Based Metabqlomics Research Of Estimating Blood Purify Method's Efficiency In Chronic Renal Insufficient Patients

Chronic kidney disease(CKD)exacerbates with the gradual losing kidney functions and when the glomerular filtration rate(GRT)is less than 15ml/min/1.73m~2,CKD turns to be End-stage of renal disease(ESRD).Uremic patients always have uremic toxins accumulated in blood and many complex complications.Hemodialysis(HD)is one of the main treatments for uremia,and it clears metabolic waste by diffusion interaction between blood and dialysate.So it is meaningful to investigate alterations in plasma of pre-hemodialysis(pre-HD)and post-hemodialysis(post-HD).Therefore,in this paper,a metabolic research about plasma metabolites among pre-HD and post-HD was carried out for evaluating efficiency of HD and its associations with complications compared with controls,which is helpful to finally achieve individual treatment in future.Firstly,an Ultra Performance Liquid Chromatography-Mass Spectrometry(UHPLC-MS)based on lipidomics method was used to investigate plasma lipids significant changes in discovery set(25 uremic patients and 30 controls).Then a validation set(16 uremic patients and 16 controls)was applied to validate the results discovered in discovery set.A total of 302 lipids were classified into 17 classes were detected in the experiment,and 108 lipids were showed significant differences between pre-HD and post-HD.Most were well eliminated by HD exclude big molecules,such as triglyceride and sphingomyelin.High levels of free fatty acid,lyso-phosphatidylinositols and lyso-phosphatidylethanolamine might increase morbility of cardiovascular disease and inflammation.Low level of cholesteryl esters was associated with mature HDL,but it was further declined;lyso-phosphatidycholine was less than normal level,and further decreased after HD treatment,sometimes it might increases the risk of infections and inflammation.Secondly,a Capillary Electrophoresis-Mass Spectrometry(CE-MS)based metabolomics method was applied to investigate difference in plasma metabolites in maintained HD and HFD treatment to estimate the differences in two models.100uremia with HD,44 uremia with HFD and 47 health were attended the experience and268 metabolites were detected.Through paired T test,122 compounds containing 54uremic toxins were found both in two models with significant changes between pre and post.And clear rate showed that 29 metabolites were obviously different between HD and HFD.HFD had a better result in some degree when uremic patients were compared with controls,amino acid metabolic disorders were commonly existing in patients.?In summary,metabolomics methods are used to investigate the alterations of plasma metabolites and it can give much useful information about efficiency of dialysis in uremic toxins clearance,as well as complication.There is no denying that this experiment can enrich detail information about treatment by dialysis and it may provide theoretical basis for further development of dialysis treatment.