Effect of recombinant human interleukin 1β (rhIL-1β) on amino acid flux in the isolated perfused rat liver

Summary We studied the effect of recombinant human IL-1 (rhIL-1) on hepatic amino acid (AA) flux in the isolated perfused rat liver model. Two experimental groups were used — a control group (n = 5) and a rhIL-1-treated group (n = 5). IL-1 was added to the perfusate in two successive boluses of 0.1µg and 0.9µg, respectively 35 min (final concentration 0.67 ng/ml) and 60 min (6 ng/ml) after beginning the perfusion. In the IL-1 treated group, a reduction in flux was observed for only three AA, alanine, phenylalanine and serine. Glucose and urea production in the IL-1-treated group was slightly but not-significantly lower than in the controls.rhIL-1 thus has only minor direct effects on AA flux and gluconeogenesis in the liver and cannot therefore be held responsible for the increase in hepatic amino acid uptake during stress.     

13C-Leucine-tracer-technique for in-vivo measurement of amino acids' metabolism by human colon carcinomas

Summary Own investigations on in-vivo tumor metabolism of the malignant human colon tumor showed a significant uptake of branched chain amino acids by the tumor itself. To study the quantitative tumor protein metabolism (compartment tumor) the¹³C-leucine-tracer-technique was modified.Beside the common¹³C-leucine-breath-test we measured also the AV-differences of¹³C-leucine,¹³C-ketoisocaproate and¹³CO₂. The Tumorblood flow was measured by venous-outflow-technique as well as the tumor mass.In this way it is possible to get quantitative results in substrate exchange of branched chain amino acids in malignant human colon tumors.     

Ratio of Dietary n-6/n-3 Polyunsaturated Fatty Acids Independently Related to Muscle Mass Decline in Hemodialysis Patients

Background

n-3 polyunsaturated fatty acids (PUFAs) might be useful nutritional strategy for treating patients with sarcopenia. We evaluated the effect of the intake of dietary n-3 PUFAs on the skeletal muscle mass (SMM), appendicular skeletal muscle mass (ASM), and its determinants in patients receiving standard hemodialysis (HD) treatment for the management of end stage renal disease.

Methods

In this cross-sectional study, data of 111 HD patients were analyzed. Anthropometric and bioelectrical impedance measurements used to estimate the muscle mass were performed the day of dialysis immediately after the dialysis session. Routine laboratory and 3-day dietary data were also collected. The cutoff value of adequate intake (AI) for both n-3 PUFAs and alpha-linolenic acid (ALA) was 1.6 g/day and 1.1 g/day for men and women, respectively.

Results

The mean age, mean dietary n-3 PUFAs intake, ALA intake, ratio of n-6/n-3 PUFAs intake, SMM, and ASM of patients were 61.4 ± 10.4 years, 2.0 ± 1.3 g/day, 1.5 ± 1.0 g/day, 9.5 ± 6.7 g/day, 23.9 ± 5.5 kg, and 17.5 ± 4.5 kg, respectively. A higher SMM and ASM significantly observed in patients who achieved an AI of n-3 PUFAs. Similar trends appeared to be observed among those patients who achieved the AI of ALA, but the difference was not significantly, except for ASM (P = 0.047). No relevant differences in demographics, laboratory and nutritional parameters were observed, regardless of whether the patients achieved an AI of n-3 PUFAs. Multivariate analysis showed that the BMI and equilibrated Kt/V were independent determinants of the muscle mass. Moreover, the ratio of n-6/n-3 PUFAs was an independent risk determinant of reduced ASM in HD patients.

Conclusion

Patients with an AI of n-3 PUFAs had better total-body SMM and ASM. A higher dietary ratio of n-6/n-3 PUFAs seemed to be associated with a reduced muscle mass in HD patients.     

