-
PDF
- Split View
-
Views
-
Cite
Cite
Guillaume Chazot, Sandrine Lemoine, Gabriel Kocevar, Emilie Kalbacher, Laetitia Gabrielle NORMAND, Dominique Sappey-Marinier, Olivier Rouviere, Laurent Juillard, FO002
INTRACELLULAR ATP AND INORGANIC PHOSPHATE DEPLETION DURING MAINTENANCE HEMODIALYSIS, Nephrology Dialysis Transplantation, Volume 34, Issue Supplement_1, June 2019, gfz107.FO002, https://doi.org/10.1093/ndt/gfz107.FO002Close - Share Icon Share
INTRODUCTION: The origin of depurated phosphate during hemodialysis (HD) remains unknown. Using phosphorus magnetic resonance spectroscopy (31P-MRS), we previously showed in an acute kidney failure model in pig, an increase of intracellular inorganic phosphate (Pi) concentration during hemodialysis associated with a decrease in ATP. This result strongly supports the hypothesis that depurated phosphate could come from the intracellular space. The aim of this study was to measure intracellular Pi in patients during maintenance HD using 31P-MRS.
METHODS: Eleven maintenance HD patients were included in the CIPHEMO study, a single-center prospective trial. They underwent a 31P-MRS exam using a 3-Tesla system and a surface coil placed over the calf muscle region for measuring Pi and ATP contents during a standard hemodialysis session (4 hours). 31P-MR spectra were acquired before, during (every 152 seconds) and after the HD session. Phosphatemia, depurated phosphate and calcemia were monitored during HD and parathyroid hormone levels were measured at the beginning and at the end of the session. Calcium balance was also measured.
RESULTS: During the first hour of HD, phosphatemia decreased rapidly (-41%, p<0.001) whereas intracellular Pi didn’t change (p=0.9). After 1 hour of HD, phosphatemia decreased slowly, intracellular Pi decreased (p=0.001). PCr/βATP increased significantly during the HD session (+31%, p=0.001). PCr/βATP seems to display a biphasic evolution. Depurated phosphate is nearly constant during the session. Calcemia increased (p<0.01) and parathyroid hormone decreased (p<0.05) during HD. Calcium balance is positive (mean of 17.1 mmol).
CONCLUSIONS: This study showed a significant decrease in both intracellular ATP and Pi during hemodialysis. These findings, reported for the first time in HD patients, support the hypothesis that a large part of depurated phosphate could come from the intracellular space in patients on maintenance hemodialysis.
Comments