A rapid high performance liquid chromatographic method for the analysis of choline in human plasma and peritoneal dialysis effluent: application in the assessment of choline loss in continuous ambulatory peritoneal dialysis.

Mesothelial cells lining the peritoneal cavity utilize choline in the synthesis of a phosphatidylcholine-rich material thought to play a role in peritoneal homeostasis. This function is particularly important for patients undergoing continuous ambulatory peritoneal dialysis (CAPD). To assess choline loss in these patients, we measured choline in plasma and peritoneal dialysis effluent (PDE) by a rapid high performance liquid chromatography (HPLC) procedure that combined electrochemical detection with an immobilized enzyme reactor. Chromatography was performed directly on plasma and PDE ultrafiltrates. In 30 patients, the amount of choline lost to the dialysate was 129 +/- 49 mumol per day and 32 +/- 8 mumol per dwell (mean +/- SD). The average plasma choline concentration was 22.5 mumol/L, a value somewhat higher than the mean value reported for normal adults (9 mumol/L). The average PDE choline concentration was 14 mumol/L. There was a positive correlation between daily choline loss of dialysate and plasma choline concentrations (r = 0.826).