. In BMC Infectious Diseases (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12879-023-08898-2

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Subtotal cholecystectomy lowers risk of bile duct injury in tough gallbladders

UK: Subtotal cholecystectomy (STC) seems to be an effective technique to avoid common bile duct (CBD) injuries in difficult cholecystectomy cases; indicating it is a viable alternative to total cholecystectomy (TC) in these situations, a recent study has found. 

“Subtotal cholecystectomy significantly reduced the risk of CBD injury compared to total cholecystectomy,” the researchers reported in the Annals of the Royal College of Surgeons of England. However, compared to TC, STC raised the risk of postoperative endoscopic retrograde cholangiopancreatography (ERCP), bile leaks, need for reoperation, and intraabdominal collections.”

Severe adhesions or inflammation can impede safe dissection in the hepatocystic triangle (HCT), leading to an intraoperative decision to perform subtotal cholecystectomy. The STC rate is likely to increase in the future as an increasing number of cholecystectomies are attempted in the acute setting when inflammation in the HCT may be at its peak. The term subtotal cholecystectomy is used when most of Hartmann’s pouch is left in situ with or without stump closure.

The study was conducted by Somaiah Aroori, University Hospitals Plymouth NHS Trust, UK, and colleagues to evaluate the safety profile of subtotal cholecystectomy.

For this purpose, the researchers retrospectively reviewed all patients who had STC between 2009 and 2019. STC was divided into two types, reconstituting (R-STC) and fenestrating (F-STC), depending on whether the gall bladder remnant was closed or left open. The study excluded patients who had cholecystectomy for gall bladder malignancy or as part of another operation.

The study led to the following findings:

  • A total of 5,664 patients underwent cholecystectomy during the study period. Of these, 1.7% underwent subtotal cholecystectomy.
  • The laparoscopic to open conversion rate was high at 48.8%, as was the overall postoperative complication rate (45.4%).
  • No patient suffered iatrogenic bile duct injury.
  • 19.6% of patients suffered postoperative bile leak. This was significantly higher in patients who had STC in the acute setting (41% versus 13% for elective STC cases).
  • There was no significant difference in the rate of bile leak or other complications between R-STC and F-STC types. The 90-day readmission rate was 8.2%.
  • No mortalities were recorded within 90 days post-STC.

The study revealed subtotal cholecystectomy to be an effective technique to prevent bile duct injury. However, it is associated with relatively high rates of postoperative morbidity, long hospital stays, and bile leaks.

The researcher suggests, “Surgeons should be aware of the implications of undergoing STC, and suitable precautions must be taken to minimise the STC risk.”

“Patients should be informed of the risks of STC before planned TC and be consented to accordingly,” they concluded.

Reference:

Ibrahim R, Abdalkoddus M, Mahendran B, Mownah OA, Nawara H, Aroori S. Subtotal cholecystectomy: is it a safe option for difficult gall bladders? Ann R Coll Surg Engl. 2023 May;105(5):455-460. doi: 10.1308/rcsann.2021.0291. Epub 2021 Nov 25. PMID: 34821508; PMCID: PMC10149244.

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Novel model based on C-peptide and creatinine measurement predicts diabetes remission after bariatric surgery

Italy: Findings from a pilot study have shown the utility of a novel model for predicting diabetes remission after bariatric surgery (BS) based on serum C-peptide and creatinine measurement. The findings were published online in Nutrition, Metabolism and Cardiovascular Diseases on December 16, 2023.

The researchers revealed the potential clinical application of ln(C-peptide/creatinine) ratio in assessing the likelihood of type 2 diabetes (T2D) remission after bariatric surgery.

Bariatric surgery is effective for type 2 diabetes treatment in obese patients. However, a significant proportion of these patients fail to achieve diabetes remission after the surgery, even after significant metabolic improvement and weight loss. C-peptide is a valuable marker of insulin secretion and beta cell function, but renal function must be considered when interpreting measurements in T2D patients.

