Serum Glycosylated Albumin and Fructosamine in Patients with Chronic Renal Failure Undergoing Dialysis / 대한신장학회잡지

ABSTRACT

Glucose intolerance commonly occurs in patients with renal failure undergoing hemodialysis. whether this mild glucose intolerance contributes to pathogenesis of uremic complication in unknown. Abnormally elevated levels of Hb A1 have been reported in patients with chronic renal failure, whether or not they were undergoing hemodialysis. However serum levels of glycosylated albumin and fructosamine were not evaluated well. Our study was designed to examine fructosamine and glycosylated albumin to assess non-enzymatic glycosylation in patients with chronic renal failure undergoing maintenance dialysis(15 CAPD and 35 hemodialysis patients) and 33 healthy control subjects. Serum fructosamine levels were high in the hemodialysis patients(391.00+/-128.43micromol/L, P<0.05) than control(268.91+/-58.31micromol/L) and CAPD patients(267.7+/-41.27micromo/L). And serum glycosylated albumin levels were also high in the hemodialysis patients(240.40+/-43.99micromol/L, P<0.05) than control (146.22+/-24.88micromol/L) and CAPD patients(172.3+/-42.89micromol/L). After correction for serum albumin concentration, glycosylated albumin was raised in hemodialysis patients(6365.74+/-1307.98micromol/g, P< 0.05) compare with control subject(3259.74+/-581.07micromol/g) and CAPD patients(4988.13+/-1316.47micromol/g). And after correction for serum albumin or protein , fructosmaine was raised in the hemodialysis patients (10282.06+/-3927.37, 3760.00+/-12600.00micromol/g, respectively, P<0.05) compared with control(5705.81+/-1411.36, 1906.67+/-6869.50micromol/g, respectively) and CAPD patients(7752.33+/-2260.16, 869.05+/-5919.35micromol/ g, respectively) This result suggest that dialysis patients have increased protein glycosylation especially in case of hemodialysis patients, most likely reflecting increased non-enzymatic glycosylation of serum protein by impaired glucose tolerance.