A capillary gas chromatographic method, using the chiral stationary phase Chirasil-L-Val, after treatment and isolation with Dowex 50W X8 cation exchanger and conversion into trifluoroacetyl-1-propyl esters or pentafluoropropionyl-1 (or 2)-propyl esters, has been developed for the determination of the relative amounts of free d-amino acids in the blood serum of eighteen patients with renal failure (continuous ambulatory peritoneal dialysis (CAPD), n = 11; hemodialysis, n = 5; nephrotic syndrome, n = 2) and compared with data obtained from healthy volunteers ( n = 5). Significant amounts of d-Ala (0.5–13%) and d-Asx (1.5–7.7%; Asx = Asp + Asn) were found in all serum samples. d-Ser was detected in the serum of all patients with renal disorders and, in addition, d-Pro (0.6–2.5%) was found in the serum of all patients undergoing hemodialysis and with nephrotic syndrome. d-Ser (2.9–3.1%) and d-Pro (0.6–0.9%) were also found in the samples of three volunteers. d-Leu (1.2–1.7%) was present in three patients with CAPD, and d-Glx (0.3–1.3%; Glx = Glu + Gln) was present in eight of eighteen patients with renal malfunction. Linear regression analysis of the relative amounts of d-amino acids and the serum creatinine levels of all donors revealed positive correlation factors for d-Asx ( r = 0.748) and d-Ser ( r = 0.667), but not for d-Pro and d-Ala. Remarkably high amounts of d-Ser (12.1 and 19.8%) were found in two hemodialysates investigated. Participation of intestinal bacteria and nutrition are discussed as possible sources of serum d-amino acids. An increase of some d-amino acids in the serum of patients with renal diseases might be explained, in part, by decreased activity of renal d-amino acid oxidase.
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