Abstract
Purpose: This study aimed to use proteomics methods to investigate the changes in serum protein levels after high- and low-flux hemodialysis (HD).Methods: Before and after HD, serum samples were obtained from two selected patients who were treated with a Polyflux 140 H high-flux dialyzer and a Polyflux 14 L low-flux dialyzer during two continuous therapy sessions. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed to identify the proteins.Results: A total of 212 and 203 serum proteins were identified after high-flux and low-flux HD, respectively. After high-flux HD, 21 proteins increased, and 132 proteins decreased. After low-flux HD, 87 proteins increased, and 45 proteins decreased. High-flux HD led to a significantly greater reduction in protein levels than low-flux HD (0.73 ± 0.13 vs. 0.84 ± 0.18, p = .00). Among the increased and decreased proteins, the isoelectric point (pI) values mainly ranged from 5 to 7, and the molecular weights (Mws) were mostly smaller than 30 kDa. The serum proteins showed no difference in pI or Mw for high- and low-flux HD. Gene ontology (GO) analysis showed that the detected proteins were related to immune system processes and complement activation.Conclusions: Serum protein levels differentially changed after high- and low-flux HD. Long-term effects should be observed in future studies.
Highlights
Hemodialysis (HD) is one of the most effective therapeutic methods for patients with uremia and is closely related to their outcomes
Serum protein levels changed after high-flux HD
More serum proteins tended to increase after low-flux HD while more tended to decrease after high-flux HD
Summary
Hemodialysis (HD) is one of the most effective therapeutic methods for patients with uremia and is closely related to their outcomes. High-flux and low-flux HD are two routine modalities of clinical application. Many studies have compared the similarities and differences between high-flux and low-flux HD with regard to different factors. Some large prospective clinical studies, such as the Haemodialysis (HEMO) study and the Membrane Permeability Outcome (MPO) Study, have failed to show a generally better outcome with high-flux HD than with low-flux HD treatment [5]. Many studies indicate that differences exist in the urea, phosphate, and b2-microglobulin (b2-MG) clearance [6] and in high-sensitivity C-reactive protein, blood glucose, blood insulin, interleukin-6 (IL-6), IL-8, and tumor necrosis factor a (TNF-a) levels between high-flux HD and low-flux HD treatment [7,8]. In some subgroups of HD patients, the use of high-flux membranes seems to improve the clinical outcome [9]. Proteomics methods have been successfully applied to the study of HD [6,12–17]. We applied proteomics methods to identify the changes in serum proteins after the two forms of HD were performed and to identify the meaningful proteins to provide the basis for further research
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