Santo Colosimo, School of Nutrition Science, University of Milan, Milan, Italy, and colleagues aimed to investigate the association of serum C-peptide levels adjusted for creatinine with diabetes remission and achievement of the glycemic target after bariatric surgery in patients with T2D and obesity. They used a logarithmic transformation (ln) of the C-peptide/creatinine ratio to reflect beta cell function better.

The research team collected prospective data from a cohort of 84 patients with T2D and obesity submitted to Roux-en-Y gastric bypass (RYGB) at baseline and at least a 6-month follow-up.

Based on the study, the researchers reported the following findings:

  • A multivariate binomial regression model showed that Ln(C-peptide/creatinine) and age were significantly associated with 6-month type 2 diabetes remission.
  • The area under the curve for the receiver operating characteristic analysis (AUROC) to predict remission was 0.87, and more accurate than the AUROC based on C-peptide levels alone (0.75).
  • The same model was also able to predict achieving an HbA1c target of 7% (53mmol/mol) (AUROC 0.96).

“The findings suggest Ln(C-peptide/creatinine) ratio is a useful tool in predicting type 2 diabetes remission and target achievement after RYGB surgery, providing a more accurate reflection of beta cell function in bariatric patients,” the researchers concluded.

Reference:

Colosimo, S., Martínez-Sánchez, M. A., Balaguer-Román, A., Fernández-Ruiz, V. E., Núñez-Sánchez, M. A., Ferrer-Gómez, M., Frutos, M. D., Tomlinson, J. W., Bertoli, S., Marchesini, G., & Ramos-Molina, B. (2023). A novel model for predicting diabetes remission after bariatric surgery based on the measurement of C-peptide and creatinine in serum: A pilot study. Nutrition, Metabolism and Cardiovascular Diseases. https://doi.org/10.1016/j.numecd.2023.12.008

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Gut-skin connection is key factor in atopic dermatitis, research review shows

Atopic dermatitis (AD) is a chronic inflammatory skin disease whose main symptoms are redness, swelling, and itchy rashes. It is more common in people with a genetic predisposition. Manifestation of symptoms depends on interactions among the immune system, environmental factors and gut microbiota. Many pieces of this complex jigsaw puzzle are still undiscovered, but recent research has identified relevant factors. For example, alterations in gut microbiota composition can contribute to the severity of the disease; environmental factors such as allergens and pollution can also make it worse; genetic variations are associated with susceptibility; and both diet and fecal transplantation are promising strategies for treatment.

Knowing how these factors correlate is fundamental to a better understanding of the disease and serves as a basis for novel therapies, according to a review article published in the International Journal of Molecular Sciences by researchers at the University of São Paulo (USP) and the Federal University de São Paulo (UNIFESP) in Brazil.

Also known as atopic eczema, AD affects 7%-10% of adults and 20%-25% of young children. There is no consensus as to whether boys or girls are more affected. The number of cases has increased significantly in the twenty-first century. Scientists believe the rise is due to several factors, such as genetics, autoimmunity, impaired skin barrier integrity, viral infections, gut microbiome composition, dietary habits and lifestyle changes.

A hypothesis that has been proposed to explain the significant increase in developing countries is lack of exposure to beneficial bacteria, which may affect immune maturation (the process by which the immune system develops a response after first contact with microorganisms).

Importance of gut microbiota

The authors of the review, which was supported by FAPESP, show that gut microbiota is at the center of the most recent research. “Besides being responsible for 70% of immune system regularization, for maintaining skin barrier integrity and the structure of the gastrointestinal tract, and for controlling nutrient absorption and energy balance, the gut microbiome is directly connected to the skin via what’s known as the gut-skin axis,” said Sabri Saeed Sanabani, a researcher at the Institute of Tropical Medicine (IMT-USP) and last author of the article.

The article features recent evidence that alterations to gut microbiome composition can contribute to the pathogenesis of AD. Studies have reported increased abundance of Clostridium difficile, Escherichia coli and Staphylococcus aureus, as well as decreased abundance of bacteria that produce short-chain fatty acid (SCFAs), such as Bifidobacteria and Bacteroides, in the gut microbiome of AD patients compared to healthy controls. A reduction in levels of SCFAs is often associated with intestinal inflammation in otherwise healthy subjects.

