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Correlation between Serum Levels of Protein-Bound Uremic Toxins in Hemodialysis Patients Measured by LC/MS/MS.
Mass Spectrom (Tokyo). 2013; 2(Spec Iss):S0017.MS

Abstract

Uremic toxins are involved in a variety of symptoms in advanced chronic kidney disease. Especially, the accumulation of protein-bound uremic toxins in the blood of dialysis patients might play an important role in the development of cardiovascular disease. Serum concentration of protein-bound uremic toxins such as indoxyl sulfate, indoxyl glucuronide, indoleacetic acid, p-cresyl sulfate, p-cresyl glucuronide, phenyl sulfate, phenyl glucuronide, phenylacetic acid, phenylacetylglutamine, hippuric acid, 4-ethylphenyl sulfate, and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF) in hemodialysis patients were simultaneously measured by liquid chromatography/tandem mass spectrometry. Serum levels of these protein-bound uremic toxins were increased in hemodialysis patients. Indoxyl sulfate, p-cresyl sulfate, and CMPF could not be removed efficiently by hemodialysis due to their high protein-binding ratios. Serum level of total indoxyl sulfate did not show any significant correlation with total p-cresyl sulfate. However, free indoxyl sulfate correlated with free p-cresyl sulfate, and reduction rate by hemodialysis of indoxyl sulfate correlated with that of p-cresyl sulfate. Serum levels of total and free indoxyl sulfate showed significantly positive correlation with those of indoxyl glucuronide, phenyl sulfate, and phenyl glucuronide. Serum levels of total and free p-cresyl sulfate showed significantly positive correlation with those of p-cresyl glucuronide, phenylacetylglutamine, and phenylacetic acid. Indoxyl sulfate and indoxyl glucuronide are produced from indole which is produced in the intestine from tryptophan by intestinal bacteria. p-Cresyl sulfate and p-cresyl glucuronide are produced from p-cresol which is produced in the intestine from tyrosine by intestinal bacteria. Thus, intestinal bacteria play an important role in the metabolism of protein-bound uremic toxins.

Authors+Show Affiliations

Biomedical Research Laboratories, Kureha Corporation.Biomedical Research Laboratories, Kureha Corporation.Biomedical Research Laboratories, Kureha Corporation.Meiyo Clinic.Department of Advanced Medicine for Uremia, Nagoya University Graduate School of Medicine.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24349936

Citation

Itoh, Yoshiharu, et al. "Correlation Between Serum Levels of Protein-Bound Uremic Toxins in Hemodialysis Patients Measured By LC/MS/MS." Mass Spectrometry (Tokyo, Japan), vol. 2, no. Spec Iss, 2013, pp. S0017.
Itoh Y, Ezawa A, Kikuchi K, et al. Correlation between Serum Levels of Protein-Bound Uremic Toxins in Hemodialysis Patients Measured by LC/MS/MS. Mass Spectrom (Tokyo). 2013;2(Spec Iss):S0017.
Itoh, Y., Ezawa, A., Kikuchi, K., Tsuruta, Y., & Niwa, T. (2013). Correlation between Serum Levels of Protein-Bound Uremic Toxins in Hemodialysis Patients Measured by LC/MS/MS. Mass Spectrometry (Tokyo, Japan), 2(Spec Iss), S0017. https://doi.org/10.5702/massspectrometry.S0017
Itoh Y, et al. Correlation Between Serum Levels of Protein-Bound Uremic Toxins in Hemodialysis Patients Measured By LC/MS/MS. Mass Spectrom (Tokyo). 2013;2(Spec Iss):S0017. PubMed PMID: 24349936.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation between Serum Levels of Protein-Bound Uremic Toxins in Hemodialysis Patients Measured by LC/MS/MS. AU - Itoh,Yoshiharu, AU - Ezawa,Atsuko, AU - Kikuchi,Kaori, AU - Tsuruta,Yoshinari, AU - Niwa,Toshimitsu, Y1 - 2013/04/15/ PY - 2012/07/30/received PY - 2012/11/05/accepted PY - 2013/12/19/entrez PY - 2013/12/19/pubmed PY - 2013/12/19/medline KW - indoxyl glucuronide KW - indoxyl sulfate KW - p-cresyl glucuronide KW - p-cresyl sulfate KW - phenyl sulfate KW - phenylacetylglutamine SP - S0017 EP - S0017 JF - Mass spectrometry (Tokyo, Japan) JO - Mass Spectrom (Tokyo) VL - 2 IS - Spec Iss N2 - Uremic toxins are involved in a variety of symptoms in advanced chronic kidney disease. Especially, the accumulation of protein-bound uremic toxins in the blood of dialysis patients might play an important role in the development of cardiovascular disease. Serum concentration of protein-bound uremic toxins such as indoxyl sulfate, indoxyl glucuronide, indoleacetic acid, p-cresyl sulfate, p-cresyl glucuronide, phenyl sulfate, phenyl glucuronide, phenylacetic acid, phenylacetylglutamine, hippuric acid, 4-ethylphenyl sulfate, and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF) in hemodialysis patients were simultaneously measured by liquid chromatography/tandem mass spectrometry. Serum levels of these protein-bound uremic toxins were increased in hemodialysis patients. Indoxyl sulfate, p-cresyl sulfate, and CMPF could not be removed efficiently by hemodialysis due to their high protein-binding ratios. Serum level of total indoxyl sulfate did not show any significant correlation with total p-cresyl sulfate. However, free indoxyl sulfate correlated with free p-cresyl sulfate, and reduction rate by hemodialysis of indoxyl sulfate correlated with that of p-cresyl sulfate. Serum levels of total and free indoxyl sulfate showed significantly positive correlation with those of indoxyl glucuronide, phenyl sulfate, and phenyl glucuronide. Serum levels of total and free p-cresyl sulfate showed significantly positive correlation with those of p-cresyl glucuronide, phenylacetylglutamine, and phenylacetic acid. Indoxyl sulfate and indoxyl glucuronide are produced from indole which is produced in the intestine from tryptophan by intestinal bacteria. p-Cresyl sulfate and p-cresyl glucuronide are produced from p-cresol which is produced in the intestine from tyrosine by intestinal bacteria. Thus, intestinal bacteria play an important role in the metabolism of protein-bound uremic toxins. SN - 2187-137X UR - https://www.unboundmedicine.com/medline/citation/24349936/Correlation_between_Serum_Levels_of_Protein_Bound_Uremic_Toxins_in_Hemodialysis_Patients_Measured_by_LC/MS/MS_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24349936/ DB - PRIME DP - Unbound Medicine ER -
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