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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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