Abstract: FR-PO0105
Ergothioneine Depletion by Continuous Kidney Replacement Therapy
Session Information
- AKI: Epidemiology and Clinical Trials
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Vasquez Espinosa, William Andres, Stanford University, Stanford, California, United States
- Lee, Seolhyun, Stanford University, Stanford, California, United States
- Suba, Josef Karoly, Stanford University, Stanford, California, United States
- Keo, Lindsey, 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
Ergothioneine (Ergo) is a diet-derived compound with mass 229 Da and notable antioxidant properties. A highly specific membrane transporter SLC22A4 reabsorbs Ergo from the glomerular filtrate and facilitates its uptake into tissues where it exerts antioxidant effects. We previously found that plasma Ergo levels are markedly reduced in hemodialysis (HD) patients due to rapid clearance of Ergo by HD. Continuous kidney replacement therapy (CKRT) provides higher time-averaged clearances of small solutes than HD. This study examined whether Ergo is depleted in patients with acute kidney injury (AKI) who receive CKRT.
Methods
Plasma Ergo levels were assessed in three groups: 1) 9 patients with AKI who initiated CKRT; 2) 16 critically ill patients without AKI, and 3) 15 healthy controls. Plasma Ergo levels in the AKI patients were measured before starting CKRT and 86±22 hours later when the CKRT dose was 27±2 ml/kg/hr. Ergo levels were measured in the CKRT effluent to confirm its clearance by CKRT.
Results
Compared to control subjects, plasma Ergo levels were depleted in critically ill subjects with and without AKI (Table). There was a trend towards reduction of Ergo levels after initiating CKRT in the AKI subjects (0.96±1.1 vs. 0.58±0.39 μM, p 0.065). The clearance of Ergo by CKRT averaged 32±10 mL/min leading to removal of 6.2±3.4 mg of Ergo per day.
Conclusion
Plasma Ergo levels were low in critically ill subjects. Initiation of CKRT may lead to further reduction in Ergo levels in subjects with AKI. Additional studies are needed to test whether Ergo depletion has adverse effects in critical illness.
Table - Subject Characteristics and Solute Levels
| AKI (n=9) | Critically Ill (n=16) | Controls (n=15) | ||
| Pre-CRRT | Post-CRRT (86±22 hours) | |||
| Cardiovascular Sequential Organ Failure Assessment (SOFA) Score | 2.9 ± 0.6 | - | 2.5 ± 1.0 | n/a |
| Plasma creatinine (mg/dL) | 3.5 ± 1.5a,b | 1.8 ± 0.8c | 0.80 ± 0.16 | 0.92 ± 0.21 |
| Plasma Ergothioneine (μM) | 0.96 ± 1.1a | 0.58 ± 0.39 | 0.90 ± 0.86a | 2.3 ± 1.7 |
AKI pre-CKRT, Critically Ill, and Controls were compared using the Tukey method with Bonferroni adjustment. a p<0.05, vs. Control; b p<0.05, vs. Critically Ill. AKI pre- and post-CKRT were compared using the paired t-test. c p<0.05, AKI pre- vs. post-CKRT.