Phenylacetic acid and arterial vascular properties in patients with chronic kidney disease stage 5 on hemodialysis therapy.
BACKGROUND
Phenylacetic acid (PAA) is a recently described uremic toxin that inhibits inducible nitric oxide synthase expression and plasma membrane calcium ATPase and may therefore also be involved in remodeling of arteries. Such vascular effects have not been evaluated yet in patients with chronic kidney disease stage 5.


METHODS
We prospectively measured the plasma concentrations of PAA using nuclear magnetic resonance spectroscopy in 50 patients with chronic kidney disease stage 5 (37 men, 13 women) on maintenance hemodialysis. Arterial vascular properties were quantified by the reflective index obtained from digital photoplethysmography.


RESULTS
During the hemodialysis session the plasma PAA concentration was reduced from 3.38 +/- 0.24 mmol/l (mean +/- SEM; median, 2.85 mmol/l; interquartile range, 2.02-4.52 mmol/l) to 2.25 +/- 0.11 mmol/l (median, 2.06 mmol/l; interquartile range, 1.62-2.86 mmol/l; n = 50; p < 0.001). There was a significant correlation between the PAA concentration and the reflective index before the start of the hemodialysis session.


CONCLUSIONS
The study demonstrates an association of PAA and arterial vascular properties in patients with chronic kidney disease stage 5.
Scholze
Alexandra
A
Medizinische Klinik IV, Nephrologie, Charité Campus Benjamin Franklin, Berlin, Germany.
Jankowski
Vera
V
Henning
Lars
L
Haass
Wiltrud
W
Wittstock
Antje
A
Suvd-Erdene
Sukhbaatar
S
Zidek
Walter
W
Tepel
Martin
M
Jankowski
Joachim
J
D000368:Aged; D001158:Arteries / Q000502:physiology; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010648:Phenylacetates / Q000097:blood*; D011446:Prospective Studies; D006435:Renal Dialysis; D014661:Vasoconstriction / Q000502:physiology
D010648:Phenylacetates; C025136:phenylacetic acid