Słowik-Zyłka Dorota, Safranow Krzysztof, Dziedziejko Violetta, Ciechanowski Kazimierz, Dziewanowski Krzysztof, Chlubek Dariusz
Department of Physiopathology, Pomeranian Medical University, Szczecin, Poland.
Pol Arch Med Wewn. 2009 Oct;119(10):614-20.
Advanced glycation end products (AGEs), which accumulate in plasma of hemodialyzed patients, participate in the development of complications associated with hemodialysis (HD). Carbonyl stress plays an essential role in the formation of AGEs, including pentosidine.
The aim of the study was to assess the effect of various low-flux dialysis membranes on plasma concentrations of total (P(tot)) and free (P(free)) pentosidine.
We examined 56 adult patients (aged 50 +/-13 years) on chronic HD. Plasma pentosidine concentrations were measured with high-performance liquid chromatography with fluorescence detection. Plasma proteins were subjected to acid hydrolysis or precipitation with trichloroacetic acid before measurement of P(tot) and P(free), respectively.
Significantly lower concentrations of P(tot) were observed in patients dialyzed with polysulfone than non-polysulfone membranes before the HD session (22.0 +/-11.9 vs 34.4 +/-12.5 pmol/mg protein, respectively, p = 0.0008) and after the HD session (22.5 +/-12.9 vs 32.9 +/-12.0 pmol/mg protein, p = 0.004). Moreover, there was a strong inverse correlation between the percentage of HD sessions performed with polysulfone membranes during the last 3 months and P(tot) concentration before HD (Rs = -0.44, p = 0.0011) and after HD (Rs = -0.45, p = 0.00073).
The results suggest that polysulfone membranes reduce carbonyl stress more effectively than modified or unmodified cellulose membranes in patients on chronic HD. Determination of plasma pentosidine in hemodialyzed patients may help in comparing the physicochemical and biological properties of dialysis membranes. It may also contribute to the development of optimal strategies for renal replacement therapy.
晚期糖基化终产物（AGEs）在血液透析患者的血浆中蓄积，参与血液透析（HD）相关并发症的发生发展。羰基应激在包括戊糖苷在内的AGEs形成过程中起重要作用。
本研究旨在评估不同低通量透析膜对血浆总戊糖苷（P(tot)）和游离戊糖苷（P(free)）浓度的影响。
我们对56例接受慢性HD的成年患者（年龄50±13岁）进行了研究。采用高效液相色谱荧光检测法测定血浆戊糖苷浓度。在分别测定P(tot)和P(free)之前，血浆蛋白分别进行酸水解或用三氯乙酸沉淀。
在HD治疗前，使用聚砜膜透析的患者P(tot)浓度显著低于未使用聚砜膜的患者（分别为22.0±11.9和34.4±12.5 pmol/mg蛋白，p = 0.0008），HD治疗后也是如此（22.5±12.9和32.9±12.0 pmol/mg蛋白，p = 0.004）。此外，过去3个月使用聚砜膜进行HD治疗的次数百分比与HD治疗前P(tot)浓度（Rs = -0.44，p = 0.0011）和HD治疗后P(tot)浓度（Rs = -0.45，p = 0.00073）之间存在强烈的负相关。
结果表明，在慢性HD患者中，聚砜膜比改性或未改性纤维素膜更有效地降低羰基应激。测定血液透析患者的血浆戊糖苷可能有助于比较透析膜的物理化学和生物学特性。它也可能有助于制定最佳的肾脏替代治疗策略。
