| Uremic toxins is which kidney function decline and retention in the body and cause symptoms of uremia substance, protein binding toxin as important uremic toxins, attach importance to more and more people.Protein-bound toxins not only have the kidney toxicity, but also are closely related to cardiovascular events, dialysis related amyloidosis, renal osteodystrophy, itchy skin, and many other closely related diseases, serious influence on survival and quality of life.It is not known if the protein-bound toxoins levels in chronic kidney disease(CKD) in the body and its protein binding rate is associated with the progression of CKD. These research at home and abroad are less. This study was to investigate the protein-bound toxins level and their protein binding rate in the body for patients with CKD, to discuss the relation between renal fuction and toxins level.This study will be divided into 112 cases of patients with CKD based on renal fuction, in addition to choose 60 cases of healthy volunteers as control group. Application of High performance liquid chromatographyTandem Mass Spectrometry(HPLS-MS/MS) detection technology determination the total concentration of serum hippuric acid(HA), indoxyl sulfate( IS), p-cresyl sulfate(PCS) and 3-carboxyl-4- methyl- 5-propyl-2-furan propionic acid(CMPF). Also analysis the correlation between e GFR and 4 kinds of toxin levels.Selected 10 cases from CKD3-5 stages and healthy groupe, respectively. Using ultrafiltration method to separate the free HA, IS, PCS, CMPF, calculated and determination of its concentration, protein binding rate of the material in different renal period.Then to know the relationship between the free concentration, the proteinbinding rate and renal function changes. The concentration of HA, IS, PCS and CMPF in healthy controls are 0.80(0.4-1.30)μg/ml, 0.96(0.54-1.26)μg/ml, 1.45(0.49-2.93)μg/ml, 0.92(0.45-1.89)μg/ml respectively; The concentration of HA, IS, PCS and CMPF in CKD3-5 stages are respectively:(CKD3 stage) 1.50(0.98-2.33) μg/ml, 1.97μg/ml(1.15-4.47), 3.97(1.20-5.68) μg/ml, 2.60(1.09-3.34) μg/ml;(CKD4stage) 5.45μg/ml(2.53- 7.33), 5.35(3.50-7.93) μg/ml, 9.75 μg/ml(5.25-13.49), 2.93(1.50-4.50) μg/ml;(CKD5 stage) 12.45(5.43-13.73)μg/ml, 16.23(6.72-22.04) μg/ml, 19.14(11.76-33.98)μg/ml, 3.71(1.13-4.79) μg/ml. The free concentration of HA, IS, PCS and CMPF in these gropes are respectively : healthy controls were 2.13(1.36-3.53),0.11(0.07-017), 0.43(0.14-0.59), 0.26(0.24-0.28)μg/ml;(CKD3 stage)2.88(1.76-5.63), 0.23(0.05-0.48), 0.96(0.56-2.08), 0.30(0.25-0.31)μg/ml;(CKD4 stage) 8.78(3.32-17.88), 0.55(0.26-0.91), 1.21(0.53-4.33),0.32(0.29-0.50)μg/ml;(CKD5 stage) 24.05(3.56-62.55), 3.16(0.96-8.10),5.42(0.62-12.83), 0.28(0.25-0.35)μg/ml. The protein binding rate of HA,IS, PCS and CMPF in healthy controls were(83.44 ± 3.04) %,(98.73 ±0.55) %,(98.42 ± 0.95) %,(96.66 ±2.65) %, which were(79.72 ± 3.82) %,(99.18±0.45) %,(98.64 ±0.64) %,(95.89 ±3.52) % in CKD3 stage.(71.09±7.66) %,(98.24±0.95) %,(98.26 ± 0.73) %,(91.82±5.10)% in CKD4 stage,(61.22 ±7.62) %,(97.41±1.10) %,(96.85±1.51) %,(97.51 ±1.52) %in CKD5 stage respectively.Compared with healthy controls, the levels of HA, IS, PCS and CMPF were significantly higher(P < 0.01)in patients with CKD; in CKD3-5 stages, the levels of HA, IS, PCS were increased significantly with the renal function declined(P < 0.01), while CMPF serum level of no significant change(P > 0.05); It is negatively related between e GFR and serum total concentration of HA, IS,PCS, and CMPF for patients with CKD.The free concentration of HA, IS, PCS in late chronic kidney disease(CKD) stage appeared to rise, and their protein binding rate are reduced at the same time. But the free concentration andprotein binding rate of CMPF has no obvious change. IS, PCS, CMPF combined with human serum albumin(HSA)are high strength, HA is relatively low. |
PDF Full Text Request