Contribution of Uremia to Ureaplasma -Induced Hyperammonemia

Abstract

Ureaplasma -induced hyperammonemia is a deadly complication affecting around 4% of lung transplant recipients and, to a lesser extent, other solid organ transplant patients. Understanding the underlying mechanisms will inform patient management, potentially decreasing mortality and morbidity. Here, it is shown that uremia is a plausible contributing factor to the pathophysiology of the condition.

Study on Nursing Effect of Psychological Intervention on Uremic Hemodialysis Patients

“…Uremia is a series of poisoning symptoms when acute or chronic renal insufficiency develops to a serious stage, often accompanied by water, electrolyte disorder, endocrine dysfunction, and other symptoms, which poses a serious threat to the life safety of patients [ 14 – 16 ]. Hemodialysis is one of the important treatment methods for patients with uremia, which can effectively improve the survival rate of patients.…”

Flurofamide Prevention and Treatment of Ureaplasma -Induced Hyperammonemia

“…Lastly, it should be noted that the animals in this study experienced mild HA, and thus the ability of flurofamide to treat more severe cases will require further investigation. Given the established link of uremia to increased ureaplasmal NH 3 production ( 14 ), an acute kidney injury model could be used in place of the dietary uremia model in future studies.…”

“… U. parvum IDRL-10774 aliquots were pelleted at 15,000 × G for 20 min at 4°C and resuspended in saline or saline + 0.1% agar. C3H male and female mice (18-22 g, Charles River Laboratories, Wilmington, MA) were pharmacologically immunosuppressed for 7 days with methylprednisone, tacrolimus, and mycophenolate mofetil, and administered 40 g/L urea ad libitum in drinking water for 10 days to induce mild uremia, as previously described ( 14 ). Following immunosuppression and uremic induction, mice were administered 6 mg/kg flurofamide via IP injection (based on Ligon and Kenney 1990) ( 20 ), 1 h prior to IT and IP Ureaplasma challenge.…”

“…Sample input was 200 μL and elution output 100 μL. qPCR for Ureaplasma was performed as previously described on a LightCycler 480 II (Roche Applied Science) ( 14 , 23 ).…”

“… urealyticum and U. parvum , are particularly vulnerable to bacterial overproduction of NH 3 to such a degree that it overwhelms host detoxification capacity, resulting in cerebral edema and often death ( 9 – 13 ). Although the mechanisms that make LTRs exceptionally vulnerable to this clinical manifestation are not completely understood, the heavily immunocompromised status of LTRs, coupled with infection site advantages, such as ischemic tissue resulting from incomplete lung revascularization, and increased urea availability due to uremia resulting from acute renal failure ( 14 ), are likely contributing factors. Although Ureaplasma -directed antibiotic therapy can be curative and preventative in these patients, greatly reducing mortality ( 15 , 16 ), antibiotic use can lead to selection of resistance, resulting in relapse and treatment failure ( 1 ).…”