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      A Comprehensive Skin Gas Analysis of Substances Related to Uraemia in Patients With End‐Stage Kidney Disease: A Pilot Study

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          ABSTRACT

          Recent progress in gas‐sensing technology has enabled the rapid collection and highly sensitive analysis of skin gases associated with body odour. Skin gases can be collected less invasively, more continuously, and less consciously than blood or urine. Patients with end‐stage kidney disease (ESKD) have a characteristic uremic odour that fades after initiating kidney replacement therapy. We investigated the potential for objectively and quantitatively evaluating the factors underlying uraemia. Skin gases were collected using a passive flux sampler placed on the forearm, with peak intensities measured using gas chromatography–mass spectrometry (GC/MS). We investigated the changes in skin gases obtained from the haemodialysis (HD) group before and after the first HD session of patients undergoing incident dialysis and compared them between the ESKD groups (HD and non‐HD) and the healthy group. Thermal desorption enabled the collection of volatile molecules for 20 min using GC/MS preprocessing. Amongst 137 volatile molecules collected from the HD group ( N = 5), 16 were detected in all patients. Aldehydes and alkanes were detected more frequently, and four volatile molecules, including 6‐methyl‐5‐hepten‐2‐one, were detected in all participants in the ESKD ( N = 11) and healthy ( N = 7) groups. Benzaldehyde and undecanal showed significantly higher intensities in the ESKD group. Additionally, five unidentified volatile molecules were undetectable after dialysis, suggesting an association with the uremic odour. A comprehensive skin gas analysis technique has enabled the identification of volatile molecules related to ESKD. With a short sampling time, skin gas analysis has potential applications in clinical testing and telemedicine.

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          Most cited references20

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          Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets

          Chronic kidney disease (CKD) is a progressive loss of renal function. The gradual decline in kidney function leads to an accumulation of toxins normally cleared by the kidneys, resulting in uremia. Uremic toxins are classified into three categories: free water-soluble low-molecular-weight solutes, protein-bound solutes, and middle molecules. CKD patients have increased risk of developing cardiovascular disease (CVD), due to an assortment of CKD-specific risk factors. The accumulation of uremic toxins in the circulation and in tissues is associated with the progression of CKD and its co-morbidities, including CVD. Although numerous uremic toxins have been identified to date and many of them are believed to play a role in the progression of CKD and CVD, very few toxins have been extensively studied. The pathophysiological mechanisms of uremic toxins must be investigated further for a better understanding of their roles in disease progression and to develop therapeutic interventions against uremic toxicity. This review discusses the renal and cardiovascular toxicity of uremic toxins indoxyl sulfate, p-cresyl sulfate, hippuric acid, TMAO, ADMA, TNF-α, and IL-6. A focus is also placed on potential therapeutic targets against uremic toxicity.
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            Recent Advances in Emerging 2D Material‐Based Gas Sensors: Potential in Disease Diagnosis

              • Record: found
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              Detection of volatile organic compounds (VOCs) from exhaled breath as noninvasive methods for cancer diagnosis

                Author and article information

                Contributors
                mnangaku@m.u-tokyo.ac.jp
                Journal
                Nephrology (Carlton)
                Nephrology (Carlton)
                10.1111/(ISSN)1440-1797
                NEP
                Nephrology (Carlton, Vic.)
                John Wiley & Sons Australia, Ltd (Melbourne )
                1320-5358
                1440-1797
                13 March 2025
                March 2025
                : 30
                : 3 ( doiID: 10.1111/nep.v30.3 )
                : e70020
                Affiliations
                [ 1 ] Division of Nephrology and Endocrinology, Graduate School of Medicine The University of Tokyo Tokyo Japan
                [ 2 ] Department of Bioengineering, Graduate School of Engineering The University of Tokyo Tokyo Japan
                Author notes
                [*] [* ] Correspondence:

                Masaomi Nangaku ( mnangaku@ 123456m.u-tokyo.ac.jp )

                Author information
                https://orcid.org/0000-0002-9755-0935
                Article
                NEP70020 NEP-2024-0775.R1
                10.1111/nep.70020
                11907091
                40083095
                61ab7e41-a809-4498-99d4-49aebbd28187
                © 2025 The Author(s). Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 27 January 2025
                : 13 November 2024
                : 04 March 2025
                Page count
                Figures: 2, Tables: 1, Pages: 6, Words: 3800
                Funding
                Funded by: Japan Agency for Medical Research and Development , doi 10.13039/100009619;
                Award ID: JP22zf0127006
                Funded by: Nanosystem Integration Center at the University of Tokyo
                Funded by: Research Network Center for Next Generation Clinical Biomedical Measurement Technology, Nakatani Foundation
                Categories
                Brief Communication
                Brief Communication
                Custom metadata
                2.0
                March 2025
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.5.4 mode:remove_FC converted:14.03.2025

                chronic kidney disease,comprehensive analysis,end‐stage kidney disease,skin gas,uremic odour

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