With regard to genetics, the latest research on the subject involves genome-wide association studies (GWAS), focusing on the identification of associations between genetic variants and important phenotypes, and has so far found several markers that correlate with susceptibility to AD and its progression, including mutations in the filaggrin gene (FLG) that are the most well-established risk factor for AD. Filaggrin (a portmanteau for filament aggregating protein) is a protein that binds to keratin fibers in epithelial cells. Whether gut microbiome alterations are genetically determined is unknown, however.

While environmental factors also remain mostly unknown, scientists are certain that allergens, irritants, pollution and exposure to microbes contribute to skin barrier impairment and gut microbiome dysbiosis.

The review also covers promising therapeutic approaches, such as those targeting epigenetic alterations and modulation of changes to gut microbiome diversity via diet, probiotics and prebiotics, as well as fecal transplants.

“Like all such reviews, ours set out to analyze the findings of the available scientific studies and verify knowledge gaps that need to be filled by future research,” Sanabani said.

Reference:

Pessôa, R.; Clissa, P.B.; Sanabani, S.S. The Interaction between the Host Genome, Epigenome, and the Gut–Skin Axis Microbiome in Atopic Dermatitis. Int. J. Mol. Sci. 2023, 24, 14322. https://doi.org/10.3390/ijms241814322.

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Genicular artery embolization improves knee function for 3 months in knee osteoarthritis patients

Osteoarthritis is a common musculoskeletal disease that affects weight-bearing joints like the hip and knee. It affects 13.4% of the European population. Knee osteoarthritis, in particular, can significantly reduce a person’s ability to work and participate in leisure activities. There is no cure for knee osteoarthritis, but medications and non-pharmacological treatments can help manage symptoms and slow its progression. In severe cases, total or partial knee replacement surgery may be necessary.

An Original article published in Diagnostic and Interventional Imaging concluded thatGenicular artery embolization improves pain and knee function for at least three months in patients with a history of knee osteoarthritis.

This study is published according to a study published on December 15 in Diagnostic and Interventional Imaging.

This study assessed the safety and efficacy of transient genicular artery embolization (GAE) with an ethiodized oil-based emulsion for treating KOA.

This study was a prospective, single-arm, open-label, multicenter, first-in-human cohort trial. The main inclusion criterion was a diagnosis of KOA with a VAS pain score of ≥40 mm despite conservative treatment for at least three months. Treatment efficacy was assessed using changes in VAS pain score, normalized WOMAC function score (ranging from 0-100), and OMERACT-OARSI responder criteria.

Key findings from this study are:

  • Twenty-two patients with a mean age of 66 years were included and underwent GAE.
  • The emulsion consisted of a mixture of ioversol and ethiodized oil in a ratio of 1:3, which was prepared extemporaneously.
  • The serious adverse events rate attributed to GAE within one month was 5%, with reversible worsening of renal function. The immediate technical success rate was 100%.
  • The mean VAS pain score dropped from 74.4 ± 16.5 mm to 37.2 ± 26.7 mm (from baseline to three months).
  • The mean WOMAC function score decreased from 57.3 ± 17.1 to 33.5 ± 25.9 at three months.
  • At three months, 16/22 participants (73%) were considered responders according to the OMERACT-OARSI set of responder criteria, including high improvement in either pain or WOMAC function or improvement in both.

In conclusion, they wrote, “Our study highlighted that Genicular artery embolization is a new treatment modality for managing cases of KOA. They found ethiodized oil-based emulsion to be safe in the treatment.

Reference:

Sapoval et al. Genicular artery embolization for knee osteoarthritis: Results of the LipioJoint-1 trial. Diagnostic and Interventional Imaging.

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Modified Epley maneuver bests traditional approach for treating PC-benign paroxysmal positional vertigo

China: A recent study has revealed the modified Epley maneuver is more effective than the traditional Epley maneuver in improving the single repositioning success rate and reducing the canal switching rate for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV).

