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Breath analysis in patients with end‐stage renal disease: effect of haemodialysis
Author(s) -
Rolla G.,
Bruno M.,
Bommarito L.,
Heffler E.,
Ferrero N.,
Petrarulo M.,
Bagnis C.,
Bugiani M.,
Guida G.
Publication year - 2008
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.2008.02016.x
Subject(s) - exhaled breath condensate , medicine , end stage renal disease , chemistry , nox , gastroenterology , hemodialysis , asthma , organic chemistry , combustion
Background There is no agreement about exhaled nitric oxide (FE NO ) and its change after haemodialysis (HD) in end‐stage renal disease (ESRD) patients. To comprehensively assess NO production in the respiratory system, NO metabolites in exhaled breath condensate (EBC) needs to be measured in addition to FE NO , taking into account the influence on these markers of airway pH, which may be regulated by ammonia (), present in large amounts in the breath of ESRD patients and removed by HD. Study design FE NO and NO metabolites (NOx, , ), pH and in EBC were measured in 12 ESRD patients, before and after HD. Twelve healthy subjects acted as controls. Results FE NO values of ESRD patients were similar to normals, while EBC‐NOx, , and pH were significantly higher in ESRD patients compared to normals (EBC‐NOx 12·3, range 11·1–41·9 µ m vs. 9·4, range 4·6–10·9 µ m , P = 0·007; 4·70, range 1·17–8·22 µ m vs. 0·90, range 0·72–1·17 µ m , P = 0·023; 2340, range 1325–3922 µ m vs. 660, range 406–872 µ m , P < 0·001; pH 7·16, range 6·82–7·44 vs. 6·60, range 6·42–6·76, P = 0·004, respectively). HD caused a mild significant decrease of FE NO , and normalization of , NOx, and pH. A significant positive relationship between EBC‐pH and EBC‐ before and after HD ( r 2 = 0·65, P = 0·000) was observed, explaining higher than normal EBC‐pH before HD, while no relationship was found between EBC‐pH and FE NO or NO metabolites. Conclusion Oxidative stress, and not EBC‐pH, is the most probable cause of increased NO metabolites in ESRD patients before HD.