Metabolomics Evaluation of Patients With Stage 5 Chronic Kidney Disease Before Dialysis, Maintenance Hemodialysis, and Peritoneal Dialysis.
Metabolomics Evaluation of Patients With Stage 5 Chronic Kidney Disease Before Dialysis, Maintenance Hemodialysis, and Peritoneal Dialysis.
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5期慢性肾脏病患者透析前、维持性血液透析和腹膜透析的代谢组学评估
DOI：
10.3389/fphys.2020.630646
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发表时间：
2020
影响因子：
4
通讯作者：
Yu SQ
中科院分区：
文献类型：
--
作者：
Zhu S;Zhang F;Shen AW;Sun B;Xia TY;Chen WS;Tao X;Yu SQ
透析前5期慢性肾脏病患者（透析前CKD-5）的当前治疗选择取决于个人情况，经济因素和医生的建议。本研究旨在探讨透析前CKD-5患者与维持性血液透析（HD）和腹膜透析（PD）患者的血浆代谢特征，以了解透析过程对血液环境的影响。我们的研究入组了31例透析前CKD-5患者、31例HD患者和30例PD患者。使用靶向代谢组学平台，通过应用超高效液相色谱-串联质谱法进行代谢物分析，并在所有三组之间进行后续比较，以探索代谢改变。透析前CKD-5患者和两组透析患者之间的半胱氨酸代谢显著改变。嘌呤代谢紊乱是HD和PD组之间发现的最广泛变化的途径。从组间比较中筛选出血浆浓度波动较大的20种不同代谢产物，包括2-酮基-D-葡萄糖酸、犬尿烯酸、s-腺苷高半胱氨酸、L-谷氨酰胺、腺苷和烟酰胺。本研究对透析前CKD-5、HD和PD患者进行了全面的代谢组学评价，描述了代谢途径的紊乱、鉴别代谢物及其可能的生物学意义。与透析治疗相关的特定代谢物的鉴定可能为晚期CKD阶段的管理提供见解，并为共同决策提供信息。
Current treatment options for patients with stage 5 chronic kidney disease before dialysis (predialysis CKD-5) are determined by individual circumstances, economic factors, and the doctor’s advice. This study aimed to explore the plasma metabolic traits of patients with predialysis CKD-5 compared with maintenance hemodialysis (HD) and peritoneal dialysis (PD) patients, to learn more about the impact of the dialysis process on the blood environment. Our study enrolled 31 predialysis CKD-5 patients, 31 HD patients, and 30 PD patients. Metabolite profiling was performed using a targeted metabolomics platform by applying an ultra-high-performance liquid chromatography-tandem mass spectrometry method, and the subsequent comparisons among all three groups were made to explore metabolic alterations. Cysteine metabolism was significantly altered between predialysis CKD-5 patients and both groups of dialysis patients. A disturbance in purine metabolism was the most extensively changed pathway identified between the HD and PD groups. A total of 20 discriminating metabolites with large fluctuations in plasma concentrations were screened from the group comparisons, including 2-keto-D-gluconic acid, kynurenic acid, s-adenosylhomocysteine, L-glutamine, adenosine, and nicotinamide. Our study provided a comprehensive metabolomics evaluation among predialysis CKD-5, HD, and PD patients, which described the disturbance of metabolic pathways, discriminating metabolites and their possible biological significances. The identification of specific metabolites related to dialysis therapy might provide insights for the management of advanced CKD stages and inform shared decision-making.
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影响因子：
5.4
作者：
Kalim S;Clish CB;Wenger J;Elmariah S;Yeh RW;Deferio JJ;Pierce K;Deik A;Gerszten RE;Thadhani R;Rhee EP
通讯作者：
Rhee EP
影响因子：
--
作者：
Liakopoulos V;Roumeliotis S;Gorny X;Dounousi E;Mertens PR
通讯作者：
Mertens PR
影响因子：
2.3
作者：
Kalim S;Clish CB;Deferio JJ;Ortiz G;Moffet AS;Gerszten RE;Thadhani R;Rhee EP
通讯作者：
Rhee EP
影响因子：
13.2
作者：
Bellinghieri, G;Santoro, D;Savica, V
通讯作者：
Savica, V
影响因子：
--
作者：
Liakopoulos V;Roumeliotis S;Gorny X;Eleftheriadis T;Mertens PR
通讯作者：
Mertens PR