A modified Epley maneuver for posterior semicircular canal BPPV treatment, involving extended time in the healthy side-lying position and final bowing, achieved an impressive 85% success rate after the first attempt, compared to the traditional Epley maneuvre’s success rate of 63%,” the researchers reported in Frontiers in Neurology.

” After two attempts, the experimental group reached 100% repositioning success, while the control group required three attempts for an 86% success rate.”

Benign paroxysmal positional vertigo is a prevalent cause of vertigo, accounting for 17–42% of reported cases. Manifesting as brief episodes of nystagmus and vertigo, BPPV is triggered by alterations in head position relative to gravity, such as turning over, lying down, or standing up. BPPV is further divided based on the involved semicircular canal, with posterior canal BPPV (PC-BPPV) being the most prevalent, accounting for 80% of cases.

Xiaosu Chen, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, China, and colleagues compared the repositioning effect of the modified Epley maneuver and the traditional Epley maneuver for posterior semicircular canal benign paroxysmal positional vertigo.

The study included sixty-five patients with unilateral PC-BPPV. They were randomly divided into two groups: the experimental group received the modified Epley maneuver, which prolonged the time in the healthy side-lying position and the final bowing position and the control group received the traditional Epley maneuver.

The researchers recorded and compared the number of successful repositions after one, two, and three attempts and the total number of successful repositions between the two groups. A BPPV virtual simulation model was used to analyze the mechanism of the modified Epley maneuver.

The study revealed the following findings:

  • The first repositioning success rate of the experimental group was significantly higher than that of the control group (85% versus 63%).
  • The experimental group achieved a 100% repositioning success rate after two attempts, while the control group needed three attempts to reach an 86% repositioning success rate.
  • Four cases in the control group experienced canal switching during the repositioning process, while none in the experimental group did.
  • The BPPV virtual simulation model showed that the modified Epley maneuver could facilitate the passage of otoliths through the posterior arm of the posterior semicircular canal, especially through the location of the obstruction.

“Our study contributes a novel treatment approach for posterior canal BPPV patients, particularly those with refractory cases, offering a promising therapeutic option,” the researchers concluded.

Reference:

Chen, X., Mao, J., Ye, H., Fan, L., Tong, Q., Zhang, H., Wu, C., & Yang, X. (2023). The effectiveness of the modified Epley maneuver for the treatment of posterior semicircular canal benign paroxysmal positional vertigo. Frontiers in Neurology, 14, 1328896. https://doi.org/10.3389/fneur.2023.1328896

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Thrombolytics in cardiac arrest from pulmonary embolism may lead to return of spontaneous circulation

USA: The use of intravenous (IV) thrombolytics during cardiac arrest due to presumed pulmonary embolism (PE) may provide clinical benefits, findings from a meta-analysis have shown. The findings were published online in the Journal of Intensive Care Medicine on November 30, 2023. 

“Using IV thrombolytics in cardiac arrest due to presumed or confirmed PE is linked with increased return of spontaneous circulation (ROSC) but not survival to hospital or change in bleeding complications,” reported Jordan Feltes, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, and colleagues.

They continued, “Currently, we recommend continuing to follow existing consensus guidelines supporting thrombolytics use for this indication.”

IV thrombolytics are commonly used for patients whose underlying aetiology of cardiac arrest is presumed to be related to pulmonary embolism during cardiopulmonary resuscitation. Dr Feltes and colleagues aimed to evaluate clinical outcomes in patients who received thrombolytics during cardiac arrest secondary to pulmonary embolism.

For this purpose, the researchers performed a systematic review and meta-analysis of the existing literature focusing on thrombolytics use for cardiac arrest due to confirmed or presumed PE. Outcomes of interest included the return of spontaneous circulation, neurologically intact survival, survival to hospital discharge, and bleeding complications.

The review included thirteen studies comprising 803 patients. Most studies included were retrospective and single-armed.

The study led to the following findings:

  • Thrombolytic agent and dose were heterogeneous between studies.
  • Among those with control groups, intravenous thrombolysis was associated with higher rates of ROSC (OR 2.55), but without a significant difference in survival to hospital discharge (OR 1.41) or bleeding complications (OR 2.21).

