Microbiota Quality and Mitochondrial Activity Link with Occurrence of Muscle Cramps in Hemodialysis Patients using Citrate Dialysate: A Pilot Study

Blood Purif. 2018;46(4):301-308. doi: 10.1159/000490612. Epub 2018 Jul 26.

Abstract

Background/aims: Hemodialysis-associated muscle cramp (HAMC) is a common complication under citrate dialysate (CD) occurring in 30% of cases. Our objectives were to assess the gut microbiota quality, mitochondrial activity, and to investigate their possible relationship with HAMC.

Methods: Ten end-stage renal disease patients (78.9 ± 2.1 years) treated by hemodialysis (HD) with CD were enrolled and then classified according to the frequency of HAMCs: "frequent HAMCs group" (n = 5) and "absence of HAMCs group" (n = 5). Gut microbiota quality, mitochondrial activity, and some markers of oxidative stress (OS) were investigated.

Results: In patients with cramps, gut microbiota diversity seemed lower and some genera including Helicobacter, Lachnospira, Roseburia, and Haemophilus seemed over-expressed, a significant increase of citratemia and significant lowering mitochondrial function were observed. No difference was observed on the OS markers.

Conclusion: This first clinical study revealed a possible dysbiosis of microbiota and a mitochondrial dysfunction into HD patients with cramps under CD compared to patients without cramp.

Keywords: Citrate dialysate; Hemodialysis; Hypercitratemia; Microbiota; Mitochondria; Muscle cramps.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bacteria* / classification
  • Bacteria* / growth & development
  • Citric Acid / blood*
  • Dysbiosis / blood
  • Dysbiosis / microbiology
  • Dysbiosis / therapy
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Kidney Failure, Chronic* / blood
  • Kidney Failure, Chronic* / microbiology
  • Kidney Failure, Chronic* / therapy
  • Male
  • Mitochondria, Muscle / metabolism*
  • Mitochondria, Muscle / pathology
  • Muscle Cramp
  • Pilot Projects
  • Renal Dialysis*

Substances

  • Citric Acid