부산대학교 도서관

Indoxyl sulfate (IS) and hippuric acid (HA) in plasma from 38 patients with chronic renal failure receiving maintenance hemodialysis (HD patients), 4 patients with moderately advanced renal failure (Ccr 50-60ml/min) and 4 nomal subjects were analyzed by means of high-performance liquid chromatography. For the HD patients, IS and HA in both red blood cells and dialysate, as well as in plasma, were quantified. The clearance and reduction rates of IS and HA by various types of dialyzer including a high-flux (high-performance) membrane, and their predicted and measured amounts removed were calculated.The plasma levels of IS and HA were 2.81±1.48mg/dl and 4.05±1.07mg/dl, respectively, being 30-60 times and 10-20 times as much as in normal subjects, respectively.The clearance rates of IS and HA by conventional dialysis membrane were 13-17ml/min and 60-80ml/min, respectively, at an ultrafiltrationrate of 0ml/min, The clearance of IS was increased by using an ultrafiltration technique with a high-flux membrane (high-performance membrane, HPM).The actually measured amounts of IS and HA removed by hemodialysis were larger than the predicted amounts, although the difference was not significant. This suggests that IS on red blood cells might be released relatively easily from their surface or intesior probably by interaction with the dialysis membrane, and further precise studies will be necessary in order to obtain a conclusive result.From these results, it is concluded that IS and HA are significantly and markedly accumulated in the body fluid of patients with severe uremia, and that IS might be removed most effectively by hemodiafiltration with HPM.The clearance of HA was compatible with the predicted value calculated on the basis of its molecular weight, which was contrary to our initial expectation at the start of the present study.