Dialysis modality-dependent changes in serum metabolites: accumulation of inosine and hypoxanthine in patients on haemodialysis
Dialysis modality-dependent changes in serum metabolites: accumulation of inosine and hypoxanthine in patients on haemodialysis
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DOI：
10.1093/ndt/gfq554
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发表时间：
2011-04-01
影响因子：
6.1
通讯作者：
Kim, Yong-Lim
中科院分区：
文献类型：
--
作者：
Choi, Ji-Young;Yoon, Yoo Jeong;Kim, Yong-Lim
背景。终末期肾病患者的身体代谢可能因长期透析治疗而改变。此外，血清代谢物的模式可能会根据所使用的透析方式的类型而变化。然而，人们对透析方式依赖性血清代谢物变化知之甚少。我们的目的是通过利用基于 H-1-NMR 的代谢组学新方法来全面分析血清代谢物，并确定接受血液透析 (HD) 和腹膜透析 (PD) 的受试者代谢物模式的差异。方法。无尿和非糖尿病 HD 患者与 PD 患者的年龄、性别和透析持续时间相匹配。使用目标分析程序确定血清代谢物的准确浓度，并使用多变量分析比较代谢物水平的差异。结果。主成分分析得分图显示代谢模式可以通过透析方式来区分。次黄嘌呤和肌苷仅在 HD 时出现，而血清黄嘌呤氧化酶活性和尿酸水平没有差异。相反，PD与较高水平的乳酸、葡萄糖、麦芽糖、丙酮酸、琥珀酸、丙氨酸和谷氨酸有关，而这些物质与葡萄糖代谢和三羧酸循环有关。麦芽糖仅出现在使用艾考糊精溶液治疗 PD 的患者中。已知的尿毒症潴留溶质，如尿素、肌酐、肌醇和三甲胺-N-氧化物，在两个透析组中均有所增加。结论。代谢组学显示 HD 和 PD 之间的血清代谢物谱存在明显差异，这受到透析相关过程的影响。肌苷和次黄嘌呤仅存在于 HD 患者中，这可能代表更多的缺氧和氧化应激。
Background. The body metabolism of patients with end-stage renal disease may be altered in response to long-term dialysis treatment. Moreover, the pattern of serum metabolites could change depending on the type of dialysis modality used. However, dialysis modality-dependent changes in serum metabolites are poorly understood. Our aim was to profile comprehensively serum metabolites by exploiting a novel method of H-1-NMR-based metabonomics and identify the differences in metabolite patterns in subjects receiving haemodialysis (HD) and peritoneal dialysis (PD).Methods. Anuric and non-diabetic HD patients were matched to PD patients for age, sex and dialysis duration. Accurate concentrations of serum metabolites were determined using the target-profiling procedure, and differences in the levels of metabolites were compared using multivariate analysis.Results. Principal Components Analysis score plots showed that the metabolic patterns could be discriminated by dialysis modalities. Hypoxanthine and inosine were present only with HD, whereas serum xanthine oxidase activity and uric acid levels were not different. In contrast, PD was associated with higher levels of lactate, glucose, maltose, pyruvate, succinate, alanine, and glutamate linked to glucose metabolism and the tri-carboxylic acid cycle. Maltose appeared only in patients using icodextrin solution for PD. Known uraemic retention solutes such as urea, creatinine, myo-inositol and trimethylamine-N-oxide were increased in both dialysis groups.Conclusions. Metabonomics shows apparent differences in the profiles of serum metabolites between HD and PD, which were influenced by dialysis-related processes. Inosine and hypoxanthine are present only in HD patients, which is likely to represent more hypoxic and oxidative stress.