Study reveals potential Risk Factors that Limit Physical Activity in OHCA Survivors

Among survivors of out-of-hospital cardiac arrest (OHCA), various potential risk factors can hinder individuals from achieving the recommended levels of physical activity. Recent study examined the level of physical activity among out-of-hospital cardiac arrest (OHCA) survivors at 6 months and explored potential risk factors associated with a low level of physical activity. The study was a post-hoc analysis of the international multicentre Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial.

Participant Analysis

At the 6-month follow-ups, 807 of 939 (86%) OHCA survivors answered two questions on self-reported physical activity. Based on these responses, the participants were categorized into three groups: low, moderate, and high level of physical activity. One third (34%) of the OHCA survivors reported a low, 44% a moderate, and 22% a high level of physical activity.

Risk Factor Assessment

Logistic regression analyses were performed to identify potential risk factors for a low level of physical activity. In the final multivariable model, obesity (OR=1.75, 95% CI 1.10-2.77, p=0.018), mobility problems (OR=1.73, 95% CI 1.06-2.84, p=0.029), and cognitive impairment (OR=1.78, 95% CI 1.13-2.82, p=0.013) were significantly associated with a low level of physical activity.

Implications of Findings

The study findings indicate that a substantial proportion of OHCA survivors have insufficient physical activity levels at 6 months. Importantly, those with obesity, mobility problems, and cognitive impairment were at higher risk of having a low level of physical activity. These individuals may benefit from targeted interventions to help them attain the recommended levels of physical activity, which could reduce their risk of further cardiac events.

Key Points

1. The study examined the level of physical activity among out-of-hospital cardiac arrest (OHCA) survivors at 6 months and explored potential risk factors associated with a low level of physical activity. It was a post-hoc analysis of the international TTM2 trial.

2. At the 6-month follow-ups, 807 of 939 (86%) OHCA survivors answered questions on self-reported physical activity. One-third (34%) reported a low level, 44% a moderate level, and 22% a high level of physical activity.

3. Logistic regression analyses identified three significant risk factors for a low level of physical activity: obesity (OR=1.75), mobility problems (OR=1.73), and cognitive impairment (OR=1.78).

4. The study findings indicate that a substantial proportion of OHCA survivors have insufficient physical activity levels at 6 months.

5. Individuals with obesity, mobility problems, and cognitive impairment were at higher risk of having a low level of physical activity.

6. These high-risk individuals may benefit from targeted interventions to help them attain the recommended levels of physical activity, which could reduce their risk of further cardiac events.

Reference –

K. Heimburg et al. (2024). Low Physical Activity Level In Out-Of-Hospital Cardiac Arrest Survivors With Obesity, Mobility Problems And Cognitive Impairment: Results From The TTM2 Trial.. *Resuscitation*, 110407 . https://doi.org/10.1016/j.resuscitation.2024.110407

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Diabetes Drugs SGLT2i and GLP-1 RAs may Reduce Risk of Pneumonia and Sepsis, finds research

Researchers have discovered that sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), often used for the treatment of type 2 diabetes (T2D), are associated with a decreased risk of developing pneumonia and severe sepsis. A recent study was conducted by Alex H. and colleagues which was published in the journal BMJ Thorax.

These drugs are already known for their ability to protect the heart and kidneys and regulate glucose. They may also contribute to significant protection against serious infections. A retrospective cohort study analyzed anonymized electronic medical records to examine this association, finding important reductions in incident pneumonia and severe sepsis among patients treated with SGLT2i or GLP-1 RAs compared with those treated with DPP-4i.

This study used a retrospective cohort design, drawing on the global TriNetX database, which contains electronic medical records. Two separate intention-to-treat analyses were conducted: Eligible patients were adults diagnosed with T2D who were new users of these medications. Propensity score matching (1:1) controlled for possible confounders, ensuring that baseline characteristics were balanced between groups. The main outcomes measured included time-to-incident pneumonia and severe sepsis within a 12-month follow-up period. Secondary analyses compared the effects of SGLT2i and GLP-1 RAs with other glucose-lowering therapies.

