End-stage Renal Disease (ESRD)
Conditions
Keywords
Hemodialysis, Aerobic capacity, Deformability, Erythrocyte
Brief summary
End-stage renal disease (ESRD) disrupts erythrocyte deformability due to osmotic imbalances, oxidative stress, and uremic toxins, leading to impaired microcirculation and oxygen transport. Dysregulation of ion channels, particularly the Gardos channel, exacerbates dehydration and eryptosis, further compromising vascular integrity. Given the critical role of erythrocyte flexibility in oxygen delivery, this study investigates its relationship with aerobic capacity in ESRD patients, highlighting potential mechanisms of microvascular dysfunction
Detailed description
End-stage renal disease (ESRD) profoundly alters osmotic homeostasis, disrupting erythrocyte deformability and impairing microcirculatory dynamics, ultimately compromising oxygen delivery to tissues. Persistent oxidative stress, hyperosmotic fluctuations, and accumulation of uremic toxins collectively modulate ion channel activity, particularly by stimulating cation influx and perturbing calcium regulation. These disruptions accelerate erythrocyte aging and promote eryptosis, a programmed form of red blood cell death. Furthermore, dysregulation of the Gardos channel exacerbates potassium efflux, leading to excessive cell dehydration, increased blood viscosity, and further deterioration of vascular integrity. Given the pivotal role of erythrocyte flexibility in oxygen transport efficiency, impairments in osmotic deformability may contribute to the reduced aerobic capacity frequently observed in ESRD patients. This study aims to elucidate the interplay between erythrocyte biomechanical properties and cardiopulmonary fitness in this population, shedding light on potential therapeutic targets to mitigate microvascular dysfunction.
Interventions
OTHERBlood collection
Erythrocyte osmotic deformability was evaluated via osmotic gradient ektacytometry.
Cardiopulmonary Exercise Testing (CPET) is a non-invasive assessment that evaluates the integrated function of the cardiovascular, pulmonary, and muscular systems during exercise.
Sponsors
Chang Gung Memorial Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Receiving hemodialysis and medication at least for 6 weeks * Kt/V score \> 1.2
Exclusion criteria
* Under 20 years-old * Hyperkalemia occurs within 3 month * Having orthopedic or muscular diseases * Other concerned medical, psychological or physiological diseases * Pregnancy * Other exercise contraindications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Deformability of erythrocytes | Data collection was completed within one week of participant enrollment | Deformability refers to the cells' ability to adapt their shape to the dynamically changing flow conditions so as to minimize their resistance to flow. |
| Aggregation of erythrocytes | Data collection was completed within one week of participant enrollment | Erythrocyte aggregation is the reversible clumping of red blood cells (RBCs) under low shear forces or at stasis. |
| Cardiopulmonary fitness | Data collection was completed within one week of participant enrollment | ESRD patients performed cardiopulmonary exercise testing (CPET) to assess their aerobic capacity. CPET composed of continuous workload increment of 10 W/min until exhaustion (usually within 8-12 minutes). Oxygen consumption, carbon dioxide production, ventilation, respiratory rate would be recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life in ESRD patients | Data collection was completed within one week of participant enrollment | The investigators would use a qusionnaire, The Kidney Disease Quality of Life 36-item short form survey (KDQOL-36), to record and scale the qulaity of life in ESRD patients. The KDQOL-36 (Kidney Disease Quality of Life 36-Item Short Form Survey) measures the quality of life in kidney disease patients. It uses a score range from 0 to 100, where higher scores indicate better quality of life and lower scores indicate worse outcomes. Ensure to note this when reporting results to clarify that higher scores reflect fewer symptoms and better overall well-being. |
| Gardos function | Data collection was completed within one week of participant enrollment | Gardos channel activation leads to K⁺ efflux, followed by water loss, resulting in erythrocyte dehydration and increased fragility. Dysfunctional regulation of this channel contributes to impaired microcirculation and reduced oxygen delivery, exacerbating vascular complications in ESRD. |
Countries
Taiwan
Contacts
Primary ContactJong-Shyan Wang, PhD
Outcome results
None listed