Huberts, M. (Marleen) (2016) Een Pilotstudy naar de tryptofaan balans bij dialysepatienten : Inname van tryptofaan met de voeding, verwijdering door de dialyse behandeling en de relatie tussen ontstekingsmarkers en afbraakprodukten van tryptofaan. thesis, Medicine.
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Abstract
Background: Depression is common among dialysis patients. Tryptophan (TRP)-deficiency may be a treatable factor. TRP is the precursor of the mood regulator serotonin. Dialysis patients have decreased TRP levels. The cause of this is unknown but reduced nutritional intake, loss with dialysis, and increased catabolism of TRP in the setting of inflammation are likely contributors. Inflammation is associated with increased degradation of TRP because of induction of IDO and TDO that catabolize TRP to kynurenine (KYN) resulting in reduced availability of TRP for serotonin production. Methods: In 20 hemodialysis (HD) and 6 peritoneal dialysis (PD) patients, the TRP balance was investigated with estimation of intake of TRP by a 5-day food diary and removal of TRP by measurement of TRP in dialysis fluid and urine. Blood concentrations of TRP, KYN, CRP and IL-6 were determined and were compared with healthy controls from previous studies. Results: The average age was 64±12 years; 65% was male. Plasma TRP concentrations were decreased, KYN and the KYN/TRP ratio were increased. The intake of TRP (91,9±231,2 mg/24h) was higher than the recommended daily requirement (RDR) (250-425 mg). TRP was removed by both HD (42,8±13,3 mg/24h) and PD (14,5±5 mg/24h), but the average total loss was only <5% of the RDI. KYN/TRP correlated with serum IL-6 (R=0,42 p=0,03). Conclusion: Plasma levels of TRP are reduced in dialysis patients. The intake of TRP is higher than the RDR and removal of TRP with dialysis is limited. The significant correlation between IL-6 and KYN/TRP suggests that inflammation-related catabolism of TRP in the KYN pathway is a major factor in the TRP deficiency of dialysis patients.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Onder begeleiding van and Franssen dr. C.F.M. en and Bakker, prof dr. S.J.L. and Interne geneeskunde, nefrologie UMCG / DCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/746 |
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