Abstract
Uremic toxins are suggested to be involved in the pathophysiology of hemodialysis (HD) patients. However, the profile of uremic solutes in HD patients has not been fully elucidated. In this study using capillary electrophoresis mass spectrometry (CE-MS), we comprehensively quantified the serum concentrations of 122 ionic solutes before and after HD in 11 patients. In addition, we compared the results with those in non-HD patients with chronic kidney disease (CKD) to identify HD patient-specific solutes. We identified 38 solutes whose concentrations were higher in pre-HD than in CKD stage G5. Ten solutes among them did not significantly accumulate in non-HD CKD patients, suggesting that these solutes accumulate specifically in HD patients. We also identified 23 solutes whose concentrations were lower in both pre- and post-HD than in CKD stage G5. The serum levels of 14 solutes among them were not affected by renal function in non-HD patients, suggesting that these solutes tend to be lost specifically in HD patients. Our data demonstrate that HD patients have a markedly different profile of serum uremic solute levels compared to that in non-HD CKD patients. The solutes identified in our study may contribute to the pathophysiology of HD patients.
Highlights
IntroductionIn chronic kidney disease (CKD) patients, various uremic solutes, which are normally excreted into urine by the kidney, accumulate as the renal function declines
Using capillary electrophoresis mass spectrometry (CEMS), we identified solutes that are increased or decreased in HD patients compared to non-HD
We show that HD patients have a different profile of uremic solutes by identifying molecules that increased or decreased in HD patients
Summary
In CKD patients, various uremic solutes, which are normally excreted into urine by the kidney, accumulate as the renal function declines. If these retained solutes have a harmful effect on the body, they are called “uremic toxins”. As uremic toxins can cause various symptoms and increase mortality [2], clarifying the profile of uremic solutes is urgently needed for better outcomes in CKD patients. We reported a comprehensive profile of uremic solutes in non-HD CKD patients using capillary electrophoresis mass spectrometry (CE-MS) [8]
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