Evaluation of protein related homocysteine transportation and metabolic disorders in patients treated with chronic hemodialysis

Objective: The aim of the study was the evaluation of homocysteine transportation by plasma proteins and metabolic abnormalities associated with mitochondrial dysfunction in patients treated with chronic hemodialysis. Materials and Methods: Plasma samples from healthy donors and patients treated with chronic hemodialysis using two types of dialysis solution were studied: commonly used bicarbonate or one with succinate. Homocysteine and glutathione were quantified with HPLC. For evaluation of the filterability protein-bond aminothiols by ultrafiltration procedure we introduce filtering factor (F) that is the ratio of the aminothiol concentration in the ultrafiltrate to its overall concentration in the plasma. Results: In the group of healthy donors the value of 25th percentile of factor F for homocysteine was 0.44. Patients with moderate hyperhomocysteinemia showed the decreased filterability of homocysteine, but not glutathione. Low homocysteine filterability (F<0.44) shows the predominant binding of homocysteine to high molecular weight proteins or to protein aggregates, but not to the albumin fraction. Perhaps, the high value of F characterizes the “less dangerous” hyperhomocysteinemia. Conclusion: In this paper, we demonstrated the evaluation of decreased homocysteine transportation by plasma albumin in patients treated with chronic hemodialysis, and introduced the ultrafiltration procedure to estimate the homocysteine binding to macromolecular fraction of blood proteins. Application of succinate-containing dialysis solution was associated with the improvement in the homocysteine filterability of and with decreased level of the mitochondrial dysfunction markers compared to patients receiving bicarbonate hemodialysis.

общий гомоцистеин, гемодиализ, гомоцистеинилирование белков, ультрафильтрация, митоходриальная дисфункция, сукцинат, глутатион, total homocysteine, hemodialysis, homocysteinylation of proteins, ultrafiltration, mitochondrial dysfunction, succinate, glutathione

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