Results

SGLT2i Cohort:

  • Total patients after matching: 352,687

  • Incident pneumonia risk reduction: Hazard Ratio (HR) 0.75 (95% CI 0.73–0.78)

  • Severe sepsis risk reduction: HR 0.75 (95% CI 0.73–0.77)

GLP-1 RA Cohort:

  • Total patients after matching: 331,863

  • Incident pneumonia risk reduction: HR 0.60 (95% CI 0.58–0.62)

  • Severe sepsis risk reduction: HR 0.61 (95% CI 0.59–0.63)

  • Both drug classes demonstrated a significant protective effect against pneumonia and sepsis compared to DPP-4 inhibitors.

SGLT2i and GLP-1 RAs have been associated with reduced risks of pneumonia and severe sepsis among T2D patients. All this further adds to established benefits and points out their use as potential agents in lowering the infection-related complications for further clinical exploration.

Reference:

Henney, A. E., Riley, D. R., Hydes, T. J., Anson, M., Ibarburu, G. H., Frost, F., Alam, U., & Cuthbertson, D. J. (2024). Comparative estimate of glucose-lowering therapies on risk of incident pneumonia and severe sepsis: an analysis of real-world cohort data. Thorax, thorax-2024-221906. https://doi.org/10.1136/thorax-2024-221906

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Triglyceride-glucose index promising predictor of risk of gallstone, suggests study

A new study published in the Nature Science Reports showed that triglyceride-glucose (TyG) index is helpful in determining whether people are more likely to develop gallstone disease (GSD). The common gastrointestinal condition, gallstones affect 10% to 15% of persons worldwide, where this disease affects 10% to 20% of Americans, and the percentage is rising.

Cholecystitis, cholangitis, and gallbladder cancer are among the complications that might affect 3% to 8% of people with gallstones. These issues can occasionally even be fatal and can have major repercussions. According to earlier studies, diabetes, kidney stones, coronary heart disease, and other conditions are all closely linked to an elevated TyG index.

Triglycerides and fasting blood glucose are two biomarkers that are used in the TyG index to quantify insulin resistance (IR) and evaluate insulin sensitivity in the human body. So, Hongliang Li and colleagues used data from the National Health and Nutrition Examination Survey (NHANES) that spanned from 2017 to 2020 to look into the relationship between gallstones and the TyG index.

This objective of this survey was to evaluate the current state of health of the Americans. Every NHANES program participant gave their informed consent and freely took part in the study. In this study, subgroup analysis, logistic regression analysis, smooth curve fitting, and participant characteristics were used to assess the association between TyG index and gallstones.

Gallstones were reported by 403 of the 3870 people over the age of 20 in the research, representing a 10.4% prevalence rate. The incidence of gallstones rose by 41% for every unit rise in the TyG index after controlling for all confounding variables (OR 1.41, 95% CI 1.07, 1.86). Gallstones and the TyG index were positively correlated, according to the smooth curve fitting.

According to subgroup analysis, the TyG index significantly increased the incidence of gallstones in those under 50, women, the individuals with total cholesterol levels greater than 200 mg/dL, people with body mass index (BMI) greater than 25, and people without diabetes. Overall, the study finds a strong link between gallstone risk and a higher TyG index. 

Reference:

Li, H., & Zhang, C. (2024). Association between triglyceride-glucose index and gallstones: a cross-sectional study. In Scientific Reports (Vol. 14, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1038/s41598-024-68841-6

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Study Questions Appropriateness of Biologic and Biosynthetic Mesh Use in Ventral Hernia Repairs

USA: A recent study published in JAMA Surgery has provided valuable insights into the use of biologic and biosynthetic mesh in current practices for ventral hernia repair.

The researchers revealed that in a large cohort of patients undergoing ventral hernia repair, 1 in 10 mesh-based repairs involved using biologic or biosynthetic mesh. While these materials were more likely to be used in urgent or emergent surgeries and cases with wound contamination, nearly 90% of their use was in elective repairs with clean wound classifications. This finding raises concerns about the appropriateness of their application in routine clinical practice.

Originally designed for use in contaminated fields, biologic and biosynthetic meshes are increasingly questioned for their effectiveness in ventral hernia repair. Despite this, little is known about their current prevalence and usage patterns. To address this gap, Cody L. Mullens, Department of Surgery, University of Michigan, Ann Arbor, and colleagues aimed to analyze the prevalence of biologic and biosynthetic mesh in ventral hernia repair and identify the factors influencing their application.

