Nephrology Dialysis Transplantation, Vol 12, Issue 11 2332-2338, Copyright © 1997 by Oxford University Press
M Suliman, B Anderstam, B Lindholm and J Bergstrom
Fasting plasma concentrations of sulphur amino acids (sAA) were measured in
none non-dialysed (ND) chronic uraemic patients on conservative treatment,
10 patients on continuous ambulatory peritoneal dialysis (CAPD), nine
patients on haemodialysis (HD) treatment, and 10 healthy subjects (HS).
Methionine and taurine concentrations were significantly decreased in the
CAPD and HD patients and tended to be low in the ND patients. Cysteine
sulphinic acid (CSA) levels were significantly higher in all patient
groups. Total (t), free (f), and protein-bound (pb) homocysteine (Hcy) and
cysteine (Cys) were significantly increased in all patient groups. Serine,
a substrate for cystathionine synthesis from Hcy,, showed significantly
lower concentrations in all patient groups. The percentages of pbHcy were
significantly higher in the CAPD and HD patients than in the ND patients (P
<0.0001, P=0.002 respectively) or in the HS (P <0.0001,
P=0.008 respectively), whereas the percentages of pbCys in CAPD and HD
patients were significantly higher than in ND patients (P=0.0006, P=0.009
respectively) and tended to be high without reaching statistical
significance compared to the HS. A single HD treatment decreased tHcyby
26%, fHcy by 39%, and pbHcy by 22%, as well as tCys by 40%, fCys by 54%,
and pbCys by 27%. The tHcy concentration, although decreased by HD
treatment, remained higher than in HS, whereas tCys was normalized by the
dialysis session. In addition, HD treatment significantly decreased the
plasma concentrations of methionine, CSA, taurine, and serine. We conclude
that, except for methionine and taurine, the plasma sAA in their different
forms are markedly increased in dialysed and non-dialysed uraemic patients.
The percentages of pbHcy and pbCys were significantly higher in dialysed
than in ND uraemic patients. HD treatment can normalize the tCys
concentration, and decrease the tHcy concentration but not normalize it.
The observed hyperhomocysteineaemia and low taurine levels may contribute
to the high incidence of cardiovascular disease in uraemic patients.
Key words: continuous ambulatory peritoneal dialysis;
cystein; haemodialysis; homocysteine; sulphur amino acid; taurine; uraemia
ORIGINAL ARTICLES
Total, free, and protein-bound sulphur amino acids in uraemic patients
Divisions of Renal Medicine K-56 and Baxter Novum, Department of Clinical Science, Huddinge University Hospital, Karolinska Institute, S-141 86 Huddinge, Sweden; Corresponding author
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