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终末期肾病血液透析患者的硫胺素二磷酸状态和透析相关丢失。

Thiamine Diphosphate Status and Dialysis-Related Losses in End-Stage Kidney Disease Patients Treated with Hemodialysis.

机构信息

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.

出版信息

Blood Purif. 2017;44(4):294-300. doi: 10.1159/000480651. Epub 2017 Oct 28.

DOI:10.1159/000480651
PMID:29080898
Abstract

AIM

(1) To describe the whole blood content of thiamine diphosphate (TDP), a biologically active form of vitamin B1 in end-stage kidney disease patients treated with hemodialysis (HD); (2) to establish the impact of a single HD procedure on TDP blood concentrations; and (3) to describe potential explanatory variables influencing TDP dialysis related losses, including dialysis prescription, vitamin B1 dietary intake and supplementation.

METHODS

Single-center, cross-sectional study in 50 clinically stable maintenance HD patients. The assessment of whole blood TDP with the High Performance Liquid Chromatography method, before and after a single, middle-week dialysis session and analysis of clinical and laboratory parameters potentially influencing TDP status Results: We report a significant difference in TDP levels before and after HD sessions - 42.5 (95% CI 38.7-46.2) μg/L and 23.6 (95% CI 18.9-28.2) μg/L, respectively (p = 0.000). The magnitude of intradialytic TDP changes is highly variable among individuals and is negatively associated only with the body weight of the patients (p < 0.013). Vitamin B1 dietary intake and supplementation do not influence whole blood TDP and dialysis-related loss of TDP.

CONCLUSIONS

TDP, a bioactive compound of vitamin B1, is substantially lost during the HD procedure, and the magnitude of its loss is associated with the patient's body weight but it is not influenced by vitamin B1 dietary intake and standard supplementation dose.

摘要

目的

(1)描述接受血液透析(HD)治疗的终末期肾病患者全血中硫胺素二磷酸(TDP)的含量,TDP 是维生素 B1 的一种生物活性形式;(2)建立单次 HD 程序对 TDP 血液浓度的影响;(3)描述影响 TDP 透析相关损失的潜在解释变量,包括透析处方、维生素 B1 饮食摄入和补充。

方法

对 50 例临床稳定的维持性 HD 患者进行单中心、横断面研究。采用高效液相色谱法评估全血 TDP,在单次、中位周 HD 治疗前后进行,并分析可能影响 TDP 状态的临床和实验室参数。

结果

我们报告了 HD 前后 TDP 水平的显著差异 - 分别为 42.5(95%CI 38.7-46.2)μg/L 和 23.6(95%CI 18.9-28.2)μg/L(p=0.000)。个体间透析过程中 TDP 变化的幅度差异很大,仅与患者的体重呈负相关(p<0.013)。维生素 B1 的饮食摄入和补充并不影响全血 TDP 和 TDP 的透析相关损失。

结论

TDP 是维生素 B1 的一种生物活性化合物,在 HD 过程中大量丢失,其丢失的幅度与患者的体重有关,但不受维生素 B1 饮食摄入和标准补充剂量的影响。

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