A Causal-Pathway Phenotype of Chronic Fatigue Syndrome due to Hemodialysis in Patients with End-Stage Renal Disease

Halah Asad; Hussein Al-Hakeim; Shatha MoustafaMichael Maes

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A Causal-Pathway Phenotype of Chronic Fatigue Syndrome due to Hemodialysis in Patients with End-Stage Renal Disease

机译：A Causal-Pathway Phenotype of Chronic Fatigue Syndrome due to Hemodialysis in Patients with End-Stage Renal Disease

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Background: End-stage renal disease (ESRD) is associated with fatigue and physiosomatic symptoms. Objective: The objective of this study is to delineate the associations between severity of fatigue and physio-somatic symptoms and glomerular filtration rate, inflammatory biomarkers, and Wnt/cateninpathway proteins. Methods: The Wnt-pathway related proteins β-catenin, Dickkopf-related protein 1 (DKK1), R-spondin- 1, and sclerostin were measured by ELISA technique in 60 ESRD patients and 30 controls. The Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale was used to assess the severity of FF symptoms. Results: ESRD is characterized by a significant increase in the total FF score, muscle tension, fatigue, sadness, sleep disorders, gastro-intestinal (GI) symptoms, and a flu-like malaise. The total-FF score was significantly correlated with serum levels of urea, creatinine, and copper (positively), and β-catenin, eGFR, hemoglobin, albumin, and zinc (inversely). The total-FF score was associated with the number of total dialysis and weekly dialysis sessions, and these dialysis characteristics were more important in predicting FF scores than eGFR measurements. Partial Least Squares analysis showed that the FF score comprised two factors that are differently associated with biomarkers: a) 43.0 of the variance in fatigue, GI symptoms, muscle tension, sadness, and insomnia is explained by hemoglobin, albumin, zinc, β-catenin, and R-spondin-1; and b) 22.3 of the variance in irritability, concentration and memory impairments by increased copper and cations/chloride ratio, and male sex. Conclusion: ESRD patients show high levels of fatigue and physio-somatic symptoms associated with hemodialysis and mediated by dialysis-induced changes in inflammatory pathways, the Wnt/catenin pathway, and copper.

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《CNS & neurological disorders drug targets》 |2023年第2期|191-206|共16页
作者
Halah Asad; Hussein Al-Hakeim; Shatha MoustafaMichael Maes;
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作者单位

Al Najaf Health Directorate, Higher Health Institute,Najaf,Iraq,;

College of Science, University of Kufa,Department of Chemistry,Iraq,;

College of Pharmacy, Hawler Medical University,Department of Clinical Analysis,Erbil,Iraq,Faculty of Medicine, Chulalongkorn University,Department of Psychiatry,Bangkok,Thailand,|Medical;

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正文语种英语
中图分类神经病学与精神病学;
关键词
Myalgic Encephalomyelitis/chronic fatigue syndrome; physiological stress; inflammation; neuro-immune; oxidative stress; biomarkers.;

A Causal-Pathway Phenotype of Chronic Fatigue Syndrome due to Hemodialysis in Patients with End-Stage Renal Disease

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