{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T22:46:45Z","timestamp":1768949205568,"version":"3.49.0"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The liver plays an important role to prevent translocation of gut\u2010derived toxins from the portal to the systemic circulation. Chronic inflammation is common in patients receiving hemodialysis, and increased gut permeability to microbial material has been implicated in its pathogenesis. This study sought to establish if flow\u2010dependent hepatic function was impaired in chronically inflamed individuals treated with hemodialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty adults receiving outpatient hemodialysis were recruited. Subjects with known liver or gastrointestinal disease, acute inflammation, and hemodynamic instability during hemodialysis were excluded.<\/jats:p>\n                    <jats:p>\n                      Participants were divided into two groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925): individuals with chronic inflammation (defined as a median high\u2010sensitivity C\u2010reactive protein (hs\u2010CRP) \u2265\u20095\u2009mg\/dL over the preceding 3\u2009months) with no apparent cause and a noninflamed group.\n                    <\/jats:p>\n                    <jats:p>Flow\u2010dependent hepatic function (defined as a composite of hepatic perfusion, hepatocyte clearance and biliary excretion) was assessed following hemodialysis by indocyanine green clearance to derive: (1) indocyanine green\u2010plasma disappearance rate and (2) indocyanine green\u2010retention after 15\u2009min. Serum beta\u2010D\u2010glucan levels pre\u2010 and post\u2010hemodialysis were measured as surrogate markers of gastrointestinal permeability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Indocyanine green\u2010plasma disappearance rate was reduced in the inflamed group versus the noninflamed group (19.4 (8.7)%\/min vs. 23.8 (14.4)%\/min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Indocyanine green\u2010retention after 15\u2009min was higher in the inflamed group (5.4 (6.8)% vs. 2.9 (5.0)%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Noninvasive hepatic fibrosis and steatosis assessments were similar in both groups. Pre\u2010hemodialysis beta\u2010D\u2010glucan levels were similar (63 (42) pg\/ml vs. 49 (11) pg\/ml;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.13), whereas post\u2010hemodialysis beta\u2010D\u2010glucan levels were higher in the inflamed group (82 (48) pg\/ml vs. 58 (27) pg\/ml;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and in those with flow\u2010dependent hepatic impairment (72 (45) vs. 55 (32) pg\/ml;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). In linear regression analysis, indocyanine green\u2010retention after 15\u2009min and post\u2010hemodialysis beta\u2010D\u2010glucan levels were independent predictors of median hs\u2010CRP, explaining 21% of the variation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Individuals with otherwise unexplained inflammation had impaired hepatic function post\u2010hemodialysis and higher post\u2010hemodialysis beta\u2010D\u2010glucan levels. These findings are compatible with the notion that impaired hepatic gut\u2010derived toxin removal propagates chronic inflammation in hemodialysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hdi.70016","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T04:50:31Z","timestamp":1755233431000},"page":"118-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post\u2010Hemodialysis Flow\u2010Dependent Hepatic Function Impairment in Individuals With End Stage Kidney Disease and Chronic Inflammation"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-8276","authenticated-orcid":false,"given":"Oscar","family":"Swift","sequence":"first","affiliation":[{"name":"School of Life and Medical Science University of Hertfordshire  Hatfield Hertfordshire UK"},{"name":"Department of Renal Medicine Lister Hospital, East and North Hertfordshire NHS Trust  Stevenage Hertfordshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bobby V. M.","family":"Dasari","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Liver Transplant Surgery Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust  Birmingham West Midlands UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm A.","family":"Finkelman","sequence":"additional","affiliation":[{"name":"Associates of Cape Cod Inc.  East Falmouth Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonglong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Associates of Cape Cod Inc.  East Falmouth Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sivakumar","family":"Sridharan","sequence":"additional","affiliation":[{"name":"School of Life and Medical Science University of Hertfordshire  Hatfield Hertfordshire UK"},{"name":"Department of Renal Medicine Lister Hospital, East and North Hertfordshire NHS Trust  Stevenage Hertfordshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enric","family":"Vilar","sequence":"additional","affiliation":[{"name":"School of Life and Medical Science University of Hertfordshire  Hatfield Hertfordshire UK"},{"name":"Department of Renal Medicine Lister Hospital, East and North Hertfordshire NHS Trust  Stevenage Hertfordshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Farrington","sequence":"additional","affiliation":[{"name":"School of Life and Medical Science University of Hertfordshire  Hatfield Hertfordshire UK"},{"name":"Department of Renal Medicine Lister Hospital, East and North Hertfordshire NHS Trust  Stevenage Hertfordshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.1999.00422.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajkd.2003.07.016"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-064174"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy175"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2012.01647.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000345969"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg004"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12782"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12781"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmgh.2015.01.001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/bs.ircmb.2022.04.006"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12810"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-13-43"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2014.328"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab230"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0145411"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.02.008"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI104072"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2006.01.049"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.208595"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12406"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1042\/BSR20181704"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2016.00404"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.105.085415"},{"issue":"1","key":"e_1_2_9_26_1","first-page":"51","article-title":"Blood Clearance of (1\u21923)\u2010Beta\u2010D\u2010Glucan in MRL Lpr\/Lpr Mice","volume":"13","author":"Miura N. 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