Phenylsuccinate reduces KCL-induced release of GABA evidence for the participation of the ketodicarboxylate carrier in the biosynthesis of transmitter-GABA

Summary The present study investigates the effects of phenylsuccinate (PS), an inhibitor of the mitochondrial ketodicarboxylate carrier (KCC), on release of-aminobutyric acid (GABA), glutamate (Glu), glutamine (Gln), and glycine (Gly), induced by potassium chloride (KCl) and by cardiac arrest caused by a halothane overdose. Microdialysates were collected from the hippocampus of anaesthetized rats, and analyzed by HPLC. Continuous perfusion of 50 mM PS through the dialysis probe, reduces release of GABA induced by KCl (50 mM for 10 min through the dialysis probe) by up to 72%. In addition, PS abolished KCl-induced release of Glu. Release of GABA during cardiac arrest was not reduced by PS, whereas PS reduced release of Glu in the early stage of cardiac arrest. PS furthermore increased the basal level of Gln, and reversed a decrease of Gln induced by cardiac arrest.It is proposed that the KCC is present in GABA'ergic neurons of the rat hippocampus, and that GABA, released by KCl, can be synthesized in a KCC dependent manner. It is also suggested that ischemia-induced release of GABA, to some extent, has a non-transmitter origin. The results furthermore indicate that uptake of Gln into GABA'ergic and Glu'ergic neurons is not regulated by simple demand mechanisms.Abbreviations PS phenylsuccinate - KCC ketodicarboxylate carrier - GABA -aminobutyric acid - Glu glutamate - Gln glutamine - Gly glycine - -KG -ketoglutarate - Mal malate - KRB-buffer Krebs-Ringer bicarbonate-buffer - HPLC high pressure liquid chromatography     

Production of tyrosine and other aromatic compounds from phenylalanine by rumen microorganisms

Summary Rumen contents from three fistulated Japanese native goats fed Lucerne hay cubes (Medicago sativa) and concentrate mixture were collected to prepare the suspensions of mixed rumen bacteria (B), mixed protozoa (P) and a combination of the two (BP). Microbial suspensions were anaerobically incubated at 39°C for 12h with or without 1 MM ofl-phenylalanine (Phe). Phe, tyrosine (Tyr) and other related compounds in both supernatant and microbial hydrolysates of the incubations were analyzed by HPLC. Tyr can be produced from Phe not only by rumen bacteria but also by rumen protozoa. The production of Tyr during 12h incubation in B (183.6 mol/g MN) was 4.3 times higher than that in P. One of the intermediate products between Phe and Tyr seems to bep-hydroxyphenylacetic acid. The rate of the net degradation of Phe incubation in B (76.O mol/g MN/h) was 2.4 times higher than in P. In the case of all rumen microorganisms, degraded Phe was mainly (>53%) converted into phenylacetic acid. The production of benzoic acid was higher in P than in B suspensions. Small amount of phenylpyruvic acid was produced from Phe by both rumen bacteria and protozoa, but phenylpropionic acid and phenyllactic acid were produced only by rumen bacteria.     

Changes in amino acid content of an algal feed species (Navicula sp.) and their effect on growth and survival of juvenile abalone (Haliotis rubra)

The growth and survival of juvenile Haliotis rubra, when fed with the diatom Navicula sp. cultured in f/2 medium containing combined nitrogen at 24.71 mg NO₃-N L^–1 (high), 12.35 mg NO₃-N L^–1 (standard) or 2.47 mg NO₃-N L^–1 (low), were compared in a 33-day trial. The alga in the low nitrogen medium contained 37% less total amino acid than that in the high and standard nitrogen media. There was a slightly greater reduction in essential amino acids (40%) compared to non-essential amino acids (35%). Juvenile abalone feeding on Navicula grown in medium with low nitrate and lower total amino acid content grew more slowly than when fed on the same species grown in standard or higher nitrogen medium with a higher amino acid content. The growth rate of juveniles was highest (43 m d^–1) in the high nitrate treatment followed (40 m d^–1) by the standard nitrate treatment and lowest (31 m d^–1) in the low nitrate treatment. The survival of the juveniles was also effected by the diet. Survival was better in the high and standard nitrogen media (88%) than the low nitrogen medium (75%). The results suggest that in order to achieve uniformity in nutritional quality of diatoms and good growth of abalone juveniles in commercial abalone nurseries, the nitrogen concentration in tanks should be monitored and additional nitrate added to provide an optimum concentration of between 2 and 12 mg NO₃-N L^–1.     

