Serum hyaluronic acid and procollagen III amino terminal propeptide in chronic renal failure.

Elevated serum concentrations of hyaluronic acid (HA) and procollagen III amino terminal propeptide (PIIINP) have been found in various diseases characterized by altered metabolism of collagen. In the present study, their serum levels were measured in 105 renal patients and 22 normal controls. Median HA concentrations were 23 micrograms/l in controls, 47 micrograms/l in patients with chronic renal failure (CRF, not on dialysis; p less than 0.001), 75 micrograms/l on CAPD (p less than 0.001) vs. controls, p = 0.045 vs. CRF), and 167 micrograms/l on hemodialysis (p less than 0.001 vs. controls, CRF, and CAPD), respectively. The values correlated positively with age but not with renal function or the type of renal disease. In hemodialysis patients, HA correlated with the duration of renal replacement therapy and serum beta 2-microglobulin but not with serum alkaline phosphatase or C-terminal parathormone. Serum HA did not change significantly during hemodialysis treatment and was independent of the type of dialyzer membrane material. Median PIIINP values were 2.7 micrograms/l in controls, 4.4 micrograms/l in patients with CRF (p less than 0.001), 6.9 micrograms/l on CAPD (p less than 0.001 vs. controls, p = 0.022 vs. CRF), and 8.6 micrograms/l on hemodialysis (p = 0.001 vs. controls, NS vs. CRF or CAPD). Values correlated with HA only in patients on CAPD but they did not correlate with age, renal function or duration of renal replacement therapy. It is concluded that renal failure, especially long-term dialysis treatment, is associated with elevated serum concentrations of HA and--to a minor degree--PIINP. Thus, they may be a sign of altered connective tissue metabolism in patients on long-term dialysis.