Metabolomic profiling of uremic solutes in CKD patients.
Early detection and accurate monitoring of patients with chronic kidney disease (CKD) is likely to improve care and decrease the risk of cardiovascular and cerebrovascular diseases. As a new diagnostic tool, we examined the retention of uremic solutes as a simpler, more accurate method to assess renal function. To achieve this, we comprehensively evaluated these solutes in CKD patients. By capillary electrophoresis with mass spectrometry, we found 22 cations and 30 anions that accumulated significantly as the estimated glomerular filtration rate (eGFR) decreased. These compounds included 9 cations and 27 anions that were newly identified in this study. In contrast, we also found 7 cations (2 new) and 5 anions (all new) that decrease significantly as eGFR declines. We evaluated each substance for its suitability to detect early CKD stage. Compounds that are highly correlated with eGFR and whose plasma concentration changed in a manner approximated by the first-degree equation are excellent candidates for detecting CKD and identifying uremic toxins that might aggravate kidney function in the early stage of CKD. These results identify a number of uremic compounds, many of which are novel and which predict worsening renal function. These compounds provide diagnostic information and may be targets for therapies designed to treat the complications of CKD patients.
Toyohara
Takafumi
T
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Akiyama
Yasutoshi
Y
Suzuki
Takehiro
T
Takeuchi
Yoichi
Y
Mishima
Eikan
E
Tanemoto
Masayuki
M
Momose
Ayako
A
Toki
Naoko
N
Sato
Hiroshi
H
Nakayama
Masaaki
M
Hozawa
Atsushi
A
Tsuji
Ichiro
I
Ito
Sadayoshi
S
Soga
Tomoyoshi
T
Abe
Takaaki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism*; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D055432:Metabolomics; D008875:Middle Aged; D014511:Uremia / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism*
D003404:Creatinine