Diabetes Mellitus and Younger Age Are Risk Factors for Hyperphosphatemia in Peritoneal Dialysis Patients

Imtiaz, Rameez; Hawken, Steven; McCormick, Brendan; Leung, Simon; Hiremath, Swapnil; Zimmerman, Deborah

doi:10.3390/nu9020152

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…This finding was incongruent with previous studies [ 88 , 89 ] with inconsistencies existed [ 85 , 90 ]. Earlier studies revealed that medicines prescribed for the treatment of diabetes mellitus may incorporate highly bioavailable inorganic phosphate as an additive, which attributes to the elevation of serum phosphate levels [ 91 ]. Nevertheless, the exact mechanism concerning hyperphosphataemic episodes in diabetic hemodialysis patients remains unclear and requires more extensive and in-depth studies in the future.…”

Section: Discussionmentioning

confidence: 99%

Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia

Wong

Kamaruddin

et al. 2020

IJERPH

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Despite optimal control of serum phosphate level being imperative to avoid undesirable health outcomes, hyperphosphataemia is a highly prevalent mineral abnormality among the dialysis population. This study aimed to determine factors associated with hyperphosphatemia among hemodialysis patients in Malaysia. Multiple linear regression analysis was used to ascertain the possible factors that influence serum phosphate levels. A total of 217 hemodialysis patients were recruited. Hyperphosphatemia was prevalent. Only approximately 25% of the patients were aware that optimal control of hyperphosphatemia requires the combined effort of phosphate binder medication therapy, dietary restriction, and dialysis prescription. The presence of diabetes mellitus may affect serum phosphate levels, complicating dietary phosphorus management. Patients who were less depressive portrayed higher serum phosphate levels, implying intentional non-compliance. Better compliance on phosphate binder, longer sleep duration, and higher social support was associated with a lower level of serum phosphate. Despite sleep disturbance being one of the most prevalent and intense symptom burdens identified by hemodialysis patients, relatively few studies have addressed this issue. It is time to formulate sleep therapeutic interventions besides the encouragement of strong social support, hoping which many clinical outcomes including hyperphosphatemia can be better controlled among hemodialysis patients.

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Section: Discussionmentioning

confidence: 99%

Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia

Wong

Kamaruddin

et al. 2020

IJERPH

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“…Interestingly, emerging evidence indicates that phosphate metabolism is altered in diabetes [ 33 , 34 ]. Hyperphosphatemia has been described in an animal model of diabetes [ 35 ], and diabetes is considered a major risk factor for hyperphosphatemia through kidney disease [ 36 ]. Hence, disturbances in the levels of plasma phosphate could be a cause for the observed higher levels of platelet and plasma polyP in diabetes.…”

Section: Discussionmentioning

confidence: 99%

Proinflammatory Polyphosphate Increases in Plasma of Obese Children with Insulin Resistance and Adults with Severe Type 2 Diabetes

et al. 2022

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Obesity increases the risk of insulin resistance and type 2 diabetes through increased inflammation at cellular and tissue levels. Therefore, study of the molecular elements involved in obesity-related inflammation may contribute to preventing and controlling it. Inorganic polyphosphate is a natural phosphate polymer that has recently been attracting more attention for its role in inflammation and hemostasis processes. Polyphosphates are one of the main constituents of human platelets, which are secreted after platelet activation. Among other roles, they interact with multiple proteins of the coagulation cascade, trigger bradykinin release, and inhibit the complement system. Despite its importance, determinations of polyphosphate levels in blood plasma had been elusive until recently, when we developed a method to detect these levels precisely. Here, we perform cross sectional studies to evaluate plasma polyphosphate in: 25 children, most of them with obesity and overweight, and 20 adults, half of them with severe type 2 diabetes. Our results show that polyphosphate increases, in a significant manner, in children with insulin resistance and in type 2 diabetes patients. As we demonstrated before that polyphosphate decreases in healthy overweight individuals, these results suggest that this polymer could be an inflammation biomarker in the metabolic disease onset before diabetes.

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“…In many studies related to peritoneal dialysis, diabetes mellitus was considered as a factor that may have an influence on the results ( Author Anonymous, 1996 ; Rocco M. et al, 2000 ; Wang et al, 2003 ). A younger age and diabetes were reported as significant risk factors for hyperphosphatemia in PD patients ( Imtiaz et al, 2017 ), indicative of inadequate PD. PD, as a form of home dialysis, has a requirement of proficient operation and patience during daily dialysis.…”

Section: Methodsmentioning

confidence: 99%

Association between anemia-related biomarkers and the adequacy of peritoneal dialysis in Chinese patients with chronic kidney disease

Li¹,

Cai²,

Zhao³

et al. 2023

Front. Physiol.

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Objectives: The study aimed to examine the association of three anemia-related biomarkers with the adequacy of peritoneal dialysis (PD) in patients with chronic kidney disease (CKD).Methods: This study included 127 PD patients. The total Kt/V urea (Kt/V) was calculated according to the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines. All patients were classified into two groups based on Kt/V, viz., adequate (Kt/V ≥1.7) and inadequate (Kt/V <1.7) groups. Effect sizes are expressed as odds ratios (ORs) and 95% confidence interval (CI).Results: After adjusting for age, gender, hypertension, diabetes, and PD duration, 20 g/L increment in hemoglobin (Hgb) was observed to significantly reduce the risk of inadequate PD by 19% (OR; 95% CI; P: 0.81; 0.70 to 0.95; 0.009), 5 g/L increment in the mean corpuscular hemoglobin concentration (MCHC) by 7% (0.93; 0.88 to 0.98; 0.009), and 5% increment in transferrin saturation (TS) by 23% (0.77; 0.64 to 0.94; 0.012). The gender-specific nomogram model was constructed by incorporating three significant anemia-related biomarkers and convenient influencing factors, and the prediction accuracy was good (concordance index (C-index): 0.686 for men and 0.825 for women).Conclusion: Our findings indicate that the deterioration of three anemia-related biomarkers (Hgb, MCHC, and TS) can precipitate the development of inadequate PD in Chinese patients with CKD.

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Diabetes Mellitus and Younger Age Are Risk Factors for Hyperphosphatemia in Peritoneal Dialysis Patients

Cited by 7 publications

References 26 publications

Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia

Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia

Proinflammatory Polyphosphate Increases in Plasma of Obese Children with Insulin Resistance and Adults with Severe Type 2 Diabetes

Association between anemia-related biomarkers and the adequacy of peritoneal dialysis in Chinese patients with chronic kidney disease

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