Zhang Zhi-Hao, Mao Jia-Rong, Chen Hua, Su Wei, Zhang Yuan, Zhang Li, Chen Dan-Qian, Zhao Ying-Yong, Vaziri Nosratola D
Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University, No. 229 Taibai North Road, Xi'an, Shaanxi 710069, China; School of Traditional Chinese Pharmacy, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 211198, China.
Department of Nephrology, Shaanxi Traditional Chinese Medicine Hospital, No. 2 Xihuamen, Xi'an, Shaanxi 710003, China.
Clin Biochem. 2017 Dec;50(18):1078-1086. doi: 10.1016/j.clinbiochem.2017.09.012. Epub 2017 Sep 18.
Although dialysis ameliorates uremia and fluid and electrolytes disorders, annual mortality rate remains high in dialysis population reflecting its shortcoming in replacing renal function. Unlike the normal kidney, dialysis causes dramatic shifts in volume and composition of body fluids and indiscriminate removal of vital solutes. Present study was undertaken to determine the impact of hemodialysis on plasma metabolites in end-stage renal disease (ESRD) patients.
80 hemodialysis patients and 80 age/gender-matched healthy controls were enrolled in the study. Using ultra performance liquid chromatography-high-definition mass spectrometry, we measured plasma metabolites before, during, and after hemodialysis procedure and in blood entering and leaving the dialysis filter.
Principal component analysis revealed significant difference in concentration of 214 metabolites between healthy control and ESRD patients' pre-dialysis plasma (126 increased and 88 reduced in ESRD group). Comparison of post-dialysis with pre-dialysis data revealed significant changes in the 362 metabolites. Among ESI metabolites 195 decreased and 55 increased and among ESI metabolites 82 decreased and 30 increased following hemodialysis. Single blood passage through the dialyzer caused significant changes in 323 metabolites. Comparison of ESRD patients' post-hemodialysis with healthy subjects' data revealed marked differences in metabolic profiles. We identified 55 of the 362 differential metabolites including well known uremic toxins, waste products and vital biological compounds.
In addition to uremic toxins and waste products hemodialysis removes large number of identified and as-yet un-identified metabolites. Depletion of vital biological compounds by dialysis may contribute to the high morbidity and annual mortality rate in this population.
尽管透析可改善尿毒症以及体液和电解质紊乱，但透析人群的年死亡率仍然很高，这反映了其在替代肾功能方面的不足。与正常肾脏不同，透析会导致体液的体积和成分发生巨大变化，并不加区分地清除重要溶质。本研究旨在确定血液透析对终末期肾病（ESRD）患者血浆代谢物的影响。
80名血液透析患者和80名年龄/性别匹配的健康对照者参与了本研究。我们使用超高效液相色谱-高清质谱法，在血液透析过程之前、期间和之后以及进入和离开透析滤器的血液中测量血浆代谢物。
主成分分析显示，健康对照者和ESRD患者透析前血浆中214种代谢物的浓度存在显著差异（ESRD组中126种升高，88种降低）。透析后与透析前数据的比较显示362种代谢物有显著变化。血液透析后，ESI代谢物中有195种减少，55种增加；APCI代谢物中有82种减少，30种增加。单次通过透析器会导致323种代谢物发生显著变化。ESRD患者透析后的代谢谱与健康受试者的数据比较显示存在明显差异。我们在362种差异代谢物中鉴定出55种，包括众所周知的尿毒症毒素、废物和重要生物化合物。
除了尿毒症毒素和废物外，血液透析还会清除大量已鉴定和尚未鉴定的代谢物。透析导致重要生物化合物的消耗可能是该人群高发病率和年死亡率的原因之一。
