Abstract | BACKGROUND: OBJECTIVE: DESIGN: Thirteen adult patients (10 men, 3 women) who had required hemodialysis for a mean of 10.8 years were studied. Dialysis was performed 3 times weekly for 4 hours using either a cellulose acetate or polysulfone dialyzer membrane. Venous and arterial blood, and dialysate samples were taken for measurement of plasma free and phospholipid-bound choline concentration before beginning dialysis and after each hour of dialysis. An in vitro system was devised to determine if choline could bind to a significant degree to the dialysis membrane. RESULTS: Plasma free choline concentration was increased above normal (11.7 +/- 3.7 nmol/mL) at baseline and declined progressively during dialysis. In contrast, plasma phospholipid-bound choline concentration increased progressively during dialysis. The decrease in plasma free choline (-1.8 +/- 0.3 nmol/mL(-1)/h(-1); P = 1.6 x 10(-6)) was almost entirely related to that which was removed during dialysis, although the magnitude of the loss was not correlated with the increase in plasma phospholipid-bound choline concentration (125 +/- 20.5 nmol/mL(-1)/h(-1); P < 1.2 x 10(-6)). Patients lost a mean of 246 pmol of free choline during hemodialysis. Choline did not bind to the dialysis membrane. CONCLUSION: Plasma free choline concentration is elevated before dialysis, and choline is lost to a significant degree in the dialysate. Further investigation is necessary to determine whether a transient, dialysis-induced choline deficiency develops, and whether there is a role for choline supplementation in these patients. The choline homeostatic mechanism requires further investigation in renal failure patients.
|
Authors | A L Buchman, D Jenden, W N Suki, M Roch |
Journal | Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
(J Ren Nutr)
Vol. 10
Issue 3
Pg. 133-8
(Jul 2000)
ISSN: 1051-2276 [Print] United States |
PMID | 10921534
(Publication Type: Journal Article)
|
Chemical References |
- Hemodialysis Solutions
- Phospholipids
- Choline
|
Topics |
- Adult
- Choline
(blood, metabolism)
- Choline Deficiency
(diet therapy, prevention & control)
- Female
- Hemodialysis Solutions
(chemistry)
- Humans
- In Vitro Techniques
- Kidney Failure, Chronic
(complications, therapy)
- Male
- Parenteral Nutrition, Total
- Phospholipids
(analysis, metabolism)
- Renal Dialysis
|