For this purpose, the researchers conducted a retrospective cohort study using a statewide clinical registry in Michigan to analyze data from adults who underwent mesh-based ventral hernia repair between January 1, 2021, and December 31, 2023. Data analysis was performed from February to May 2024. The study focused on comparing biologic or biosynthetic mesh with synthetic mesh, with the primary outcome being the use of biologic or biosynthetic mesh as recorded in operative reports. Multivariable logistic regression was applied to identify factors associated with the use of these advanced mesh types.

The following were the key findings of the study:

  • A total of 10,838 patients underwent mesh-based ventral hernia repair, with a mean age of 55.7 years; 42.6% (4,619) were female.
  • Among these, 10.8% (1,174 repairs) were performed using biologic or biosynthetic mesh, while 89.2% (9,664 repairs) used synthetic mesh.
  • Of the 1,174 cases using biologic or biosynthetic mesh:
    • 87.1% (1,023 cases) had clean wound classifications.
    • 88.5% (1,039 cases) were performed electively.
  • Wound contamination was significantly associated with the use of biologic or biosynthetic mesh:
    • Clean-contaminated wounds: Adjusted odds ratio (aOR) 2.17.
    • Contaminated wounds: aOR 2.95.
    • Dirty or infected wounds: aOR 36.22.
  • Other factors linked to increased odds of biologic or biosynthetic mesh use included:
    • Urgent or emergent surgical priority (aOR 1.69).
    • Laparoscopic or robotic surgical approach (aOR 1.31).
    • Larger hernia width (aOR 1.03 per centimeter).
    • Use of myofascial release (aOR 2.10).

The authors concluded that 1 in 10 ventral hernia repairs involved biologic or biosynthetic mesh. While its use was more likely in nonelective surgeries and cases with wound contamination, nearly 90% of these cases were elective repairs with clean wound classifications. This finding raises concerns about its appropriateness in routine practice and highlights potential opportunities to enhance patient outcomes and reduce healthcare costs.

Reference:

Mullens CL, Schoel L, McGee MF, Ehlers AP, Telem D, Howard R. Use of Biologic and Biosynthetic Mesh for Ventral Hernia Repair in Current Practice. JAMA Surg. Published online December 11, 2024. doi:10.1001/jamasurg.2024.5293

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Atopic Dermatitis Linked to Higher Risk of Hyperparathyroidism, Independent of Vitamin D Levels: Study

China: A recent analysis from the National Health and Nutrition Examination Survey (NHANES) 2005–2006 revealed that individuals with atopic dermatitis (AD) have nearly double the odds of developing hyperparathyroidism (OR 1.86). This association was independent of vitamin D, calcium, phosphorus, BMI, or CRP levels, indicating other underlying factors.

The relationship was strongest in individuals over 60 and those with normal vitamin D levels, underscoring the importance of monitoring older AD patients closely. The findings were published online in the Archives of Dermatological Research on December 12, 2024.

The association between atopic dermatitis and hyperparathyroidism remains unclear. While individuals with atopic dermatitis typically have lower serum vitamin D levels, it is uncertain whether this is a contributing factor or other potential mechanisms are involved. Considering this, Lan Xu and Yi Cao, researchers from China, aimed to investigate the impact of AD on hyperparathyroidism and identify the direct mediators of this relationship.

For this purpose, the researchers included 7,266 participants from the 2005–2006 NHANES. Atopic dermatitis diagnoses were based on questionnaire responses, while hyperparathyroidism was assessed through biochemical analysis. Weighted logistic regression analysis was used to calculate odds ratios (ORs), and mediation analysis was conducted to evaluate potential mediating effects. Additionally, after confirming the association, subgroup analysis stratified by age and vitamin D levels was performed.

The study led to the following findings:

  • Participants with atopic dermatitis had higher odds of developing hyperparathyroidism (OR 1.86).
  • Vitamin D levels, calcium, phosphorus, BMI, or CRP levels did not mediate the association.
  • Subgroup analysis showed variations in the association based on age and vitamin D levels, particularly in individuals older than 60 years and those with normal vitamin D levels.
  • Individuals with AD are more likely to develop hyperparathyroidism.

The findings underscore the need for heightened awareness of hyperparathyroidism in AD patients, particularly in older adults. Researchers recommend that clinicians monitor this condition more rigorously in patients over 60 and those with normal vitamin D levels.

This study adds new depth to the ongoing exploration of factors contributing to hyperparathyroidism and its relationship with atopic dermatitis. While vitamin D has often been implicated as a potential mediator, these findings highlight that other biological or environmental mechanisms may be at play.

