Jadoul M, Ueda Y, Yasuda Y, Saito A, Robert A, Ishida N, Kurokawa K, Van Ypersele De Strihou C, Miyata T
Department of Nephrology, University of Louvain Medical School, Brussels, Belgium.
Kidney Int. 1999 Jun;55(6):2487-92. doi: 10.1046/j.1523-1755.1999.00468.x.
Influence of hemodialysis membrane type on pentosidine plasma level, a marker of "carbonyl stress."
The accumulation of advanced glycation end products (AGEs) in uremia has been ascribed to the retention of carbonyl precursors of AGEs. Pentosidine plasma level has been identified as a surrogate marker of carbonyl precursors ("carbonyl stress"). The influence of hemodialysis (HD) membrane type and residual diuresis on carbonyl stress has not been studied.
We measured protein-linked and free plasma pentosidine (a surrogate marker of carbonyl stress) by high-performance liquid chromatography in patients on HD with low-flux cellulose (N = 29), high-flux polysulfone (PS; N = 57), polymethylmethacrylate (PMMA) (N = 25), and AN69 (N = 15).
Both protein-linked and free pentosidine were similar on low-flux cellulose, high-flux PMMA, and AN69, but were lower (P < 0.01) on high-flux PS. Pentosidine levels were virtually identical on Fresenius and Asahi PS in Japanese and Belgian patients. By multivariate analysis, only the type of HD membrane and residual diuresis proved to be independent determinants (P < 0.001) of pentosidine levels. During a single HD session, the clearance of free pentosidine was similar with all membranes. In three patients who were switched from AN69 to PS, the protein-linked pentosidine level dropped to the control level after resumption of the AN69 membrane.
Both HD membrane type and residual diuresis are independent determinants of pentosidine plasma level, which is a marker of carbonyl stress.
血液透析膜类型对戊糖苷血浆水平（“羰基应激”的标志物）的影响
尿毒症中晚期糖基化终产物（AGEs）的积累归因于AGEs羰基前体的潴留。戊糖苷血浆水平已被确定为羰基前体（“羰基应激”）的替代标志物。血液透析（HD）膜类型和残余利尿对羰基应激的影响尚未得到研究。
我们采用高效液相色谱法测量了接受低通量纤维素透析（N = 29）、高通量聚砜（PS；N = 57）、聚甲基丙烯酸甲酯（PMMA）（N = 25）和AN69（N = 15）的HD患者的蛋白质结合型和游离血浆戊糖苷（羰基应激的替代标志物）。
低通量纤维素、高通量PMMA和AN69上的蛋白质结合型和游离戊糖苷相似，但高通量PS上的较低（P < 0.01）。日本和比利时患者中，费森尤斯和旭化成PS上的戊糖苷水平几乎相同。通过多变量分析，仅HD膜类型和残余利尿被证明是戊糖苷水平的独立决定因素（P < 0.001）。在单次HD治疗期间，所有膜对游离戊糖苷的清除相似。在3例从AN69转换为PS的患者中，恢复使用AN69膜后，蛋白质结合型戊糖苷水平降至对照水平。
HD膜类型和残余利尿均为戊糖苷血浆水平的独立决定因素，戊糖苷血浆水平是羰基应激的标志物。