Stimulation of renal amino acid reabsorption after treatment with triiodothyronine or dexamethasone in amino acid loaded rats

Summary In adult female anaestetized rats, the influence of triiodothyronine or dexamethasone on renal amino acid handling was investigated in leucine (20mg/100g b.wt.) or glutamine (45mg/100g b.wt.) loaded animals. Bolus injections of both amino acids were followed by temporary increase in fractional excretion of the administered amino acids as well of the endogenous amino acids which were not administered.Under load conditions (leucine and glutamine), dexamethasone treatment (60 g/100 g b.wt. for 3 days, i.p. once daily) was followed by a stimulation of renal amino acid reabsorption. The increase in fractional amino acid excretion after amino acid load was significantly lower than in untreated rats. The effect of triiodothyronine (20,g/1008 b.wt. for 3 days, i.p. once daily) was different in leucine and glutamine loaded animals: after leucine bolus injection a comparable stimulatory effect as shown for dexamethasone could be demonstrated, but after glutamine administration the stimulatory action of T3 was masked. T3 even increases fractional amino acid excretion in glutamine loaded rats as a sign of enhanced house-keeping in the renal tubular cells. These results confirm previous findings and indicate different effects of both hormones on the renal handling of amino acids.     

Structural organization of the human eukaryotic initiation factor 5A precursor and its site-directed variant Lys50 → Arg

Summary The molecular properties of the human eukaryotic initiation factor 5A precursor and its site directed Lys50 Arg variant have been investigated and compared. Structure perturbation methods were used to gain information about the protein architecture in solution. Intrinsic and extrinsic spectroscopic probes strategically located in the protein matrix detected the independent unfolding of two molecular regions. Three cystemes out of four were titrated in the native protein and the peculiar presence of a tyrosinate band at neutral pH was detected. At alkaline pH only two tyrosines out of three were titratable in the native protein, with an apparent pK of about 9.9. Native protein and its Lys50 Arg variant reacted in a similar fashion to guanidine and to pH variation, but differently to thermal stress. The complex thermal unfolding of both proteins indicated the presence of intermediates. Spectroscopic data showed that these intermediates are differently structured. Consequently, the two proteins seem to have different unfolding pathways.Abbreviations AEDANS acetyl-N-(8-sulpho-l-naphthyl) ethylene-diamine - CD circular dichroism - DTNB 5,5-dithiobis(2-nitrobenzoic acid) - molar extinction coefficient - molar extinction difference - eIF-5A eukaryotic initiation factor 5A, namely the hypusine-containing protein - eIF-5A precursor [or ec-eIF-5A(Lys)] eukaryotic initiation factor 5A precursor, i.e., the unmodified precursor form of eIF-5A produced inEscherichia coli by expression of human eIF-5AcDNA containing Lys in position 50 - GdnHCI guanidinium chloride - I-AEDANS N-iodo-AEDANS - N-AcCys-AEDANS N-acetylcysteine-AEDANS, Mr, relative molecular mass - ODU optical density unit - RMS root mean square - TrisHCl Tris (hydroxymethyl)amino-methane hydrochloride     

