Association of Plasma Uremic Solute Levels with Residual Kidney Function in Children on Peritoneal Dialysis
| Autor: | Natalie S. Plummer, Lakshmi L. Ganesan, Tammy L. Sirich, Cecile Fajardo, Paul Brakeman, Rita D. Sheth, Timothy W. Meyer, Scott M. Sutherland, Frank J. O’Brien |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Epidemiology medicine.medical_treatment Urology Renal function Critical Care and Intensive Care Medicine Residual Kidney Kidney Function Tests Mass Spectrometry Peritoneal dialysis chemistry.chemical_compound Predictive Value of Tests Extracellular fluid medicine Humans Metabolomics Native kidney Child Uremia Transplantation business.industry Age Factors Infant Plasma levels Original Articles medicine.disease United States Treatment Outcome chemistry Nephrology Child Preschool Urea Metabolome Female Kidney Diseases business Peritoneal Dialysis Biomarkers |
| Zdroj: | Clin J Am Soc Nephrol |
| Popis: | BACKGROUND AND OBJECTIVES: Residual native kidney function confers health benefits in patients on dialysis. It can facilitate control of extracellular volume and inorganic ion concentrations. Residual kidney function can also limit the accumulation of uremic solutes. This study assessed whether lower plasma concentrations of uremic solutes were associated with residual kidney function in pediatric patients on peritoneal dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Samples were analyzed from 29 pediatric patients on peritoneal dialysis, including 13 without residual kidney function and ten with residual kidney function. Metabolomic analysis by untargeted mass spectrometry compared plasma solute levels in patients with and without residual kidney function. Dialytic and residual clearances of selected solutes were also measured by assays using chemical standards. RESULTS: Metabolomic analysis showed that plasma levels of 256 uremic solutes in patients with residual kidney function averaged 64% (interquartile range, 51%–81%) of the values in patients without residual kidney function who had similar total Kt/V(urea). The plasma levels were significantly lower for 59 of the 256 solutes in the patients with residual kidney function and significantly higher for none. Assays using chemical standards showed that residual kidney function provides a higher portion of the total clearance for nonurea solutes than it does for urea. CONCLUSIONS: Concentrations of many uremic solutes are lower in patients on peritoneal dialysis with residual kidney function than in those without residual kidney function receiving similar treatment as assessed by Kt/V(urea). |
| Databáze: | OpenAIRE |
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