“These insights could shape future diagnostic and management strategies, encouraging medical practitioners to assess hyperparathyroidism as part of routine care for individuals with AD, especially among high-risk subgroups,” the researchers concluded.

Reference

Xu, L., Cao, Y. Association between atopic dermatitis with hyperparathyroidism not mediated by vitamin D in the United States (NHANES 2005–2006). Arch Dermatol Res 317, 100 (2025). https://doi.org/10.1007/s00403-024-03609-6

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Research shows solitude is better for your health when it’s not too intense

Hiking by yourself deep in a forest and similar episodes of intense solitude are not as likely to restore energy and enhance social connectedness as less complete forms of solitude, such as reading in a café or listening to Spotify while commuting, research by Oregon State University suggests.

The findings are important because of solitude’s role in building connectedness, a key factor in a person’s overall health picture. According to the U.S. Centers for Disease Control and Prevention, strong social ties are linked with a longer lifespan, better mental health and a lower risk of serious illness, including heart disease, stroke and dementia.

Morgan Quinn Ross, assistant professor of communication in the OSU College of Liberal Arts, and Scott Campbell of the Ohio State University surveyed nearly 900 adults in the United States and found that activities that provide less complete forms of solitude, like playing a game on your phone or going to a movie by yourself, offer some advantages over a solitary drive in the desert or writing in a secluded cabin.

“We learned that less complete solitude is more likely to restore energy and maintain a feeling of connection with others,” Ross said. “In a world where social interaction is almost always just a click away, we need to understand how to balance social interaction with different types of solitude.”

Ross and Campbell examined conditions under which an individual’s solitude might be “shaded” by people and/or technology; accessibility to others and engagement with media can shade the solitude experience by causing time alone to be more social in nature, they note.

The researchers built a matrix of solitude that includes a base level-no interaction with people-and a total level, which refers to being inaccessible to others and not engaging with media. The matrix allowed them to investigate the tradeoff of solitude – i.e., does experiencing it more completely maximize restoration, while experiencing it less completely maximizes relatedness?

Ross notes that a commonly held theory, Communicate Bond Belong, posits that social interaction can build relatedness with others at the expense of social energy, and that solitude can restore social energy but at the cost of relatedness. Social energy describes a person’s capacity for social interaction and can be thought of as a battery that can be fully charged, partially charged or drained.

“Our study suggests that solitude is in fact not the flipside of social interaction,” Ross said. “Whereas more intense social interaction yields connection but depletes energy, more intense solitude depletes both energy and connection. Solitude does not seem to function simply as a way to regain energy used in social interaction.”

The scientists also learned that solitude was less detrimental to well-being for individuals who thought it helped them restore energy and maintain connection, regardless of how much energy their social interactions cost them.

Interestingly, these findings typically hold for both extroverts and introverts, said Ross, who added that one suggestion based on the study that people might try is attempting to seek solitude only when constructively motivated to do so.

“If you have a positive attitude toward solitude – because you use it to restore energy and know that you will be able to connect with people later – then choosing solitude will probably make you feel better,” he said. “But if you choose solitude because of a negative attitude toward social interaction – because you don’t want to talk to people – it will probably make you feel worse.”

Reference:

Morgan Quinn Ross ,Scott W. Campbell, The tradeoff of solitude? Restoration and relatedness across shades of solitude, PLOS ONE, https://doi.org/10.1371/journal.pone.0311738.

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Simple recalibration multipliers could improve FRAX estimation of vertebral fractures in patients who underwent VFA: JAMA

A new study published in the Journal of American Medical Association showed that simple multipliers can significantly increase the agreement between observed and anticipated fracture risk and regain FRAX calibration in people with fractures diagnosed by vertebral fracture assessment (VFA).

The most popular and reliable fracture risk prediction tool in the world is FRAX. Dual-energy x-ray absorptiometry (DXA) vertebral fracture evaluation can be used to detect vertebral fractures, which are a sign of later osteoporotic fractures. This work was set to evaluate the FRAX calibration and provide a straightforward technique for enhancing the FRAX-predicted fracture likelihood when there is a VFA-identified fracture present.

All participants in the Manitoba Bone Mineral Density Registry who had a VFA performed between March 31, 2010, and March 31, 2018, had their DXA and VFA data examined in this prognostic analysis. These people were randomized to either the validation cohort or the development cohort. Expert readers coded VFAs as either positive (≥1 vertebral fractures found) or negative using a modified algorithm-based qualitative technique. The period of statistical analysis was August 7, 2022, through May 22, 2023.