Proline metabolism in sepsis

Summary Sepsis is characterized by an abnormal increase in plasma proline (PRO) level, which tends to be related to the severity of disease. This study has been performed to assess the relationship between changes in plasma PRO and levels and doses of other amino acids (AA) in critically ill septic patients undergoing total parenteral nutrition (TPN).Sixteen septic patients receiving TPN were randomly divided into two groups: 8 patients (Group A) received TPN with a standard AA solution, and 8 patients (Group B) with a modified AA solution (isonitrogenous, branchedchain AA enriched, with unchanged PRO concentration). Serial determinations of plasma AA profiles and of other variables were performed in each patient for a total of 396 measurements. In Group A mean plasma PRO level was 372M/L; changes in PRO were tightly correlated with changes in the levels of most of the other AA, and the highest PRO levels characterized the more severely unbalanced septic metabolic profiles. In Group B, plasma levels of PRO and of the other AA (except glutamate, aspartate, taurine and the three branched-chain AA) decreased. The decrease in PRO level was well correlated with the increased branched-chain AA dose and with simultaneous decreases in plasma lactate and respiratory quotient. These changes could be related to a specific effect of branched-chain AA on septic metabolic derangement and on PRO metabolism, and to an improved balance between protein synthesis and catabolism.     

Synthesis of non-proteinogenic (D)- or (L)-amino acids by asymmetric hydrogenation

Summary Non-proteinogenic amino acids play an increasing role in oligopeptide chemistry. Their pharmacological and chemical properties, caused by D-configuration and unnatural residues, are more and more used for drug design. Different methods of asymmetric synthesis have been developed during the last decade to prepare unusual amino acids. One of them, the asymmetric hydrogenation of dehydroamino aids catalyzed by chiral rhodium (I) complexes, will be described. A series of examples, D- and L-configured, like naphthyl-, thienyl-, furyl-, and pyridylalanines, as well as phenylalanines substituted by chlorine, fluorine, p-nitro, p-methyl, p-trifluoromethyl, p-isopropyl, and p-tert-butyl have been prepared and characterized. Some analytical data like melting points and values of optical rotation are summarized in tables.Abbreviations (–)-DIOP (4R,5R)-4,5-Bis(diphenylphosphinomethyl)-2,2-dimethyl-1,3-dioxolane - (–)-BPPM (2S,4S)-N-tert-Butoxycarbonyl-4-diphenylphosphino-2-diphenylphosphinomethyl-pyrrolidine - Ph--glup Phenyl 4,6-O-(R)-benzylidene-2,3-O-bis(diphenylphosphino)--D-glucopyranoside - DuPHOS 1,2-bis-(phospholano)benzene - PROPRAPHOS 2,3-O,N-bis(diphenylphosphino)-1-(naphthoxy)-2-hydroxy-3-isopropylamino propane - PINDOPHOS 2,3-O,N-bis(diphenylphosphino)-1-(4-indolyloxy)-2-hydroxy-3-isopropylamino propane     

Simultaneous determination of the enantiomers of leucine and [H7]leucine in plasma by capillary gas chromatography–mass spectrometry

A method for the stereoselective assay of - and -enantiomers of both leucine and [²H₇]leucine in rat plasma was developed using gas chromatography–mass spectrometry–selected-ion monitoring. -[²H₃]leucine was used as an internal standard. The method involved purification by cation-exchange chromatography using BondElut SCX cartridge and derivatization with hydrochloric acid in methanol to form methyl ester followed by subsequent chiral derivatization with (+)-α-methoxy-α-trifluoromethylphenylacetyl chloride to form diastereomeric amide. The derivatization made the separation of the leucine enantiomers possible with good gas chromatographic behavior. Quantitation was performed by selected-ion monitoring of the quasi-molecular ions of the diastereomers on the chemical ionization method. The sensitivity, specificity, accuracy and reproducibility of the method were demonstrated to be satisfactory for application to pharmacokinetic studies of leucine enantiomers.     

