Possible prevention of uremic nausea by vitamin D receptor activators in non-dialysis patients with stage 5 chronic kidney disease

Masato Ikeda, Yoshimi Ueda, Yukio Maruyama, Keitaro Yokoyama, Takashi Yokoo, Nobuhiko Joki, Ryoichi Ando, Toshio Shinoda, Daijo Inaguma, Toshihiko Yamaka, Yasuhiro Komatsu, Fumihiko Koiwa, Toshifumi Sakaguchi, Shigeo Negi, Takashi Shigematsu

Research output: Contribution to journalArticle

Abstract

Background: Nausea is a major uremic symptom and a frequent indication for starting dialysis. However, preventive medication for uremic nausea has not yet been identified. Vitamin D receptor activators (VDRAs) may prevent uremic nausea via their pleiotropic actions. The objective of this study was to explore whether VDRA administration during the predialysis period is associated with a reduced prevalence of uremic nausea just prior to beginning dialysis. Methods: A multicenter, retrospective, cross-sectional study was performed to identify a medication to prevent uremic nausea. Patients with stage 5 CKD who were followed-up over 3 months were included. The primary outcomes examined were the prevalence of uremic nausea, congestive heart failure (CHF), and intractable edema at dialysis commencement. The predictor variable was VDRA use during the predialysis period. Results: One thousand five hundred and thirty six patients who had just begun dialysis in nine Japanese facilities between January 2006 and October 2013 were included. Two hundred and thirty (15.0%) patients had commenced dialysis because of uremic nausea, and three hundred and ninety two (25.5%) patients had been using VDRAs before initiating dialysis. Logistic regression analysis showed that, among the medications examined in this study, only VDRA use was independently associated with a lower frequency of uremic nausea (OR 0.512, 95% CI 0.347–0.738, P = 0.0003). On the other hand, CHF and intractable edema were not associated with VDRA administration. Conclusion: Use of VDRAs during the predialysis period was the only factor associated with a lower prevalence of uremic nausea, suggesting that VDRAs may prevent uremic nausea in patients with advanced CKD.

Original languageEnglish
Pages (from-to)825-834
Number of pages10
JournalClinical and Experimental Nephrology
Volume21
Issue number5
DOIs
Publication statusPublished - 01-10-2017

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Calcitriol Receptors
Chronic Renal Insufficiency
Nausea
Dialysis
Edema
Heart Failure
Cross-Sectional Studies
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

Cite this

Ikeda, Masato ; Ueda, Yoshimi ; Maruyama, Yukio ; Yokoyama, Keitaro ; Yokoo, Takashi ; Joki, Nobuhiko ; Ando, Ryoichi ; Shinoda, Toshio ; Inaguma, Daijo ; Yamaka, Toshihiko ; Komatsu, Yasuhiro ; Koiwa, Fumihiko ; Sakaguchi, Toshifumi ; Negi, Shigeo ; Shigematsu, Takashi. / Possible prevention of uremic nausea by vitamin D receptor activators in non-dialysis patients with stage 5 chronic kidney disease. In: Clinical and Experimental Nephrology. 2017 ; Vol. 21, No. 5. pp. 825-834.
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abstract = "Background: Nausea is a major uremic symptom and a frequent indication for starting dialysis. However, preventive medication for uremic nausea has not yet been identified. Vitamin D receptor activators (VDRAs) may prevent uremic nausea via their pleiotropic actions. The objective of this study was to explore whether VDRA administration during the predialysis period is associated with a reduced prevalence of uremic nausea just prior to beginning dialysis. Methods: A multicenter, retrospective, cross-sectional study was performed to identify a medication to prevent uremic nausea. Patients with stage 5 CKD who were followed-up over 3 months were included. The primary outcomes examined were the prevalence of uremic nausea, congestive heart failure (CHF), and intractable edema at dialysis commencement. The predictor variable was VDRA use during the predialysis period. Results: One thousand five hundred and thirty six patients who had just begun dialysis in nine Japanese facilities between January 2006 and October 2013 were included. Two hundred and thirty (15.0{\%}) patients had commenced dialysis because of uremic nausea, and three hundred and ninety two (25.5{\%}) patients had been using VDRAs before initiating dialysis. Logistic regression analysis showed that, among the medications examined in this study, only VDRA use was independently associated with a lower frequency of uremic nausea (OR 0.512, 95{\%} CI 0.347–0.738, P = 0.0003). On the other hand, CHF and intractable edema were not associated with VDRA administration. Conclusion: Use of VDRAs during the predialysis period was the only factor associated with a lower prevalence of uremic nausea, suggesting that VDRAs may prevent uremic nausea in patients with advanced CKD.",
author = "Masato Ikeda and Yoshimi Ueda and Yukio Maruyama and Keitaro Yokoyama and Takashi Yokoo and Nobuhiko Joki and Ryoichi Ando and Toshio Shinoda and Daijo Inaguma and Toshihiko Yamaka and Yasuhiro Komatsu and Fumihiko Koiwa and Toshifumi Sakaguchi and Shigeo Negi and Takashi Shigematsu",
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Ikeda, M, Ueda, Y, Maruyama, Y, Yokoyama, K, Yokoo, T, Joki, N, Ando, R, Shinoda, T, Inaguma, D, Yamaka, T, Komatsu, Y, Koiwa, F, Sakaguchi, T, Negi, S & Shigematsu, T 2017, 'Possible prevention of uremic nausea by vitamin D receptor activators in non-dialysis patients with stage 5 chronic kidney disease', Clinical and Experimental Nephrology, vol. 21, no. 5, pp. 825-834. https://doi.org/10.1007/s10157-016-1355-8

