Abstract
3-Carboxy-4-methyl-5-propyl-2-furanpropionate (CMPF) is a metabolite of furan fatty acid and a marker of fish oil intake. CMPF is described as a protein-bound uremic toxin and interacts with free oxygen radicals, which can induce cell damages. However, the clinical consequences of CMPF accumulation in haemodialysis patients remain poorly documented. The aims of this study are to investigate potential association between CMPF levels and (i) biochemical and nutritional parameters; (ii) cardiovascular events and (iii) mortality. Two hundred and fifty-two patients undergoing maintenance haemodialysis were included. Routine clinical biochemistry tests and assay for CMPF by HPLC technique were performed at the inclusion. Body composition parameters were measured using a bioimpedance spectroscopy method. The enrolled patients were prospectively monitored for cardiovascular events and mortality. CMPF level was positively correlated with nutritional parameters and lean mass and is significantly higher in patients without protein-energy wasting. However, the multivariate linear regression analysis indicated that CMPF level was not independently associated with albumin, prealbumin, creatinemia and body mass index. Elevated serum CMPF was not associated with mortality and cardiovascular morbidity. Our results indicate that CMPF is not a relevant uremic toxin in haemodialysis and in contrast could be a marker of healthy diet and omega 3 intakes.
Highlights
Chronic kidney disease (CKD) is characterized by accumulation of uremic toxins especially, some protein-bound uremic toxins as p-cresyl sulfate and indoxyl sulfate
6 cardiovascular deaths and a total of 19 deaths in the second quantile. In this large cohort of HD patients, we explored the putative effect of CMPF accumulation on biochemical parameters and mortality and we failed to demonstrate that CMPF is a clinically relevant uremic toxin
We found a positive relationship between CMPF accumulation and nutritional status in HD patients and suggest that CMPF could be an index of a favourable nutritional status
Summary
Chronic kidney disease (CKD) is characterized by accumulation of uremic toxins especially, some protein-bound uremic toxins as p-cresyl sulfate and indoxyl sulfate. The clinical manifestations of these uremic toxins are rather nonspecific and may include neurologic disorders, protein energy wasting (PEW), cardiovascular (CV) diseases, progression of CKD and mortality [1,2,3]. 3-Carboxy-4-methyl-5-propyl-2-furanpropionate (CMPF) is a one of the major endogenous metabolites of furan fatty acids (Furan FAs). Furan FAs are incorporated into phospholipids and cholesterol esters and are catabolized into dibasic urofuran acids excreted in the urine. CMPF showed high protein-binding ratios (more than 95%) and it is poorly removed by haemodialysis (HD). Blood CMPF levels are elevated in CKD [4].
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