title: Metabolic responses during hemodialysis determined by quantitative (1)H NMR spectroscopy.
abstract: A large proportion of patients with end-stage renal disease have lifelong hemodialysis (HD) treatment. HD rapidly and indiscriminately removes necessary small metabolites together with uremic toxins from plasma into dialysate. To investigate metabolic responses to HD, we determined the levels of metabolites through time-course monitoring of (1)H NMR spectroscopy of dialysate during HD. The dialysate sample is stable for analysis because it contains only small metabolites without proteins. It was collected non-invasively from 9 HD patients with chronic glomerular nephropathy, at 6 time points during 4h of HD in 5 sessions. Creatinine, alanine, lactate, pyruvate and valine were simultaneously quantified on a one-dimensional single-pulse spectrum with a single standard compound. The concentration of creatinine exhibited monotonous decay with time, while that of valine decreased slowly and then maintained its levels throughout an HD. Lactate, alanine and pyruvate increased at 2-3h after the initiation of HD. They exhibited remarkable responses to HD with production from the body. The time-course of change in the 4 metabolites of lactate, pyruvate, alanine, and valine had reproducible behavior unique to each patient during the HD. This finding may be applied to distinguish metabolic status in HD patients.
authors.affiliation: Department of Planning for Drug Development and Clinical Evaluation, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3, Aramaki-aza-aoba, Aobaku, Sendai 980-8578, Japan. Electronic address: fmasako@m.tohoku.ac.jp.
authors.forename: Masako
authors.initials: M
authors.lastname: Fujiwara
authors.affiliation: Laboratory of Clinical Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3, Aramaki-aza-aoba, Aobaku, Sendai 980-8578, Japan.
authors.forename: Itiro
authors.initials: I
authors.lastname: Ando
authors.affiliation: Department of Planning for Drug Development and Clinical Evaluation, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3, Aramaki-aza-aoba, Aobaku, Sendai 980-8578, Japan; Koujinkai Central Clinic, 2-1-6, Tsutsujigaoka, Miyaginoku, Sendai 983-0852, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takeuchi
authors.affiliation: Koujinkai Nagamachi Clinic, 2-8-2, Happonmatsu, Taihakuku, Sendai 982-0001, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Oguma
authors.affiliation: Laboratory of Clinical Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3, Aramaki-aza-aoba, Aobaku, Sendai 980-8578, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.affiliation: Koujinkai Central Clinic, 2-1-6, Tsutsujigaoka, Miyaginoku, Sendai 983-0852, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sekino
authors.affiliation: Koujinkai Nagamachi Clinic, 2-8-2, Happonmatsu, Taihakuku, Sendai 982-0001, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Planning for Drug Development and Clinical Evaluation, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3, Aramaki-aza-aoba, Aobaku, Sendai 980-8578, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000368:Aged; D000409:Alanine / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D019344:Lactic Acid / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019289:Pyruvic Acid / Q000378:metabolism; D006435:Renal Dialysis / Q000379:methods; D014633:Valine / Q000378:metabolism
chemical_list: D019344:Lactic Acid; D019289:Pyruvic Acid; D003404:Creatinine; D014633:Valine; D000409:Alanine
keywords: (1)H NMR spectroscopy; Hemodialysis; Lactate; Metabolic response; Pyruvate