The authors noted that most of the studies included were prospective observational trials, retrospective reviews, or subgroup analyses of randomized clinical trials (RCTs) and demonstrated significant heterogeneity in methods and outcomes.

“The findings showed that ROSC was more common among patients who received thrombolytics compared with those who did not; however, there was no significant difference in bleeding complications or survival to hospital discharge,” the researchers wrote.

“There is a need for larger randomized studies to validate this finding,” they concluded.

Reference:

Feltes, J., Popova, M., Hussein, Y., Pierce, A., & Yamane, D. (2023). Thrombolytics in Cardiac Arrest from Pulmonary Embolism: A Systematic Review and Meta Analysis. Journal of Intensive Care Medicine. https://doi.org/10.1177/08850666231214754

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Prolonged second stage of labor in epidural analgesia deliveries tied to increased risk of postpartum urinary retention

Japan: A recent study published in the Journal of Obstetrics and Gynaecology Research revealed a significantly higher postpartum urinary retention rate (30% versus 11%) in the case of epidural analgesia deliveries compared to the no epidural group.

The researchers identified a prolonged second stage of labour as an independent risk factor for postpartum urinary retention (OR: 3.18), along with other factors such as primiparity. All patients recovered from postpartum urinary retention by day 4.

Keisuke Miyamoto, Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan, and colleagues aimed to determine the postpartum urinary retention rate and risk factors after delivery using epidural analgesia in a single-centre retrospective study.

The study included 341 women who gave birth after at least 37 weeks of gestation from April to August 2021; from this cohort, 208 patients were examined. A comparison was done of the postpartum urinary retention rate between the epidural analgesia group (n = 101) and the no epidural analgesia group (n = 107. In the epidural analgesia group, risk factors for postpartum urinary retention were investigated.

The study revealed the following findings:

  • After adjustment by propensity score matching for age, body mass index, being primiparous, and labour induction as covariates, the analysis of the incidence of postpartum urinary retention revealed that the epidural analgesia group exhibited a significantly higher postpartum urinary retention rate than the no epidural analgesia group (30% versus 11%).
  • The investigation results regarding risk factors for postpartum urinary retention in the epidural analgesia group obtained through a univariate analysis showed that being primiparous and having a prolonged second stage of labour were significantly correlated with postpartum urinary retention.
  • Multivariate analysis indicated that a prolonged second stage of labour was an independent risk factor for postpartum urinary retention (odds ratio: 3.18).
  • All patients recovered from postpartum urinary retention by day 4.

“The findings show that the postpartum urinary retention rate after delivery using epidural analgesia was 25.7%,” the researchers wrote. “In the case of epidural analgesia deliveries, a prolonged second stage of labour was an independent risk factor for postpartum urinary retention.”

Reference:

Miyamoto, K., Komatsu, H., Nagata, H., Nagira, K., Motomura, E., Shimizu, N., & Tanaka, A. Prolonged second stage of labor in delivery using epidural analgesia is a risk factor for postpartum urinary retention. Journal of Obstetrics and Gynaecology Research. https://doi.org/10.1111/jog.15867

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CABG associated with lower six-year mortality among women with multivessel disease

A comprehensive retrospective study comparing the outcomes of two common treatments, percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG), for women with multivessel coronary artery disease reveals crucial differences in long-term results. The researchers found that CABG is associated with lower six-year mortality among women with multivessel disease.

This study was published in The Journal Of Thoracic and Cardiovascular Surgery by Edward Hannan and colleagues.

The research, conducted using the New York State cardiac registry data from 2012 to 2018, assessed outcomes in women with multivessel coronary artery disease who underwent either PCI with everolimus-eluting stents or CABG. Here are the primary findings:

  • Mortality Risk: PCI was associated with a higher six-year risk of mortality compared to CABG (25.75% vs. 23.57%).

  • Composite Major Adverse Cardiac Events: PCI showed a higher rate of the composite outcome of death, myocardial infarction, and stroke (36.58% vs. 32.89%).