The provincial data on connected population-based health care was utilized to determine incident fractures and deaths. To forecast the 10-year observed risk of fracture, cumulative incidence curves for hip fracture and major osteoporotic fractures (MOF) were created by taking competing mortality into account. With and without VFA data, the observed probability was contrasted with the fracture probability predicted by FRAX, and the FRAX was recalculated using the resulting multipliers.

The entire group of 11,766 people was divided into 2 groups at random where the validation cohort and the development cohort. FRAX was well calibrated in subgroups with negative VFA findings during a mean (SD) observation duration of 3.8 (2.3) years, with the longest observation being 7.5 years.

The 10-year FRAX-predicted MOF likelihood for people with a positive VFA test but no history of clinical fractures was 23.4% with VFA information and 16.3% without. Based on the observed 10-year risks of 26.9% and 11.2%, the recalibration multipliers for MOF and hip fracture were 1.15 and 1.31, respectively.

The 10-year FRAX-predicted probabilities for MOF and hip fracture were 25.0% and 9.3%, respectively, among those with a positive VFA test and a history of clinical fracture. Overall, the findings of this predictive analysis indicate that in individuals with fractures diagnosed by VFA, FRAX understated fracture risk.

Source:

Ye, C., Leslie, W. D., Morin, S. N., Lix, L. M., McCloskey, E. V., Johansson, H., Harvey, N. C., Lorentzon, M., & Kanis, J. A. (2023). Adjusting FRAX Estimates of Fracture Probability Based on a Positive Vertebral Fracture Assessment. In JAMA Network Open (Vol. 6, Issue 8, p. e2329253). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.29253

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History of concussions before birth may increase risk of serious mental illness, finds study

A new study published in The Journal of Clinical Psychiatry found that the mothers with a history of concussions before birth were more likely to have serious mental illness which underscored the significance of screening and supportive care for this high-risk population. A history of mental illness, a lack of social support, and a history of abuse or violence are some of the established risk factors for severe maternal mental illness. However, without these risk factors, a large number of people who give birth suffer from serious mental illness consequences.

The research investigated the association between predelivery concussion history and risk for severe maternal mental illness because concussions are the most prevalent traumatic brain injury and carry a risk for mental disease in the general population. A population-based cohort study of singleton livebirths in Ontario, Canada, was carried out between 2007 and 2017 with a follow-up until 2021. Severe maternal mental illness, as indicated by a visit to a mental health emergency room, a psychiatric hospitalization, or self-harm or suicide within 14 years after giving birth, was the main result.

Adjusted for maternal age, parity, neighborhood income quintile, rural residence, immigration status, chronic conditions, history of interpersonal violence, and history of mental illness, Cox proportional hazards regression produced adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) comparing those with a record of a health care encounter for concussion between database inception and the index delivery date versus those without a recorded health care encounter for concussion.

There were a total of 7,36,689 birthing individuals without a history of concussions and 18,064 with a history. The incidence of severe maternal mental disorder was higher among individuals with a history of concussions than among the individuals without (14.7 vs. 7.9 per 1,000 person-years; aHR 1.25, 95% CI, 1.20–1.31). The mothers without a history of mental illness showed the greatest connection after being stratified by predelivery history of mental disease. 

Overall, to minimize negative mental consequences, the findings of this study highlight the necessity of early identification and screening of pregnant women with a history of concussions, as well as continuous long-term assistance utilizing trauma-informed techniques. Birthing mothers with a history of concussions may also benefit from continuous mental health screening by their main care physician in the months and years after delivery, since they are a high-risk population.

Reference:

Krueger, S., Vigod, S. N., Chan, V., Mollayeva, T., Alonzo, R., Chung, H., & Brown, H. K. (2024). History of Concussion and Risk of Severe Maternal Mental Illness. In The Journal of Clinical Psychiatry (Vol. 85, Issue 4). Physicians Postgraduate Press, Inc. https://doi.org/10.4088/jcp.24m15373

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Estrogen-progestin therapy may increase risk of heart disease and VTE, finds study

A new study published in the British Medical Journal showed that Tibolone or oral estrogen-progestin treatment use is linked to a higher risk of developing certain cardiovascular conditions. About 30% of all fatalities worldwide are caused by cardiovascular disease, making it the leading cause of mortality worldwide. Women are more likely than males to acquire cardiovascular illness, and this tendency increases noticeably throughout midlife, which is when the menopausal transition occurs.

