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Abstract: PO1053

Metabolomic Analysis Fails to Identify Uremic Solutes Associated with Pruritus in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Bolanos, Christian G., Stanford University, Stanford, California, United States
  • Pham, Nhat M., Santa Clara Valley Medical Center, San Jose, California, United States
  • Stedman, Margaret R., Stanford University, Stanford, California, United States
  • Meyer, Timothy W., Stanford University, Stanford, California, United States
  • Sirich, Tammy L., Stanford University, Stanford, California, United States
Background

Uremic pruritus is a debilitating symptom in hemodialysis (HD) patients. That uremic solutes contribute to pruritus is suggested by the improvement after transplantation. We aimed to identify solutes associated with pruritus using metabolomic analysis comparing plasma of HD patients with severe pruritus and mild/no pruritus.

Methods

Plasma and ultrafiltrate (UF) samples from 12 HD patients with severe pruritus (Itch) and 24 HD patients with mild/no pruritus (No Itch) were analyzed. Pruritus was assessed using a 100-mm visual analogue scale with severe defined as >70 mm and mild/no defined as <10 mm. Plasma and UF were analyzed using a metabolomics platform (Metabolon Inc.). Solutes were first identified as uremic based on the finding of higher average peak areas in all 36 HD patients than in 16 controls with normal kidney function. Solutes were deemed uremic if their HD/control ratio was >4 in plasma and/or UF with a false discovery rate of <0.05. Peak areas of each solute in the Itch and No Itch HD patients were then compared to identify uremic solutes associated with pruritus.

Results

HD vintage, spKt/Vurea, and lab values were similar in both groups (Table). Metabolomic analysis identified 593 uremic solutes. No difference in the levels of these uremic solutes was found between the Itch and No Itch patients using a false discovery rate < 0.05 (Figure).

Conclusion

Metabolomic analysis did not reveal any uremic solutes associated with pruritus in HD patients. The role of uremic solutes in pruritus remains to be established.

Characteristics
 Itch (12)No Itch (24)
Visual analogue scale (mm)87± 91.5 ± 2
HD vintage (yrs)7 ± 37 ± 5
spKt/Vurea1.56 ± 0.131.61 ± 0.21
Phos (mg/dl)5.1 ± 1.76.0 ± 2.2
Ca (mg/dl)9.1 ± 0.99.0 ± 0.9
PTH (pg/ml)364 ± 236363 ± 227

Funding

  • Veterans Affairs Support