血液透析中の慢性腎不全患者の血中T4及び3, 3'-T2濃度遊離脂肪酸の影響について

概要

論文の詳細を見る
To evaluate the influence of hemodialysis on the determinations of iodothyronine concentrations, serum and plasma concentrations of thyroxine (T4), 3, 5, 3'-triiodothyronine (T3), 3, 3', 5'-triiodothyronine (rT3), and 3, 3'-diiodothyronine (3, 3'-T2), as well as total protein and non-esterified fatty acids (NEFA), were determined in 8 patients with chronic renal failure on hemodialysis. Serum samples were taken before the regular dialysis, and plasma samples during the dialysis were taken about 10 minutes after the beginning and just before the end of dialysis. T4 was determined by competitive protein binding assay (CPBA) and radioimmunoassay (RIA), and T3 rT3 and 3, 3'-T2 levels were determined by RIA. Total protein concentrations were 7.0 ± 0.1 (mean ± SE) g/dl before the dialysis, decreased to 6.3 ± 0.3 g/dl about 10 minutes after the beginning of the dialysis, and then increased to 8.8 ± 0.4 g/dl at the end of the dialysis. Therefore, plasma NEFA and iodothyronine concentrations during dialysis were corrected by the protein concentration to avoid the effect of hemodilution or hemoconcentration. Serum concentrations of T4-RIA, T4-CPBA, T3 and rT3 in patients with chronic renal failure were 6.4 ± 0.6 μg/dl, 6.9 ± 1.1 μg/di, 58 ± 4.9 ng/dl, and 16.8 ± 1.4 ng/dl, respectively; these values were all significantly lower than the normal controls. Serum 3, 3-T2 concentrations (7.5 ± 0.7 ng/dl) were, however, significantly higher than the normal controls. Plasma concentrations of T4 determined by CPBA were markedly increased at the beginning of the dialysis (12.5 ± 1.2 μg/dl), whereas T4-RIA levels were essentially constant during the dialysis. Plasma T4 concentrations were not affected by the single dialysis. But plasma rT3 concentrations were slightly decreased at the beginning and returned to the predialysis level at the end of the dialysis. Plasma 3, 3'-T2 concentrations were increased at the beginning of the dialysis (9.4 ± 1.0 ng/dl). Plasma NEFA concentrations were also increased at the beginning of the dialysis (from 510 ± 92 to 2453 ± 385 μM), and a positive correlation was observed between the increment of NEFA and that of T4-CPBA or 3, 3'-T2. Furthermore, when more than 2 mM of sodium oleate was added to the pooled serum before the determinations of T4 -CPBA, T4 -RIA, T3, rT3 and 3, 3'-T2, marked elevations of T4-CPBA and 3, 3'-T2 (RIA) levels were observed. T3-RIA levels were also increased to the extent of 40% when sodium oleate was added to give the final concentration of 8 mM. No significant influences were observed on T4-RIA and rT3 (RIA). These data confirm the previous report that NEFA falsely increase the T4 concentrations as determined by CPBA in patients on hemodialysis and indicate that NEFA can significantly affect the T3 and 3, 3'-T2 concentrations determined by RIA.
日本内分泌学会の論文

血液透析中の慢性腎不全患者の血中T<SUB>4</SUB>及び3, 3'-T<SUB>2</SUB>濃度遊離脂肪酸の影響について

スポンサーリンク

概要

著者

関連論文

スポンサーリンク