Diabetes and high blood pressure can lead to impaired renal function and even to complete kidney failure in the end. This is a life-threatening situation for the people concerned.
They need to undergo dialysis treatment regularly, but the artificial blood filtration can only replace about 10 percent of normal renal function. Therefore, dialysis patients cannot consider themselves out of danger until they receive a kidney transplant. Due to the scarce supply of donor organs, however, not everyone is fortunate enough to get a transplant.
Why is it that kidney failure has such fatal consequences? The reason lies in the fact that the waste products, which should be excreted from the body via the urine, then accumulate in the blood. This increases the risk of additional conditions, such as atherosclerosis (formation of plaques in the arteries), heart attacks and strokes.
Harmless urea gives rise to the generation of toxic cyanate
In patients with kidney disease, one of the substances accumulating in the blood is urea, an originally harmless metabolic waste product. "However, urea can be converted in the body to a toxic cyanate, which binds to the blood proteins," explains Christiane Drechsler, a medical scientist at the Department of Nephrology of the University Hospital of Würzburg.
The dangerous cyanate also binds to albumin, which is one of the most important blood proteins. This has drastic consequences: The carbamylated albumin – as the modified albumin is known by scientists – now tends to stick to defective parts in the blood vessels. This aggravates the process of atherosclerosis, thus further reducing the survival chances of dialysis patients.
Amino acids can decrease the risk
"We have found a significant correlation: A higher amount of carbamylated albumin in the blood is associated with reduced survival chances of the respective patients," says Christiane Drechsler. The concentration of the dangerous albumin, in turn, increases with decreasing amino acid levels in the blood. This is because cysteine, histidine, lysine and some other amino acids are obviously able to inhibit the formation of the "high-risk albumin" – as has also been demonstrated by the Würzburg scientists and their colleagues from Boston (USA). The study evaluated data on 1,255 dialysis patients.
Pilot study with 200 patients planned
The results are published in the current issue of the journal "Science Translational Medicine". They open up the prospect of a new therapeutic approach that might be used to increase the life expectancy of kidney and dialysis patients: The administration of amino acids as a preventive measure. "We are now going to determine whether this method works in a pilot study currently in preparation, involving about 200 dialysis patients," says Professor Christoph Wanner, who heads the Department of Nephrology at the University Hospital of Würzburg.
The three main application possibilities yielded by the study
The study of the Würzburg and Boston researchers not only points to a new way of improving the survival rates of dialysis patients. It also provides two further benefits, as Christiane Drechsler explains: "The carbamylated albumin is a suitable candidate to serve as a prognostic marker in diagnostics. Furthermore, it might become a marker for assessing the quality of dialysis treatment over prolonged periods of time – similar to the HbA1c-test for diabetics."
"Carbamylation of Serum Albumin as a Risk Factor for Mortality in Patients with Kidney Failure", Anders H. Berg, Christiane Drechsler, Julia Wenger, Roberto Buccafusca, Tammy Hod, Sahir Kalim, Wenda Ramma, Samir M. Parikh, Hanno Steen, David J. Friedman, John Danziger, Christoph Wanner, Ravi Thadhani, S. Ananth Karumanchi. Science Translational Medicine, 6 March 2013, Vol. 5 Issue 175, p. 175ra29, DOI: 10.1126/scitranslmed.3005218
Dr. Dr. Christiane Drechsler, Department of Internal Medicine I, University Hospital of Würzburg, T (0931) 201-39972, email@example.com
Robert Emmerich | Uni Würzburg
Researchers identify potentially druggable mutant p53 proteins that promote cancer growth
09.12.2016 | Cold Spring Harbor Laboratory
Plant-based substance boosts eyelash growth
09.12.2016 | Fraunhofer-Institut für Angewandte Polymerforschung IAP
Physicists of the University of Würzburg have made an astonishing discovery in a specific type of topological insulators. The effect is due to the structure of the materials used. The researchers have now published their work in the journal Science.
Topological insulators are currently the hot topic in physics according to the newspaper Neue Zürcher Zeitung. Only a few weeks ago, their importance was...
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
09.12.2016 | Life Sciences
09.12.2016 | Ecology, The Environment and Conservation
09.12.2016 | Health and Medicine