Amino acid profiles in some scented rice varieties

Summary Twelve scented (basmati) and one non-scented variety were analysed for their amino acid composition. The essential amino acid profiles of scented varieties when compared with non-scented, revealed that these varieties exhibited higher values, which ranged from 2.82 to 4.86 gm/100 gm protein for lysine, 1.92 to 3.13 for methionine, 1.67 to 4.23 for tyrosine, 3.65 to 4.91 for phenylalanine, 5.50 to 8.95 for leucine, 2.25 to 3.40 for isoleucine, 2.84 to 3.46 for threonine, 3.36 to 5.33 for valine. When these values were compared to FAO recommended standards, it was observed that most of the scented varieties had comparable or superior values, while varieties such as, Type 3, Basmati sufaid 100, Likitimachi, Randhunipagalu and Basmati 370 showed superior lysine, phenylalanine, leucine, and methionine content. These observations suggest that the scented varieties posses better amino acid profiles and exhibit superior nutritional qualities, which could be utilised in breeding varieties with improved amino acid composition.     

The effect of a taurine-containing drink on performance in 10 endurance-athletes

Summary To determine the effect of a taurine-enriched drink Red Bull on performance, 10 endurance-athletes performed three trials. After 60 min. cycling at approximately 70% VO₂ max, the subjects pedalled to exhaustion on a cycle ergometer. During each exercise, the subjects received 500 ml of a test-drink after 30 min. submaximal cycling: Red Bull without taurine, without glucuronolacton (U1), Red Bull without taurine, without glucuronolacton, without caffeine (U2) and Red Bull original drink containing taurine, glucuronolacton and caffeine (U3).The heart rate level was significantly lower in U3 (p = 0,0031) 15 min. after application. The plasma catecholamines increased slightly from begin of exercise to 15 min. after application of the drinks in all trials but remained on a significantly lower level in U3 (epinephrine (p = 0,0011) and norepinephrine (p = 0,0003). Endurance time was significantly longer with Red Bull original in U3 (p = 0,015). The results of this study show a positive effect of a taurine-containing drink on hormonal responses which leads to a higher performance.     

Electric-field effects on gravikinesis in Paramecium

Equilibrated Paramecium caudatum cells exposed to a constant DC gradient reorient with their depolarized anterior ends toward the cathode (galvanotaxis). Voltage gradients were applied to cells swimming either horizontally or vertically. Their velocity and orientation were recorded and compared to unstimulated cells. The DC field increased the horizontal velocity (= reference) up to 175% (galvanokinesis). Swimming velocities saturated after 1 min and were unchanged during the following 4 min. The upward and downward swimming velocities of stimulated cells were below those of horizontal swimmers. The difference in vertical rates (determining gravikinesis) was independent of variations in absolute velocity. Normalization of vertical velocities to horizontal velocities (= 100%) separated DC-field dependent changes from gravity-induced changes in velocities. A weak voltage gradient (0.3 V/cm) was most effective in raising downward gravikinesis up to threefold (-202 m/s) above the unstimulated reference (-66 m/s) and to change sign of gravikinesis in upward swimmers (-43 m/s +33 m/s). We conclude that DC-field stimulation is equivalent to a depolarizing bias on gravikinetic responses of Paramecium. The stimulation does not directly interfere with mechanoreception, but modulates somatic Ca²⁺ entry to induce contraction of the cell soma. This presumably affects the gating of gravisensory transduction channels.     

