Department of Neurology, Ümraniye Research and Training Hospital, Istanbul, Turkey.
Department of Neurology, Haseki Research and Training Hospital, Istanbul, Turkey.
Hemodial Int. 2024 Jan;28(1):85-91. doi: 10.1111/hdi.13120. Epub 2023 Oct 18.
The present study aims to establish the role of serum CGRP and SP levels in the disease pathophysiology in patients with dialysis headache not accompanied by primary or secondary headaches, and also whether there is a correlation between these vasoactive peptides and the severity of headache.
This study was designed as prospective and multicenter. A total of 30 dialysis headache patients and 30 patients without headache as the control group in the Nephrology outpatient clinics which implement similar dialysis procedures were included in the study. Blood samples were taken from all the patients before hemodialysis, and post-hemodialysis samples were collected. CGRP and SP contents in serum samples were measured using the ELISA method with detection kits.
A total of 60 patients were included in the study with 17 female and 13 male patients in the dialysis headache group and 18 female and 12 male patients in the control group, and there were no significant differences in sex and age between the groups. CGRP levels in the headache group were found to be significantly higher compared with the control group both before and after hemodialysis. Furthermore, pre-hemodialysis CGRP levels were significantly higher than post-hemodialysis CGRP levels in both the headache and control groups. Serum SP levels in the headache group were found to be higher compared with the control group both before and after hemodialysis, there was no significant difference between the groups. Even though SP levels in both groups decreased after hemodialysis, there was again no significant difference between the groups. No correlation was found between the patients' severity of headache and serum CGRP and SP levels.
This study concludes that CGRP and SP, even though the latter is not statistically significant, play a role in the pathophysiology of the dialysis headache, and further studies with a larger and more specific patient population may reveal the relationship between the neuropeptides and dialysis headache more clearly.
本研究旨在确定血清 CGRP 和 SP 水平在不伴有原发性或继发性头痛的透析性头痛患者疾病病理生理学中的作用，以及这些血管活性肽与头痛严重程度之间是否存在相关性。
本研究设计为前瞻性和多中心研究。共纳入 30 例透析性头痛患者和 30 例透析门诊无头痛的患者作为对照组，两组均采用相似的透析方案。所有患者在血液透析前和血液透析后采集血样，采用 ELISA 法检测试剂盒检测血清中 CGRP 和 SP 含量。
共有 60 例患者纳入研究，其中透析性头痛组 17 例为女性，13 例为男性，对照组 18 例为女性，12 例为男性，两组性别和年龄无显著差异。头痛组 CGRP 水平在血液透析前后均明显高于对照组。此外，头痛组和对照组血液透析前 CGRP 水平均明显高于血液透析后。头痛组血清 SP 水平在血液透析前后均高于对照组，两组间无显著差异。两组患者血液透析后 SP 水平均降低，但两组间无显著差异。患者头痛严重程度与血清 CGRP 和 SP 水平之间无相关性。
本研究表明，CGRP 和 SP（尽管后者无统计学意义）在透析性头痛的病理生理学中起作用，进一步的研究可能会更清楚地揭示神经肽与透析性头痛之间的关系。
