Scholze Alexandra, Jankowski Vera, Henning Lars, Haass Wiltrud, Wittstock Antje, Suvd-Erdene Sukhbaatar, Zidek Walter, Tepel Martin, Jankowski Joachim
Medizinische Klinik IV, Nephrologie, Charité Campus Benjamin Franklin, Berlin, Germany.
Nephron Clin Pract. 2007;107(1):c1-6. doi: 10.1159/000105137. Epub 2007 Jul 5.
Phenylacetic acid (PAA) is a recently described uremic toxin that inhibits inducible nitric oxide synthase expression and plasma membrane calcium ATPase and may therefore also be involved in remodeling of arteries. Such vascular effects have not been evaluated yet in patients with chronic kidney disease stage 5.
We prospectively measured the plasma concentrations of PAA using nuclear magnetic resonance spectroscopy in 50 patients with chronic kidney disease stage 5 (37 men, 13 women) on maintenance hemodialysis. Arterial vascular properties were quantified by the reflective index obtained from digital photoplethysmography.
During the hemodialysis session the plasma PAA concentration was reduced from 3.38 +/- 0.24 mmol/l (mean +/- SEM; median, 2.85 mmol/l; interquartile range, 2.02-4.52 mmol/l) to 2.25 +/- 0.11 mmol/l (median, 2.06 mmol/l; interquartile range, 1.62-2.86 mmol/l; n = 50; p < 0.001). There was a significant correlation between the PAA concentration and the reflective index before the start of the hemodialysis session.
The study demonstrates an association of PAA and arterial vascular properties in patients with chronic kidney disease stage 5.
苯乙酸（PAA）是一种最近被描述的尿毒症毒素，它可抑制诱导型一氧化氮合酶的表达和质膜钙ATP酶，因此可能也参与动脉重塑。然而，尚未在5期慢性肾脏病患者中评估这种血管效应。
我们前瞻性地使用核磁共振波谱法测量了50例接受维持性血液透析的5期慢性肾脏病患者（37例男性，13例女性）的血浆PAA浓度。通过数字光电容积脉搏波描记法获得的反射指数对动脉血管特性进行量化。
在血液透析过程中，血浆PAA浓度从3.38±0.24 mmol/l（平均值±标准误；中位数，2.85 mmol/l；四分位间距，2.02 - 4.52 mmol/l）降至2.25±0.11 mmol/l（中位数，2.06 mmol/l；四分位间距，1.62 - 2.86 mmol/l；n = 50；p < 0.001）。在血液透析开始前，PAA浓度与反射指数之间存在显著相关性。
该研究证明了5期慢性肾脏病患者中PAA与动脉血管特性之间存在关联。
