Temporal serum metabolomic and lipidomic analyses distinguish patients with access-related hand disability following arteriovenous fistula creation.

Autor: Khattri RB; Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA., Louis LZ; Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA., Kim K; Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA., Anderson EM; Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, 32611, USA.; Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA., Fazzone B; Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, 32611, USA.; Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA., Harland KC; Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, 32611, USA.; Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA., Hu Q; Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, 32611, USA.; Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA., O'Malley KA; Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, 32611, USA.; Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA., Berceli SA; Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, 32611, USA.; Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA., Wymer J; Department of Neurology, University of Florida, Gainesville, FL, 32611, USA., Ryan TE; Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA.; Center for Exercise Science, University of Florida, Gainesville, FL, 32611, USA., Scali ST; Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, 32611, USA. Salvatore.Scali@surgery.ufl.edu.; Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA. Salvatore.Scali@surgery.ufl.edu.; Gainesville, USA. Salvatore.Scali@surgery.ufl.edu.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 Oct 05; Vol. 13 (1), pp. 16811. Date of Electronic Publication: 2023 Oct 05.
DOI: 10.1038/s41598-023-43664-z
Abstrakt: For end-stage kidney disease (ESKD) patients, hemodialysis requires durable vascular access which is often surgically created using an arteriovenous fistula (AVF). However, some ESKD patients that undergo AVF placement develop access-related hand dysfunction (ARHD) through unknown mechanisms. In this study, we sought to determine if changes in the serum metabolome could distinguish ESKD patients that develop ARHD from those that have normal hand function following AVF creation. Forty-five ESKD patients that underwent first-time AVF creation were included in this study. Blood samples were obtained pre-operatively and 6-weeks post-operatively and metabolites were extracted and analyzed using nuclear magnetic resonance spectroscopy. Patients underwent thorough examination of hand function at both timepoints using the following assessments: grip strength manometry, dexterity, sensation, motor and sensory nerve conduction testing, hemodynamics, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Nineteen of the forty-five patients displayed overt weakness using grip strength manometry (P < 0.0001). Unfortunately, the serum metabolome was indistinguishable between patients with and without weakness following AVF surgery. However, a significant correlation was found between the change in tryptophan levels and the change in grip strength suggesting a possible role of tryptophan-derived uremic metabolites in post-AVF hand-associated weakness. Compared to grip strength, changes in dexterity and sensation were smaller than those observed in grip strength, however, post-operative decreases in phenylalanine, glycine, and alanine were unique to patients that developed signs of motor or sensory disability following AVF creation.
(© 2023. Springer Nature Limited.)
Databáze: MEDLINE
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