Taurine transport systems in the ciliate protozoanTetrahymena pyriformis

Summary Tetrahymena pyriformis cultivated in the presence of 1 mM taurine prior to transfer of the cells to non-nutrient medium express an enhanced capacity for concentrative taurine uptake and for taurine diffusion compared to cells grown without added taurine. The unidirectional taurine influx in taurine-grown cells comprises a saturable component with K_m -257M, V_max = 21 n-moles · g dry wt^–1 sd min^–1, and a diffusion component with a diffusion constant of 0.20 ml · g dry wt^–1 · min^–1. At extracellular taurine concentrations <30M, 20% of the influx is via the saturable system and 80% is via the diffusion system. 19% of the influx in Na⁺-dependent, Cl^–-independent, and not inhibitable with structural analogues to taurine, suggesting that the transport system responsible for the saturable component in Tetrahymena is different from the Na⁺- and Cl^–-dependent taurine translocating system (the-system) described in vertebrate cells. The unidirectional taurine influx is reduced by 80% by 1mM DIDS (inhibitor of anion exchange and anion channels) and by 1 mM MK196 (indachrinone, inhibitor of anion channels) indicating that taurine diffusion inTetrahymena is via a channel, which is permanently active and which resembles the swelling-induced taurine channel seen in mammalian cells. Taurine influx is stimulated by the forskolin analogue 1,9-dideoxyforskolin and by arachidonic acid, and this stimulation is in both cases sensitive to DIDS and MK196.Abbreviations DDF dideoxyforskolin - DIDS 4,4-diisothiocyano-2,2-stilbene disulfonic acid - GABA gamma amino butyric acid - HEPES N(2-hydroxyethyl)piperazine-N-(2-ethane sulfonic acid) - MK196 indachrinone - MOPS 3-(N-morpholino)propane sulfonic acid - NMDG n-methyl-dglucamonium - OPA ortho-phtalaldehyde - PCA perchloric acid - TES N-tris(hydroxy methyl)-methyl-2-amino ethane sulfonic acid - TRIS tris(hydroxy methyl)amino methane     

Epidermal growth factor (EGF) increases the renal amino acid transport capacity in amino acid loaded rats

Summary In anaesthetized adult female rats, the influence of epidermal growth factor (EGF) on renal amino acid handling was investigated in glutamine, arginine (both 50 mg/100 g b. wt. per hour), or alanine (90 mg/ 100 g b. wt. per hour) loaded animals. Continuous infusions of the three amino acids were followed by an increase in the fractional excretion (FE) of the administered amino acids as well as of the other endogenous amino acids. Under load conditions (alanine, arginine or glutamine), EGF pretreatment (8g/100g b. wt. subcutaneously for 8 days, twice daily 8 a.m. and 4 p.m.) was followed by a stimulation of renal amino acid reabsorption. The increase in the fractional excretion of the administered amino acids was significantly lower than in non-EGF-treated rats. These changes in amino acid transport were connected with a significant reduction of GFR after EGF pretreatment (0.96 ± 0.10 vs. 0.62 ± 0.07 ml/min X 100 g b. wt.) and a distinct increase in sodium excretion (2.98 ± 0.55 vs. 4.97 ± 0.71val/100 g b. wt. X 20 min). After loading with p-aminohippurate (PAH; 200mg/100g b. wt.), PAH excretion in EGF rats was increased by about 20%, whereas urinary protein excretion was lower in EGF pretreated rats (control: 0.45 ± 0.04 vs. EGF: 0.18 ± 0.03 mg/ 100 g b. wt. X 20 min). The PAH load reduced amino acid reabsorption as a sign of overloading of renal tubular transport capacity, but in EGF pretreated animals the amino acid excretion was only slightly increased under these conditions. Furthermore, EGF pretreatment depressed normal kidney weight gain significantly (874 ± 18 vs. 775 ± 32mg/100g b. wt.). EGF can improve the renal tubular transport capacity, but, compared to well-known stimulators of renal transport like dexamethasone or tri-iodothyronine, its effect is only of a moderate degree.     

Production of polyclonal antibodies towards the immunodetection of insecticide phosalone

Summary Hapten synthesis for the production of specific insecticide phosalone polyclonal antibodies was carried out starting from an intermediate of the phosalone synthesis, 6-chloro-2-benzoxazolone1. Two haptens containing different spacers have been prepared: N-5-carboxypentyl-6-chloro-2-benzoxazolone7 and N-(2-oxo-3-aza-5-carboxypentyl)-6-chloro-2-benzoxazolone12. Each of these two haptens conjugated to bovine serum albumine (BSA) was used to immunize four rabbits. Immunoassays of phosalone were performed with ELISA using solid-phase bound hapten thyroglobulin conjugate and horseradish peroxidase labelled goat antirabbit IgG. The more sensitive response was observed when the antiserum obtained from the rabbit immunized with the hapten-BSA conjugate containing the N-2-oxo-3-aza-5-carboxypentyl spacer was in competition with the same hapten coupled to thyroglobulin. An identical response was obtained under the same conditions when using benzoxazolone instead of phosalone as competitor, showing a good recognition of the specific aromatic part of the organophosphate insecticide phosalone. Reduction of coating conjugate concentration (from 2 to 0.05g/well) and also the use of heterologous coating protein instead of homologous did improve the sensitivity, resulting in a concentration of phosalone required to inhibit binding by 50% of 2 mg/l and a detection limit of 0.02 mg/l.     

