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Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism—A Targeted Metabolomics Approach
Acetate is widely used as a dialysate buffer to avoid the precipitation of bicarbonate salts. However, even at low concentrations that wouldn’t surpass the metabolic capacity of the Krebs tricarboxylic acid (TCA) cycle, other metabolic routes are activated, leading to undesirable clinical consequenc...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569767/ https://www.ncbi.nlm.nih.gov/pubmed/36232995 http://dx.doi.org/10.3390/ijms231911693 |
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author | Broseta, José Jesús Roca, Marta Rodríguez-Espinosa, Diana López-Romero, Luis Carlos Gómez-Bori, Aina Cuadrado-Payán, Elena Devesa-Such, Ramón Soldevila, Amparo Bea-Granell, Sergio Sánchez-Pérez, Pilar Hernández-Jaras, Julio |
author_facet | Broseta, José Jesús Roca, Marta Rodríguez-Espinosa, Diana López-Romero, Luis Carlos Gómez-Bori, Aina Cuadrado-Payán, Elena Devesa-Such, Ramón Soldevila, Amparo Bea-Granell, Sergio Sánchez-Pérez, Pilar Hernández-Jaras, Julio |
author_sort | Broseta, José Jesús |
collection | PubMed |
description | Acetate is widely used as a dialysate buffer to avoid the precipitation of bicarbonate salts. However, even at low concentrations that wouldn’t surpass the metabolic capacity of the Krebs tricarboxylic acid (TCA) cycle, other metabolic routes are activated, leading to undesirable clinical consequences by poorly understood mechanisms. This study aims to add information that could biologically explain the clinical improvements found in patients using citrate dialysate. A unicentric, cross-over, prospective targeted metabolomics study was designed to analyze the differences between two dialysates, one containing 4 mmol/L of acetate (AD) and the other 1 mmol/L of citrate (CD). Fifteen metabolites were studied to investigate changes induced in the TCA cycle, glycolysis, anaerobic metabolism, ketone bodies, and triglyceride and aminoacidic metabolism. Twenty-one patients completed the study. Citrate increased during the dialysis sessions when CD was used, without surpassing normal values. Other differences found in the next TCA cycle steps showed an increased substrate accumulation when using AD. While lactate decreased, pyruvate remained stable, and ketogenesis was boosted during dialysis. Acetylcarnitine and myo-inositol were reduced during dialysis, while glycerol remained constant. Lastly, glutamate and glutarate decreased due to the inhibition of amino acidic degradation. This study raises new hypotheses that need further investigation to understand better the biochemical processes that dialysis and the different dialysate buffers induce in the patient’s metabolism. |
format | Online Article Text |
id | pubmed-9569767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-95697672022-10-17 Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism—A Targeted Metabolomics Approach Broseta, José Jesús Roca, Marta Rodríguez-Espinosa, Diana López-Romero, Luis Carlos Gómez-Bori, Aina Cuadrado-Payán, Elena Devesa-Such, Ramón Soldevila, Amparo Bea-Granell, Sergio Sánchez-Pérez, Pilar Hernández-Jaras, Julio Int J Mol Sci Article Acetate is widely used as a dialysate buffer to avoid the precipitation of bicarbonate salts. However, even at low concentrations that wouldn’t surpass the metabolic capacity of the Krebs tricarboxylic acid (TCA) cycle, other metabolic routes are activated, leading to undesirable clinical consequences by poorly understood mechanisms. This study aims to add information that could biologically explain the clinical improvements found in patients using citrate dialysate. A unicentric, cross-over, prospective targeted metabolomics study was designed to analyze the differences between two dialysates, one containing 4 mmol/L of acetate (AD) and the other 1 mmol/L of citrate (CD). Fifteen metabolites were studied to investigate changes induced in the TCA cycle, glycolysis, anaerobic metabolism, ketone bodies, and triglyceride and aminoacidic metabolism. Twenty-one patients completed the study. Citrate increased during the dialysis sessions when CD was used, without surpassing normal values. Other differences found in the next TCA cycle steps showed an increased substrate accumulation when using AD. While lactate decreased, pyruvate remained stable, and ketogenesis was boosted during dialysis. Acetylcarnitine and myo-inositol were reduced during dialysis, while glycerol remained constant. Lastly, glutamate and glutarate decreased due to the inhibition of amino acidic degradation. This study raises new hypotheses that need further investigation to understand better the biochemical processes that dialysis and the different dialysate buffers induce in the patient’s metabolism. MDPI 2022-10-02 /pmc/articles/PMC9569767/ /pubmed/36232995 http://dx.doi.org/10.3390/ijms231911693 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Broseta, José Jesús Roca, Marta Rodríguez-Espinosa, Diana López-Romero, Luis Carlos Gómez-Bori, Aina Cuadrado-Payán, Elena Devesa-Such, Ramón Soldevila, Amparo Bea-Granell, Sergio Sánchez-Pérez, Pilar Hernández-Jaras, Julio Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism—A Targeted Metabolomics Approach |
title | Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism—A Targeted Metabolomics Approach |
title_full | Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism—A Targeted Metabolomics Approach |
title_fullStr | Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism—A Targeted Metabolomics Approach |
title_full_unstemmed | Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism—A Targeted Metabolomics Approach |
title_short | Impact of Acetate versus Citrate Dialysates on Intermediary Metabolism—A Targeted Metabolomics Approach |
title_sort | impact of acetate versus citrate dialysates on intermediary metabolism—a targeted metabolomics approach |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569767/ https://www.ncbi.nlm.nih.gov/pubmed/36232995 http://dx.doi.org/10.3390/ijms231911693 |
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