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, firstname.lastname@example.org
Robert Emmerich | Source: Uni Würzburg
Further information: www.uni-wuerzburg.de
Further Reports about: amino acid > blood flow > blood protein > blood vessel > Dialysis > dialysis patients > dialysis treatment > kidney disease > kidney failure > Medicine > Nephrology > Protein > Translational Medicine > Translational Research
More articles from Life Sciences:
Tokyo Institute of Technology research: An insight into cell survival
17.05.2013 | Tokyo Institute of Technology
Asian lady beetles use biological weapons against their European relatives
17.05.2013 | Max-Planck-Institut für chemische Ökologie
Researchers have shown that, by using global positioning systems (GPS) to measure ground deformation caused by a large underwater earthquake, they can provide accurate warning of the resulting tsunami in just a few minutes after the earthquake onset.
For the devastating Japan 2011 event, the team reveals that the analysis of the GPS data and issue of a detailed tsunami alert would have taken no more than three minutes. The results are published on 17 May in Natural Hazards and Earth System Sciences, an open access journal of ...
A new study of glaciers worldwide using observations from two NASA satellites has helped resolve differences in estimates of how fast glaciers are disappearing and contributing to sea level rise.
The new research found glaciers outside of the Greenland and Antarctic ice sheets, repositories of 1 percent of all land ice, lost an average of 571 trillion pounds (259 trillion kilograms) of mass every year during the six-year study period, making the oceans rise 0.03 inches (0.7 mm) per year. ...
About 99% of the world’s land ice is stored in the huge ice sheets of Antarctica and Greenland, while only 1% is contained in glaciers.
However, the meltwater of glaciers contributed almost as much to the rise in sea level in the period 2003 to 2009 as the two ice sheets: about one third. This is one of the results of an international study with the involvement of geographers from the University of Zurich.
Second sound is a quantum mechanical phenomenon, which has been observed only in superfluid helium.
Physicists from the University of Innsbruck, Austria, in collaboration with colleagues from the University of Trento, Italy, have now proven the propagation of such a temperature wave in a quantum gas. The scientists have published their historic findings in the journal Nature.
Below a critical temperature, certain fluids become superfluid ...
Researchers use synthetic silicate to stimulate stem cells into bone cells
In new research published online May 13, 2013 in Advanced Materials, researchers from Brigham and Women's Hospital (BWH) are the first to report that synthetic silicate nanoplatelets (also known as layered clay) can induce stem cells to become bone cells without the need of additional bone-inducing factors.
Synthetic silicates are made ...
17.05.2013 | Physics and Astronomy
17.05.2013 | Physics and Astronomy
17.05.2013 | Physics and Astronomy
17.05.2013 | Event News
15.05.2013 | Event News
08.05.2013 | Event News