Kinetics of carbamylated haemoglobin in acute renal failure.
Kinetics of carbamylated haemoglobin in acute renal failure.
复制标题
急性肾衰竭中氨甲酰化血红蛋白的动力学。
DOI：
10.1093/ndt/15.8.1183
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Jacques Chanard
中科院分区：
文献类型：
--
作者：
Alain Wynckel;C. Randoux;Hervé Millart;Catherine Desroches;Philippe Gillery;E. Canivet;Jacques Chanard
背景
蛋白质被异氰酸（来自尿素的氰酸酯的反应形式）的氨甲酰化在尿毒症中增加，并可能导致尿毒症毒性。在急性肾功能衰竭（ARF）中，可能反映尿毒症毒性的氨甲酰化动力学尚未明确定义。
方法
该研究纳入了28名ARF患者和13名慢性肾衰竭（CRF）患者，以确定ARF中氨甲酰血红蛋白浓度（CarHb）的变化。该参数用于区分ARF和CRF的有用性也进行了研究。在酸水解后通过高效液相色谱法测量CarHb。
结果
ARF患者的平均CarHb水平（以微克氨甲酰缬氨酸/克（CV/g）Hb表示）（54.3+/-5.2）显著高于正常受试者（31.6+/-1.3）。入院时CarHb水平与入ICU前ARF持续时间相关（r（2）=0.723，P<0.001）。需要血液透析的患者亚组恢复时的CarHb显著高于不需要血液透析的亚组（82。4 ± 11.3 vs 46.7 ± 5.2，P<0.01）。同样，透析患者在恢复前20天体重减轻更多（8.6+/-1.4 vs 2.7+/-0.5 kg，P<0.005），平均血尿素水平更高（17. 6 ± 1.9 vs 11.3 ± 1.8 mol/l，P<0.05）。恢复后，可逆性肾功能不全患者的CarHb水平以0.219 μ g CV/g Hb/d的速度下降。CRF患者CarHb浓度较高。以CarHb值100 μ g CV/g Hb为临界值，鉴别ARF和CRF的敏感性为94%，阳性预测值为94%。
结论
CarHb动力学显示ARF患者红细胞寿命接近正常。CarHb的变化能够以良好的灵敏度区分ARF恢复患者和持续性肾损害患者，无论是由于既往CRF还是由实质后遗症所致。在肾脏疾病病史未知的患者中，CarHb的测量对ARF的临床表现有价值。
BACKGROUND
Carbamylation of proteins by isocyanic acid, the reactive form of cyanate derived from urea, is increased in uraemia and may contribute to uraemic toxicity. Kinetics of carbamylation that may reflect uraemic toxicity is not clearly defined in acute renal failure (ARF).
METHODS
Twenty-eight patients with ARF and 13 with chronic renal failure (CRF) were included in the study in order to determine changes in carbamylated haemoglobin concentration (CarHb) in ARF. The usefulness of this parameter for differentiating ARF from CRF was also investigated. CarHb was measured by high-performance liquid chromatography after acid hydrolysis.
RESULTS
Mean CarHb level (expressed as microg carbamyl valine per gram (CV/g) Hb) was significantly higher in ARF (54.3+/-5.2) than in normal subjects (31.6+/-1.3). On admission, CarHb level was correlated with duration of ARF prior to hospitalization in the intensive care unit (r(2)=0.723, P<0.001). CarHb was significantly higher at recovery in the subgroup of patients requiring haemodialysis than in the subgroup not requiring haemodialysis (82. 4+/-11.3 vs 46.7+/-5.2, P<0.01). Similarly dialysis patients lost more weight (8.6+/-1.4 vs 2.7+/-0.5 kg, P<0.005) and had higher averaged blood urea levels in the 20 days prior to recovery (17. 6+/-1.9 vs 11.3+/-1.8 mol/l, P<0.05). After recovery, CarHb level decreased at a rate of 0.219 microg CV/g Hb per day in patients with reversible renal insufficiency. CarHb concentration was higher in patients with CRF. A cut-off CarHb value of 100 microg CV/g Hb had a sensitivity of 94% and a positive predictive value of 94% for differentiating ARF from CRF.
CONCLUSIONS
Kinetics of CarHb showed a near normal red blood cell life span in ARF. Changes in CarHb enabled, with a good sensitivity, the distinction to be made between patients who recovered from ARF and those with sustained renal impairment, whether due to prior CRF or resulting from parenchymal sequelae. Measurement of CarHb is valuable at clinical presentation of ARF in patients with an unknown medical history of renal disease.
导致急性尿毒症肌肉萎缩的机制：氨基酸分解代谢的激活。
DOI：
10.1681/asn.v93439
发表时间：
1998
期刊：
Journal of the American Society of Nephrology : JASN
影响因子：
--
作者：
Price,SR;Reaich,D;Marinovic,AC;England,BK;Bailey,JL;Caban,R;Mitch,WE;Maroni,BJ
通讯作者：
Maroni,BJ
影响因子：
4.4
作者：
V. Witko-Sarsat;M. Friedlander;T. N. Khoa;C. Capeillère-Blandin;A. Nguyen;S. Canteloup;J. Dayer
通讯作者：
V. Witko-Sarsat;M. Friedlander;T. N. Khoa;C. Capeillère-Blandin;A. Nguyen;S. Canteloup;J. Dayer