Caussé E, Ribes D, Longlune N, Kamar N, Durand D, Salvayre R, Rostaing L
CHU RANGUEIL, Toulouse University, France.
Clin Nephrol. 2010 Jan;73(1):51-7. doi: 10.5414/cnp73051.
To investigate the possible relationship between homocysteine and allantoin levels in hemodialyzed patients, serum levels of thiols and purine compounds were analyzed before and after dialysis sessions.
16 clinically stable non-diabetic patients hemodialyzed on polysulfone membranes were compared with 36 control subjects. Serum samples were collected before and after hemodialysis sessions. Total homocysteine, cysteine, glutathione, cysteinylglycine, uric acid, hypoxanthine, and allantoin were measured by capillary electrophoresis.
Pre-dialysis homocysteine, allantoin, and uric acid were significantly elevated in dialysis patients as compared to controls. Cysteine, glutathione, and hypoxanthine levels were similar in both groups. Homocysteine significantly decreased, but did not normalize after dialysis sessions. Glutathione and cysteinylglycine levels remained unchanged after dialysis sessions, whereas cysteine decreased. Uric acid, hypoxanthine, and allantoin levels were significantly reduced by dialysis sessions. The allantoin/uric acid ratio was higher in dialyzed patients before hemodialysis (0.049 +/- 0.023 vs. 0.016 +/- 0.012 in controls; p < 0.001), and became elevated after a dialysis session (0.084 +/- 0.033; p = 0.002).
Despite the use of biocompatible membranes, homeostasis of thiols and purine compounds is disturbed in hemodialysed patients. We suggest that allantoin could be used as a marker for oxidative stress in hemodialyzed patients.
为了研究血液透析患者同型半胱氨酸和尿囊素水平之间可能存在的关系，在透析前后分析了血清中硫醇和嘌呤化合物的水平。
将16名使用聚砜膜进行血液透析的临床稳定非糖尿病患者与36名对照受试者进行比较。在血液透析前后采集血清样本。通过毛细管电泳测定总同型半胱氨酸、半胱氨酸、谷胱甘肽、半胱氨酰甘氨酸、尿酸、次黄嘌呤和尿囊素。
与对照组相比，透析患者透析前的同型半胱氨酸、尿囊素和尿酸显著升高。两组的半胱氨酸、谷胱甘肽和次黄嘌呤水平相似。同型半胱氨酸在透析后显著下降，但未恢复正常。透析后谷胱甘肽和半胱氨酰甘氨酸水平保持不变，而半胱氨酸下降。透析可显著降低尿酸、次黄嘌呤和尿囊素水平。透析患者透析前的尿囊素/尿酸比值较高（0.049±0.023，对照组为0 . 016±0 . 012；p<0.001），透析后升高（0.084±0.033；p = 0.002）。
尽管使用了生物相容性膜，但血液透析患者硫醇和嘌呤化合物的稳态仍受到干扰。我们建议尿囊素可作为血液透析患者氧化应激的标志物。