A decrease in estrogen and an increase in follicle-stimulating hormone concentrations are the hallmarks of this shift. By encouraging angiogenesis and vasodilation, decreasing cardiac fibrosis and oxidative stress, and raising high density lipoprotein cholesterol levels, experimental research has demonstrated that estrogen protects cardiovascular health. Thus, Therese Johansson and team carried out this study to evaluate the impact of modern menopausal hormone treatment on cardiovascular disease risk based on hormone combination and delivery method.

This replicated target trial was based on a national registration. From 2007 to 2020, 919,614 Swedish women between the ages of 50 and 58 who had not used hormone treatment in the preceding two years were identified. From July 2007 to December 2018, 138 nested experiments were created.

8 treatment groups as oral combined continuous, oral unopposed estrogen, oral combined sequential, oral estrogen with local progestin, tibolone, transdermal unopposed female hormones, or non-initiators of menopausal hormone therapy were assigned to the women who had not used hormone therapy in the preceding 2 years based on the prescription registry data for that particular month.

A total of 8,42,102 women did not initiate menopausal hormone treatment, whereas 77,512 women did. With the intention-to-treat studies, this research discovered that tibolone was linked to a higher risk of cardiovascular disease than non-initiation. The individuals who started using tibolone or oral estrogen-progestin treatment had a higher chance of developing ischemic heart disease.

Oral continuous estrogen-progestin treatment, sequential therapy, and estrogen-only therapy were all linked to an elevated risk of venous thromboembolism. Tibolone was linked to an increased incidence of myocardial and cerebral infarction in per-protocol analysis.

While tibolone usage was linked to an increased risk of ischemic heart disease, cerebral infarction, and myocardial infarction but not venous thromboembolism, oral estrogen-progestin treatment use was linked to an increased risk of both heart disease and venous thromboembolism. Overall these results demonstrate the varied impacts on cardiovascular disease risk of various hormone combinations and delivery systems.

Reference:

Johansson, T., Karlsson, T., Bliuc, D., Schmitz, D., Ek, W. E., Skalkidou, A., Center, J. R., & Johansson, Å. (2024). Contemporary menopausal hormone therapy and risk of cardiovascular disease: Swedish nationwide register based emulated target trial. In BMJ (p. e078784). BMJ. https://doi.org/10.1136/bmj-2023-078784

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Sodium polystyrene sulfonate associated with repeated gastric ulcers in hemodialysis patients: Case report

Sodium polystyrene sulfonate associated with repeated gastric ulcers in hemodialysis patients suggests a case report published in the BMC Nephrology.

Sodium polystyrene sulfonate (SPS) is a cation-exchange resin used to treat hyperkalemia. Although colorectal ulcers are known side effects of long-term SPS use, few studies have reported SPS-associated gastric ulcers. Herein, we report a case of repeated gastric ulcers during SPS administration.

Case presentation

The patient was a 55-year-old man who was on SPS treatment of hyperkalemia since the initiation of hemodialysis (HD) at the age of 51 years. At the age of 54 years, he started taking vonoprazan fumarate after developing a bleeding duodenal ulcer. The patient underwent laparoscopic pylorus-preserving gastrectomy for four recurrent bleeding gastric ulcers. The resected specimen showed an ulcerative lesion in the pyloric curvature of the stomach, and pathological findings showed deposition of a basophilic crystalline substance resembling a cation-exchange resin at the base of the ulcer. In this case, various factors, including diabetic gastroenteropathy, use of multiple calcium channel blockers and phosphate binders, obesity, and lifestyle, contributed to decreased gastrointestinal peristalsis. This may have promoted SPS deposition in the stomach, potentially leading to ulceration.

Reference:

Yasui, Y., Nakashima, A., Sasuga, K. et al. Sodium polystyrene sulfonate as an additional contributing factor to repeated gastric ulcers among other multiple factors in a patient undergoing hemodialysis: a case report. BMC Nephrol 25, 443 (2024). https://doi.org/10.1186/s12882-024-03890-7

Keywords:

Sodium, polystyrene, sulfonate, associated, repeated, gastric ulcers, hemodialysis patients, Case report, BMC Nephrology, Yasui, Y., Nakashima, A., Sasuga, K.

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