Metabolomic analysis of uremic pruritus in patients on hemodialysis.
Metabolomic analysis of uremic pruritus in patients on hemodialysis.
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DOI：
10.1371/journal.pone.0246765
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Sirich TL
中科院分区：
文献类型：
--
作者：
Bolanos CG;Pham NM;Mair RD;Meyer TW;Sirich TL
瘙痒是血液透析患者常见的衰弱症状。治疗是困难的，因为尿毒症瘙痒症的原因是未知的。本研究阐述了瘙痒是由肾脏衰竭时血浆中蓄积的溶质引起的假设。我们试图使用代谢组学分析来确定导致尿毒症瘙痒的溶质，以比较重度瘙痒与轻度/无瘙痒的血液透析患者的血浆。采用100 mm视觉模拟评分（VAS）评估血液透析患者的瘙痒严重程度，重度瘙痒定义为>70 mm，轻度/无瘙痒定义为<10 mm。12例重度瘙痒（瘙痒）患者和24例轻度/无瘙痒（无瘙痒）患者入选。使用已建立的代谢组学平台（Metabolon，Inc.）分析处理前血浆和血浆超滤液。为了鉴定与瘙痒相关的溶质，我们使用错误发现率（q值）和主成分分析比较了瘙痒患者与无瘙痒患者中每种溶质的平均峰面积。瘙痒和无瘙痒患者的透析年份、Kt/Vurea和血清钙、磷、PTH、白蛋白、铁蛋白和血红蛋白水平相似。代谢组学分析鉴定了1，548种溶质，其中609种被归类为尿毒症。瘙痒和无瘙痒患者之间任何溶质或溶质组的血浆或血浆超滤液水平均无差异。血液透析患者的代谢组学分析未发现任何与瘙痒相关的溶质。代谢组学分析的局限性在于感兴趣的溶质可能不包括在代谢组学平台的化学库中。尿毒症溶质在瘙痒症中的作用仍有待确定。
Pruritus is a common debilitating symptom experienced by hemodialysis patients. Treatment is difficult because the cause of uremic pruritus is not known. This study addressed the hypothesis that pruritus is caused by solutes that accumulate in the plasma when the kidneys fail. We sought to identify solutes responsible for uremic pruritus using metabolomic analysis to compare the plasma of hemodialysis patients with severe pruritus versus mild/no pruritus. Pruritus severity in hemodialysis patients was assessed using a 100-mm visual analogue scale (VAS), with severe pruritus defined as >70 mm and mild/no pruritus defined as <10 mm. Twelve patients with severe pruritus (Itch) and 24 patients with mild/no pruritus (No Itch) were included. Pre-treatment plasma and plasma ultrafiltrate were analyzed using an established metabolomic platform (Metabolon, Inc.). To identify solutes associated with pruritus, we compared the average peak area of each solute in the Itch patients to that of the No Itch patients using the false discovery rate (q value) and principal component analysis. Dialysis vintage, Kt/Vurea, and serum levels of calcium, phosphorus, PTH, albumin, ferritin, and hemoglobin were similar in the Itch and No Itch patients. Metabolomic analysis identified 1,548 solutes of which 609 were classified as uremic. No difference in the plasma or plasma ultrafiltrate levels of any solute or group of solutes was found between the Itch and No Itch patients. Metabolomic analysis of hemodialysis patients did not reveal any solutes associated with pruritus. A limitation of metabolomic analysis is that the solute of interest may not be included in the metabolomic platform’s chemical library. A role for uremic solutes in pruritus remains to be established.
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影响因子：
2.7
作者：
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通讯作者：
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DOI：
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