Stępniewska Joanna, Dołęgowska Barbara, Puchałowicz Kamila, Gołembiewska Edyta, Ciechanowski Kazimierz
Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
Department of Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland.
Chem Phys Lipids. 2017 Aug;206:71-77. doi: 10.1016/j.chemphyslip.2017.05.003. Epub 2017 May 19.
Metabolism and plasma concentration of lipids and lipid-derived compounds play an important role in kidney physiology and pathological processes. The component of membrane phospholipids - arachidonic acid (AA) and its active derivatives - eicosanoids are involved in the development of hypertension, diabetes, inflammation and may contribute to progression of chronic kidney disease (CKD). The purpose of the study was to determine, whether the type of renal replacement therapy has an effect on eicosanoids metabolism.
The study included 145 patients with CKD: on conservative treatment (n=68), on peritoneal dialysis (PD) (n=23) and undergoing chronic haemodialysis (HD) (n=54). The concentrations of TXB, 20-HETE, 8-epi-PGF in platelet poor plasma (PPP) were determined using the ELISA method and 5-HETE, 12-HETE, 15-HETE were measured using the RP-HPLC.
The concentrations of TXB in HD group, both before (2.28±0.72ng/mL) and after (1.49±0.63ng/mL) haemodialysis treatment differed significantly from PD group (57.76±6.13ng/mL). Haemodialysis session led to the significant decrease in TXB plasma concentration (p=0.046). 20-HETE concentrations in HD group (113.55±107.54pg/mL and 199.54±142.98pg/mL before and after haemodialysis, respectively) were significantly higher than in CKD 3-5 group (8.96±12.66pg/mL) and PD group (47.78±34.07pg/mL). The highest concentration of 12-HETE was obtained in PD patients (3.58±3.99ng/mL) and differed significantly from HD group after haemodialysis (0.97±0.28ng/mL) and CKD3-5 group (1.06±0.52ng/mL). The concentrations of 5-HETE, 15-HETE and 8-epi-PGF-III did not differ significantly among examined groups.
The concentrations of active AA metabolites depend on the mode of renal replacement therapy and are associated with intensity of oxidative stress. They might be considered as potential indicators of kidney damage.
脂质及脂质衍生化合物的代谢和血浆浓度在肾脏生理及病理过程中发挥着重要作用。膜磷脂成分——花生四烯酸(AA)及其活性衍生物——类二十烷酸参与高血压、糖尿病、炎症的发展,并可能促使慢性肾脏病(CKD)进展。本研究的目的是确定肾脏替代治疗类型是否对类二十烷酸代谢有影响。
本研究纳入了145例CKD患者:接受保守治疗的(n = 68)、接受腹膜透析(PD)的(n = 23)以及接受慢性血液透析(HD)的(n = 54)。采用ELISA法测定血小板缺乏血浆(PPP)中TXB、20 - HETE、8 - 表 - PGF的浓度,采用反相高效液相色谱法测定5 - HETE、12 - HETE、15 - HETE的浓度。
HD组血液透析治疗前(2.28±0.72ng/mL)和治疗后(1.49±0.63ng/mL)的TXB浓度与PD组(57.76±6.13ng/mL)有显著差异。血液透析疗程导致TXB血浆浓度显著降低(p = 0.046)。HD组的20 - HETE浓度(血液透析前后分别为113.55±107.54pg/mL和199.54±142.98pg/mL)显著高于CKD 3 - 5组(8.96±12.66pg/mL)和PD组(47.78±34.07pg/mL)。PD患者的12 - HETE浓度最高(3.58±3.99ng/mL),与血液透析后的HD组(0.97±0.28ng/mL)和CKD3 - 5组(1.06±0.52ng/mL)有显著差异。5 - HETE、15 - HETE和8 - 表 - PGF - III的浓度在各研究组之间无显著差异。
活性AA代谢产物的浓度取决于肾脏替代治疗方式,并与氧化应激强度相关。它们可能被视为肾脏损伤的潜在指标。