Assessment of uremic toxins in advanced chronic kidney disease patients on maintenance hemodialysis by LC-ESI-MS/MS

Introduction In the advanced stage of chronic kidney disease (CKD), electrolytes, fluids, and metabolic wastes including various uremic toxins, accumulate at high concentrations in the patients’ blood. Hemodialysis (HD) is the conventional procedure used worldwide to remove metabolic wastes. The cre...

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Bibliographic Details
Published in:Metabolomics 2023-02, Vol.19 (3), p.14-14, Article 14
Main Authors: Ragi, Nagarjunachary, Pallerla, Pavankumar, Babi Reddy Gari, Aravind Reddy, Lingampelly, Sai Sachin, Ketavarapu, Vijayasarathy, Addipilli, Ramunaidu, Chirra, Nagaraju, Kantevari, Srinivas, Yadla, Manjusha, Sripadi, Prabhakar
Format: Article
Language:English
Subjects:
Biochemistry
Biomedical and Life Sciences
Biomedicine
Catechol
Cell Biology
Chromatography, Liquid
Creatinine
Cresol
Developmental Biology
Guaiacol
Hemodialysis
Humans
Indican - metabolism
Kidney diseases
Life Sciences
Metabolism
Metabolomics
Molecular Medicine
Original Article
p-Cresol
Quantitative analysis
Renal Dialysis
Renal Insufficiency, Chronic - metabolism
Sulfates
Tandem Mass Spectrometry
Urea
Uremic Toxins
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Summary:Introduction In the advanced stage of chronic kidney disease (CKD), electrolytes, fluids, and metabolic wastes including various uremic toxins, accumulate at high concentrations in the patients’ blood. Hemodialysis (HD) is the conventional procedure used worldwide to remove metabolic wastes. The creatinine and urea levels have been routinely monitored to estimate kidney function and effectiveness of the HD process. This study, first from in Indian perspective, aimed at the identification and quantification of major uremic toxins in CKD patients on maintenance HD (PRE-HD), and compared with the healthy controls (HC) as well as after HD (POST-HD). Objectives The study mainly focused on the identification of major uremic toxins in Indian perspective and the quantitative analysis of indoxyl sulfate and p-cresol sulfate (routinely targeted uremic toxins), and phenyl sulfate, catechol sulfate, and guaiacol sulfate (targeted for the first time), apart from creatinine and urea in PRE-HD, POST-HD, and HC groups. Methods Blood samples were collected from 90 HD patients (both PRE-HD and POST-HD), and 74 HCs. The plasma samples were subjected to direct ESI-HRMS and LC/HRMS for untargeted metabolomics and LC-MS/MS for quantitative analysis. Results Various known uremic toxins, and a few new and unknown peaks were detected in PRE-HD patients. The p-cresol sulfate and indoxyl sulfate were dominant in PRE-HD, the concentrations of phenyl sulfate, catechol sulfate, and guaiacol sulfate were about 50% of that of indoxyl sulfate. Statistical evaluation on the levels of targeted uremic toxins in PRE-HD, POST-HD, and HC groups showed a significant difference among the three groups. The dialytic clearance of indoxyl sulfate and p-cresol sulfate was found to be
ISSN:1573-3890
1573-3882
1573-3890
DOI:10.1007/s11306-023-01978-z