Daniewska-Michalska D, Motyl T, Gellert R, Kukulska W, Podgurniak M, Opechowska-Pacocha E, Ostrowski K
Department of Medicine, Warsaw Medical School, Central Clinical Hospital, Poland.
Nephron. 1993;64(2):193-7. doi: 10.1159/000187313.
The accumulation in blood plasma and efficiency of hemodialysis of pyrimidine compounds (orotic acid, orotidine, pseudouridine, uridine, thymine) as well as uric acid and creatinine in 23 patients with chronic renal failure (CRF) was investigated. As a reference, the analysis of the above metabolites in the plasma of 30 healthy volunteers was performed. Among examined compounds, pseudouridine possessed the highest capability of accumulation in blood plasma (25 times higher concentration than physiological). It coincided with the lowest efficiency of pseudouridine hemodialysis (44%) and the longest T1/2 (relative to creatinine) in plasma. A significant linear correlation (r = 0.81, p < 0.001) between efficiency of creatinine and pseudouridine hemodialysis was calculated. The concentration of orotic acid in the blood plasma of patients before hemodialysis exceeded 14 times its level in healthy subjects; the inhibition of uric acid synthesis by allopurinol in dialyzed patients was accompanied by enlargement of orotidine and orotate accumulation in blood plasma. Extremely high plasma concentration of examined pyrimidines remaining elevated after hemodialysis creates an additional hazard for tissue metabolism and health of patients with CRF.
对23例慢性肾衰竭（CRF）患者血浆中嘧啶化合物（乳清酸、乳清苷、假尿苷、尿苷、胸腺嘧啶）以及尿酸和肌酐的蓄积情况和血液透析效率进行了研究。作为对照，对30名健康志愿者血浆中的上述代谢物进行了分析。在所检测的化合物中，假尿苷在血浆中的蓄积能力最强（浓度比生理浓度高25倍）。这与假尿苷血液透析效率最低（44%）以及血浆中最长的T1/2（相对于肌酐）相吻合。计算出肌酐和假尿苷血液透析效率之间存在显著的线性相关性（r = 0.81，p < 0.001）。血液透析前患者血浆中乳清酸的浓度超过健康受试者的14倍；透析患者中别嘌醇对尿酸合成的抑制伴随着血浆中乳清苷和乳清酸盐蓄积的增加。血液透析后所检测嘧啶的血浆浓度极高且仍居高不下，这给CRF患者的组织代谢和健康带来了额外风险。
