Document Detail


Skin blood flow in patients with stage 5 chronic kidney disease on hemodialysis.
MedLine Citation:
PMID:  20797579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have shown previously that skin perfusion is reduced in patients with diabetes mellitus (DM). Patients with diabetes and with chronic kidney disease (CKD) stage 5 were having advanced microangiopathy. In this cross-sectional study, we measured skin blood flow in DM and non-DM patients on dialysis to assess whether any differences exist in skin perfusion in those 2 groups of patients. A total of 25 patients with DM (aged 59.9 +/- 2.2 years) and 24 patients with non-DM CKD stage 5 (44.6 +/- 2.9 years) on hemodialysis (HD) were studied. Ten healthy subjects (37 +/- 4.3 years) were used as a control group. Skin blood flow (SBF) was measured using Vasamedic Model 403B laser Doppler device (Vasamedics Inc., St. Paul, MN) in a standardized way at the plantar and dorsal surface of the finger and toe and at the pretibial surface of the leg at 2 different local skin temperatures of 35 degrees C and 44 degrees C. Laboratory biochemical data were collected at the time of SBF study. The SBF measured at 35 degrees C was lower in the patients with DM on dialysis as compared with healthy subjects and non-DM dialysis patients. The SBF response to the increase in temperature of the probe to 44 degrees C was 70% to 80% lower in DM patients as compared with healthy subjects and non-DM patients. However, non-DM subjects who displayed SBF similar to control subjects at 35 degrees C, had impaired response in SBF at 44 degrees C as well. Patients with lower serum albumin exhibited lower SBF even after adjustment for age. SBF is impaired in patients with stage 5 CKD on HD, particularly in those with DM as a cause of CKD. SBF negatively correlated with age and albumin (nutritional status) in DM and non-DM patients with stage 5 CKD on HD. Measurement of SBF can be useful in the evaluation of vasculopathy in CKD population and can potentially be used for assessment of vascular response during specific clinical intervention.
Authors:
Binh Ngo; Christine Rongey; Bryan Hiscox; Marc Rendell; David Woodley; Miroslaw Smogorzewski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation     Volume:  20     ISSN:  1532-8503     ISO Abbreviation:  J Ren Nutr     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9112938     Medline TA:  J Ren Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S89-94     Citation Subset:  IM    
Copyright Information:
Copyright 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Dermatology, University of Southern California, Keck School of Medicine, Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Flow Velocity
Cross-Sectional Studies
Diabetes Complications / physiopathology
Diabetic Angiopathies / physiopathology
Female
Humans
Kidney Failure, Chronic / complications,  physiopathology*,  therapy
Male
Middle Aged
Renal Dialysis*
Skin / blood supply*
Skin Diseases / complications,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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