Possible prevention of uremic nausea by vitamin D receptor activators in non-dialysis patients with stage 5 chronic kidney disease. / Ikeda, Masato; Ueda, Yoshimi; Maruyama, Yukio; Yokoyama, Keitaro; Yokoo, Takashi; Joki, Nobuhiko; Ando, Ryoichi; Shinoda, Toshio; Inaguma, Daijo; Yamaka, Toshihiko; Komatsu, Yasuhiro; Koiwa, Fumihiko; Sakaguchi, Toshifumi; Negi, Shigeo; Shigematsu, Takashi.

In: Clinical and Experimental Nephrology, Vol. 21, No. 5, 01.10.2017, p. 825-834.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Possible prevention of uremic nausea by vitamin D receptor activators in non-dialysis patients with stage 5 chronic kidney disease

AU - Ikeda, Masato

AU - Ueda, Yoshimi

AU - Maruyama, Yukio

AU - Yokoyama, Keitaro

AU - Yokoo, Takashi

AU - Joki, Nobuhiko

AU - Ando, Ryoichi

AU - Shinoda, Toshio

AU - Inaguma, Daijo

AU - Yamaka, Toshihiko

AU - Komatsu, Yasuhiro

AU - Koiwa, Fumihiko

AU - Sakaguchi, Toshifumi

AU - Negi, Shigeo

AU - Shigematsu, Takashi

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background: Nausea is a major uremic symptom and a frequent indication for starting dialysis. However, preventive medication for uremic nausea has not yet been identified. Vitamin D receptor activators (VDRAs) may prevent uremic nausea via their pleiotropic actions. The objective of this study was to explore whether VDRA administration during the predialysis period is associated with a reduced prevalence of uremic nausea just prior to beginning dialysis. Methods: A multicenter, retrospective, cross-sectional study was performed to identify a medication to prevent uremic nausea. Patients with stage 5 CKD who were followed-up over 3 months were included. The primary outcomes examined were the prevalence of uremic nausea, congestive heart failure (CHF), and intractable edema at dialysis commencement. The predictor variable was VDRA use during the predialysis period. Results: One thousand five hundred and thirty six patients who had just begun dialysis in nine Japanese facilities between January 2006 and October 2013 were included. Two hundred and thirty (15.0%) patients had commenced dialysis because of uremic nausea, and three hundred and ninety two (25.5%) patients had been using VDRAs before initiating dialysis. Logistic regression analysis showed that, among the medications examined in this study, only VDRA use was independently associated with a lower frequency of uremic nausea (OR 0.512, 95% CI 0.347–0.738, P = 0.0003). On the other hand, CHF and intractable edema were not associated with VDRA administration. Conclusion: Use of VDRAs during the predialysis period was the only factor associated with a lower prevalence of uremic nausea, suggesting that VDRAs may prevent uremic nausea in patients with advanced CKD.

AB - Background: Nausea is a major uremic symptom and a frequent indication for starting dialysis. However, preventive medication for uremic nausea has not yet been identified. Vitamin D receptor activators (VDRAs) may prevent uremic nausea via their pleiotropic actions. The objective of this study was to explore whether VDRA administration during the predialysis period is associated with a reduced prevalence of uremic nausea just prior to beginning dialysis. Methods: A multicenter, retrospective, cross-sectional study was performed to identify a medication to prevent uremic nausea. Patients with stage 5 CKD who were followed-up over 3 months were included. The primary outcomes examined were the prevalence of uremic nausea, congestive heart failure (CHF), and intractable edema at dialysis commencement. The predictor variable was VDRA use during the predialysis period. Results: One thousand five hundred and thirty six patients who had just begun dialysis in nine Japanese facilities between January 2006 and October 2013 were included. Two hundred and thirty (15.0%) patients had commenced dialysis because of uremic nausea, and three hundred and ninety two (25.5%) patients had been using VDRAs before initiating dialysis. Logistic regression analysis showed that, among the medications examined in this study, only VDRA use was independently associated with a lower frequency of uremic nausea (OR 0.512, 95% CI 0.347–0.738, P = 0.0003). On the other hand, CHF and intractable edema were not associated with VDRA administration. Conclusion: Use of VDRAs during the predialysis period was the only factor associated with a lower prevalence of uremic nausea, suggesting that VDRAs may prevent uremic nausea in patients with advanced CKD.

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