Fixed-bed dialysis culture of a transfectoma cell line producing chimeric Fab-fragments with “nutrient-split”-feeding strategy

The very shear sensitive transfectoma cell line, FAB 10, producing a chimeric Fab-antibody fragment specific for the human carcinoembryonic antigen (CEA), was cultivated in fixed bed reactors where the cells were immobilized in macroporous carriers. As the cell line had a very low productivity, cultures with process integrated product enrichment were performed in a membrane dialysis bioreactor with integrated fixed bed, where low molecular weight metabolites are removed over the membrane and high molecular weight products are enriched. In a new nutrient-split feeding strategy for dialysis cultures concentrated medium was supplied directly to the fixed bed unit, whereas a buffer solution was used as dialysis fluid. With the dialysis technique up to 5800 g Fab l–1 could be obtained, more than 10 times higher compared to fixed bed cultures without dialysis or batch cultures with suspended cells. The nutrient-split-feeding strategy reduced the amount of medium required per mg of antibody significantly. © Rapid Science Ltd. 1998     

Urinary mercury levels in females: Influence of skin-lightening creams and dental amalgam fillings

The influence of application of skin-lightening creams and dental amalgam fillings on the urinary mercury (Hg) level was evaluated in 225 females (ages 17 to 58 years) living in Riyadh, capital of Saudi Arabia. The arithmetic mean of the urinary Hg level was 6.96 ± 20.43 g l, in the range 0 to 204.8 g l. The mean urinary Hg level adjusted by creatinine (Cr) was 11.22 ± 37.23 g g Cr, in the range 0 to 459.37 g g. No significant difference in urinary Hg was noted between the females regarding the use of skin-lightening creams. On the other hand, results showed that urinary Hg concentration was influenced by the use and number of dental amalgam fillings. No women were identified with symptoms or signs that could be attributed to Hg intoxication. Urine analyses for creatinine, urea, uric acid, phosphorus, magnesium, glucose and calcium showed significant correlation with urinary Hg. This suggests that chronic exposure to Hg may be associated with a deterioration of renal function.     

Effect of Dialysis Initiation Timing on Clinical Outcomes: A Propensity-Matched Analysis of a Prospective Cohort Study in Korea

Background

Controversy persists regarding the appropriate initiation timing of renal replacement therapy for patients with end-stage renal disease. We evaluated the effect of dialysis initiation timing on clinical outcomes. Initiation times were classified according to glomerular filtration rate (GFR).

Methods

We enrolled a total of 1691 adult patients who started dialysis between August 2008 and March 2013 in a multi-center, prospective cohort study at the Clinical Research Center for End Stage Renal Disease in the Republic of Korea. The patients were classified into the early-start group or the late-start group according to the mean estimated GFR value, which was 7.37 ml/min/1.73 m². The primary outcome was patient survival, and the secondary outcomes were hospitalization, cardiovascular events, vascular access complications, change of dialysis modality, and peritonitis. The two groups were compared before and after matching with propensity scores.

Results

Before propensity score matching, the early-start group had a poor survival rate (P<0.001). Hospitalization, cardiovascular events, vascular access complications, changes in dialysis modality, and peritonitis were not different between the groups. A total of 854 patients (427 in each group) were selected by propensity score matching. After matching, neither patient survival nor any of the other outcomes differed between groups.

Conclusions

There was no clinical benefit after adjustment by propensity scores comparing early versus late initiation of dialysis.