Scholarlink

Background <p>Patients with chronic kidney disease undergoing maintenance hemodialysis require frequent biochemical monitoring, which conventionally relies on invasive blood sampling. Saliva represents a non-invasive biofluid that may reflect systemic metabolic changes and oral microbial dynamics. However, the feasibility of integrating salivary biochemical and microbial assessment into a rapid point-of-care (POC) workflow in dialysis settings remains incompletely explored.</p> Objectives <p>To evaluate the feasibility of a rapid saliva-based POC platform integrating biochemical assays and LAMP-PCR for assessing within-session metabolic and microbial changes in patients undergoing routine hemodialysis, and to examine its relationship with corresponding serum biochemical trends.</p> Methods <p><?tk 1?>In this prospective paired observational study, 70 maintenance hemodialysis patients provided saliva and serum samples immediately before and after a dialysis session. Salivary urea and creatinine were measured using enzymatic POC assays, while salivary microbial DNA burden was assessed using LAMP-PCR targeting bacterial 16&#xa0;S rRNA and selected oral pathogens. Serum biochemical parameters were measured using standard laboratory methods, with exploratory analysis of protein-bound uremic toxins performed in a subset. Agreement, correlation, and diagnostic performance analyses were conducted.</p> Results <p>Significant post-dialysis reductions were observed in both serum and salivary urea concentrations (both <i>p</i> &lt; 0.001). Although directional concordance was noted, changes in salivary and serum urea showed weak linear correlation (<i>r</i> = 0.016, <i>p</i> = 0.894). Bland–Altman analysis demonstrated acceptable internal consistency of salivary urea measurements. Salivary urea reduction showed moderate specificity (75.0%) but limited sensitivity (56.5%) for identifying ≥ 30% serum urea reduction. LAMP-based analysis demonstrated a significant increase in time-to-positivity post-dialysis, indicating reduced detectable salivary microbial DNA. The complete saliva-based workflow was completed within approximately 22&#xa0;min with high reproducibility.</p> Conclusion <p>This study demonstrates the feasibility of a rapid saliva-based POC platform for adjunctive metabolic and microbial monitoring in hemodialysis patients. While salivary biomarkers reflected directional biochemical trends, they did not demonstrate quantitative equivalence with serum indices and should not be interpreted as substitutes for established serum-based dialysis adequacy measures. Saliva-based POC testing may serve as a non-invasive complementary tool for bedside surveillance, pending further longitudinal and multicenter validation.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

A Rapid Saliva-Based LAMP-PCR Platform for Adjunctive Metabolic and Microbial Monitoring in Hemodialysis Patients

  • 期刊论文

  • 发表日期：

    2026年4月21日

查看全文
  • Nitya Krishnasamy,
  • Hema Shree K,
  • Sameep Shetty,
  • Kochli Channappa Niranjan

摘要

Background

Patients with chronic kidney disease undergoing maintenance hemodialysis require frequent biochemical monitoring, which conventionally relies on invasive blood sampling. Saliva represents a non-invasive biofluid that may reflect systemic metabolic changes and oral microbial dynamics. However, the feasibility of integrating salivary biochemical and microbial assessment into a rapid point-of-care (POC) workflow in dialysis settings remains incompletely explored.

Objectives

To evaluate the feasibility of a rapid saliva-based POC platform integrating biochemical assays and LAMP-PCR for assessing within-session metabolic and microbial changes in patients undergoing routine hemodialysis, and to examine its relationship with corresponding serum biochemical trends.

Methods

In this prospective paired observational study, 70 maintenance hemodialysis patients provided saliva and serum samples immediately before and after a dialysis session. Salivary urea and creatinine were measured using enzymatic POC assays, while salivary microbial DNA burden was assessed using LAMP-PCR targeting bacterial 16 S rRNA and selected oral pathogens. Serum biochemical parameters were measured using standard laboratory methods, with exploratory analysis of protein-bound uremic toxins performed in a subset. Agreement, correlation, and diagnostic performance analyses were conducted.

Results

Significant post-dialysis reductions were observed in both serum and salivary urea concentrations (both p < 0.001). Although directional concordance was noted, changes in salivary and serum urea showed weak linear correlation (r = 0.016, p = 0.894). Bland–Altman analysis demonstrated acceptable internal consistency of salivary urea measurements. Salivary urea reduction showed moderate specificity (75.0%) but limited sensitivity (56.5%) for identifying ≥ 30% serum urea reduction. LAMP-based analysis demonstrated a significant increase in time-to-positivity post-dialysis, indicating reduced detectable salivary microbial DNA. The complete saliva-based workflow was completed within approximately 22 min with high reproducibility.

Conclusion

This study demonstrates the feasibility of a rapid saliva-based POC platform for adjunctive metabolic and microbial monitoring in hemodialysis patients. While salivary biomarkers reflected directional biochemical trends, they did not demonstrate quantitative equivalence with serum indices and should not be interpreted as substitutes for established serum-based dialysis adequacy measures. Saliva-based POC testing may serve as a non-invasive complementary tool for bedside surveillance, pending further longitudinal and multicenter validation.