  • Myocardial Infarction: Patients undergoing PCI had a significantly higher rate of myocardial infarction compared to those undergoing CABG (14.94% vs. 9.12%).

  • Stroke: There was no significant difference in stroke rates between the two interventions.

  • Repeat Revascularization: PCI was associated with higher rates of repeat revascularization (21.53% vs. 11.57%).

The study’s analysis suggests that for women with multivessel coronary artery disease, CABG appears to offer more favorable long-term outcomes compared to PCI with everolimus-eluting stents. The findings highlight the importance of considering the optimal treatment strategy, especially for female patients with this specific condition.

  • No Mortality Difference in Certain Groups: Notably, when PCI patients received complete revascularization or had non-complex lesions, and among women without diabetes, there was no significant mortality difference between the interventions.

  • Lower Repeat Revascularization with CABG: The study also underscores the advantage of CABG over PCI in reducing the need for repeat revascularization procedures in this patient population.

The study findings highlight the importance of weighing the risks and benefits of different treatment strategies for women with multivessel coronary artery disease. While PCI with everolimus-eluting stents remains a viable option, the study suggests that CABG might offer more favorable long-term outcomes, emphasizing the need for individualized treatment approaches in clinical practice.

Reference:

Hannan, E. L., Wu, Y., Harik, L., Tamis-Holland, J., Jacobs, A. K., Chikwe, J., Cozzens, K. S., & Gaudino, M. Coronary artery bypass surgery vs. Percutaneous interventions for women with multivessel coronary artery disease. The Journal of Thoracic and Cardiovascular Surgery,2023. https://doi.org/10.1016/j.jtcvs.2023.12.009

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Gut microbiota dysbiosis tied to progression of chronic kidney disease

Diet, drugs, and toxins affect gut bacteria, which can contribute to chronic kidney disease. Understanding the gut microbiota may lead to new ways to slow CKD progression.

According to a recent original paper on Nephrology published in International Urology and Nephrology, gut microbiota dysbiosis significantly affects CKD progression. CKD patients exhibit distinct microbial profiles, indicating the potential for microbiota-based interventions to slow CKD progression.”

Gut microbiota dysbiosis significantly contributes to the development and complications of chronic kidney disease (CKD). By comprehending the intricacies of the intestinal microbiota, this research endeavor holds the potential to offer novel perspectives on strategies to mitigate CKD progression.

This study analyzed the gut microbiota composition of 44 stage 3-4 CKD patients and 132 healthy volunteers. Faecal samples were collected, and 16 s rDNA sequencing was conducted to examine the gut microbiota composition.

The key points of this study are:

  • Researchers reported altered diversity of intestinal microbiota in faecal samples in stage 3–4 CKD patients.
  • Among the 475 bacterial genera, 164 were shared, while 242 dominant genera were exclusive to healthya subjects and 69 to CKD stages 3–4 samples.
  • Healthy volunteers had a prevalence of intestinal Firmicutes and Bacteroidetes.
  • CKD patients had a higher abundance of Proteobacteria and Actinobacteria.
  • The presence of uncultured Coprobacillus sp. significantly aided the distinction between the two groups.
  • ROC curve analysis distinguished microbiota with high diagnostic accuracy for differentiating CKD stage 3-4 patients from healthy people.
  • Metabolic dominant pathway analysis found that healthy individuals had NADH dehydrogenase pathways, while stage 3-4 CKD patients had a phosphate acetyltransferase pathway. Additionally, CKD patients had more Gram-negative bacteria and facultative anaerobes.
  • CKD cohort had a higher proportion of Gram-negative bacteria and facultative anaerobes.

Von et al. and colleagues said, “Our research emphasizes the significant impact of gut microbiota imbalances on chronic kidney disease (CKD) progression. The unique microbial patterns identified in CKD patients suggest that microbiota-focused interventions could effectively slow down CKD progression.”

Reference:

Yang, X., Cai, S., Gong, J. et al. Characterization of gut microbiota in patients with stage 3–4 chronic kidney disease: a retrospective cohort study. Int Urol Nephrol (2023). https://doi.org/10.1007/s11255-023-03893-7

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