NDT Advance Access originally published online on February 19, 2004
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Nephrol Dial Transplant (2004) 19: 1474-1479
Nephrol Dial Transplant Vol. 19 No. 6 © ERA-EDTA 2004; all rights reserved
Original Article
Accumulation of cyanide and thiocyanate in haemodialysis patients
Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Hyogo, Japan
Correspondence and offprint requests to: Takeshi Nakanishi, MD, Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, 1-1 Mukogawa-cho, Hyogo 663-8501, Japan. Email: t-nkns{at}hyo-med.ac.jp
Background. Cyanide is a toxic agent, and its detoxification product, thiocyanate, may be a major pathogenetic substance in uraemia. Recent studies examining the myeloperoxidase(MPO)/thiocyanate system have suggested a link between thiocyanate and atherosclerosis. However, inaccuracies in conventional assays for cyanide and thiocyanate have limited the understanding of their metabolism in haemodialysis (HD) patients.
Methods. We used high-performance liquid chromatography to measure cyanide in erythrocytes and thiocyanate in plasma in 43 HD patients and in a group of 46 healthy controls that included 15 current smokers. To clarify the metabolic conversion of cyanide to thiocyanate in uraemic patients, we also measured cysteine and sulfate. We then used stepwise regression analysis to analyse factors that determine erythrocyte cyanide and plasma thiocyanate.
Results. Mean cyanide and thiocyanate were significantly greater in HD patients than in non-smoking controls. However, cyanide was far below lethal concentrations in dialysis patients. Thiocyanate was six to seven times greater in HD patients than in non-smoking controls, and decreases in thiocyanate following dialysis were only 19.3±3.5%. Multiple regression analysis showed a positive correlation between cyanide and thiocyanate in controls, but a negative correlation in HD patients. In patients, an inverse relationship between thiocyanate and BUN was also observed.
Conclusions. The elevation of thiocyanate in patients undergoing dialysis probably is secondary to both limited efficiency of HD and deranged metabolism of cyanide and thiocyanate. Because thiocyanate is a preferred substrate for MPO, it may play a role in uraemic complications including cardiovascular events.
Keywords: chronic renal failure; cyanide; cysteine; haemodialysis; thiocyanate
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. F. Perna, M. G. Luciano, D. Ingrosso, P. Pulzella, I. Sepe, D. Lanza, E. Violetti, R. Capasso, C. Lombardi, and N. G. De Santo Hydrogen sulphide-generating pathways in haemodialysis patients: a study on relevant metabolites and transcriptional regulation of genes encoding for key enzymes Nephrol. Dial. Transplant., August 4, 2009; (2009) gfp378v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. E. Broderick, P. Potluri, S. Zhuang, I. E. Scheffler, V. S. Sharma, R. B. Pilz, and G. R. Boss Cyanide Detoxification by the Cobalamin Precursor Cobinamide. Experimental Biology and Medicine, May 1, 2006; 231(5): 641 - 649. [Abstract] [Full Text] [PDF]
|
|