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PLoS One

Title:		Exhaled volatile substances mirror clinical conditions in pediatric chronic kidney disease
Author(s):		Obermeier J; Trefz P; Happ J; Schubert JK; Staude H; Fischer DC; Miekisch W;
Address:		"Department of Anesthesiology and Intensive Care Medicine, Rostock Medical Breath Research Analytics and Technologies (ROMBAT), University Medicine Rostock, Rostock, Germany. Department of Pediatrics, University Medicine Rostock, Rostock, Germany"
Journal Title:		PLoS One
Year:		2017
Volume:		20170601
Issue:		6
Page Number:		e0178745 -
DOI:		10.1371/journal.pone.0178745
ISSN/ISBN:		1932-6203 (Electronic) 1932-6203 (Linking)
Abstract:		"Monitoring metabolic adaptation to chronic kidney disease (CKD) early in the time course of the disease is challenging. As a non-invasive technique, analysis of exhaled breath profiles is especially attractive in children. Up to now, no reports on breath profiles in this patient cohort are available. 116 pediatric subjects suffering from mild-to-moderate CKD (n = 48) or having a functional renal transplant KTx (n = 8) and healthy controls (n = 60) matched for age and sex were investigated. Non-invasive quantitative analysis of exhaled breath profiles by means of a highly sensitive online mass spectrometric technique (PTR-ToF) was used. CKD stage, the underlying renal disease (HUS; glomerular diseases; abnormalities of kidney and urinary tract or polycystic kidney disease) and the presence of a functional renal transplant were considered as classifiers. Exhaled volatile organic compound (VOC) patterns differed between CKD/ KTx patients and healthy children. Amounts of ammonia, ethanol, isoprene, pentanal and heptanal were higher in patients compared to healthy controls (556, 146, 70.5, 9.3, and 5.4 ppbV vs. 284, 82.4, 49.6, 5.30, and 2.78 ppbV). Methylamine concentrations were lower in the patient group (6.5 vs 10.1 ppbV). These concentration differences were most pronounced in HUS and kidney transplanted patients. When patients were grouped with respect to degree of renal failure these differences could still be detected. Ammonia accumulated already in CKD stage 1, whereas alterations of isoprene (linked to cholesterol metabolism), pentanal and heptanal (linked to oxidative stress) concentrations were detectable in the breath of patients with CKD stage 2 to 4. Only weak associations between serum creatinine and exhaled VOCs were noted. Non-invasive breath testing may help to understand basic mechanisms and metabolic adaptation accompanying progression of CKD. Our results support the current notion that metabolic adaptation occurs early during the time course of CKD"
Keywords:		"Adolescent Body Mass Index Breath Tests/*methods Case-Control Studies Child Child, Preschool Cross-Sectional Studies Female Humans Mass Spectrometry Renal Insufficiency, Chronic/*metabolism Volatile Organic Compounds/*analysis;"
Notes:		"MedlineObermeier, Juliane Trefz, Phillip Happ, Josephine Schubert, Jochen K Staude, Hagen Fischer, Dagmar-Christiane Miekisch, Wolfram eng 2017/06/02 PLoS One. 2017 Jun 1; 12(6):e0178745. doi: 10.1371/journal.pone.0178745. eCollection 2017"