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Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis

Dissertation (MSc)--University of Pretoria, 2008.

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Other Authors: Viljoen, Margaretha
Format: Thesis
Published: University of Pretoria 2013
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access_status_str Open Access
author2 Viljoen, Margaretha
author_browse Viljoen, Margaretha
author_facet Viljoen, Margaretha
collection Thesis
dc_rights_str_mv © 2008 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria.
description Dissertation (MSc)--University of Pretoria, 2008.
format Thesis
id oai:repository.up.ac.za:2263/28884
institution University of Pretoria (South Africa)
last_indexed 2026-06-10T12:39:43.676Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository
publishDate 2013
publishDateRange 2013
publishDateSort 2013
publisher University of Pretoria
publisherStr University of Pretoria
record_format dspace
source_str UPSpace — University of Pretoria Institutional Repository
spelling oai:repository.up.ac.za:2263/28884 Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis Viljoen, Margaretha Laurens, Johannes B. upetd@up.ac.za Bipath, Priyesh Tryptophan Kynurenine Quinolinic acid Chronic renal failure Haemodialysis Peritoneal dialysis Quality of life Gas chromatography – mass spectrometry Method validation UCTD Dissertation (MSc)--University of Pretoria, 2008. Tryptophan is metabolised along the kynurenine pathway under the influence of tryptophan 2,3 dioxygenase and indoleamine 2,3 dioxygenase. Quinolinic acid and kynurenine, two neuroactive metabolites of the kynurenine pathway are, in chronic renal failure patients, considered as uraemic toxins. Related research is generally hampered by the non-availability of relevant analytical techniques. The primary aim of this study was, therefore, to develop and validate suitable methods for the determination of tryptophan, kynurenine and quinolinic acid. The second aim was to quantify the levels of these substances in the blood of chronic renal failure patients on renal replacement therapies and to compare the levels of haemodialysis patients to those on peritoneal dialysis. Patients’ quality of life was investigated relative to disturbances in tryptophan metabolism. Gas chromatography coupled to mass spectrometry (GC-MS) gave the best results for the analysis of tryptophan, kynurenine and quinolinic acid. A Hewlett Packard HP GC 6890 series gas chromatographer was coupled to a MS 5973 series mass spectrometer. Analytes were separated on a DB-5MS column with a nominal length of 30 metres, a diameter of 250.0 µm and film thickness of 0.10 µm. Helium was used as carrier gas, and the chromatographic analysis run time 12.5 minutes. The validation results were within the acceptance criteria for newly developed methods. The linear calibration curves constructed for all of the analytes gave r2 correlation coefficients >0.99. Other validation data such as precision, bias, accuracy and stability all fell within acceptable validation limits. In the study on chronic renal failure patients significant differences were seen between patients and controls. Tryptophan levels were 5.34 SD 5.04 µM for the haemodialysis group, 6.73 SD 3.18 µM for the peritoneal dialysis group and 28.4 SD 4.31 µM for the control group. Kynurenine levels were 4.7 SD 1.9 µM for the haemodialysis group, 2.9 SD 2.0 µM for the peritoneal dialysis group and 2.1 SD 0.6 µM for the control group. Quinolinic acid levels were 4.9 SD 2.0 µM for the haemodialysis group, 2.8 SD 2.0 µM for the peritoneal dialysis group and 0.3 SD 0.1 µM for the control group. Tryptophan was lower for the total patient group than for controls with significantly lower levels for haemodialysis versus control (p<0.05) and peritoneal dialysis versus control (p<0.05). Kynurenine levels were higher in the total patient group with significantly higher levels for the haemodialysis versus control group (p=0.0001). The patient groups had higher quinolinic acid levels with significantly higher levels for the haemodialysis versus control (p<0.05) and peritoneal dialysis versus control (p<0.05) groups. This study was the first to determine the three substances simultaneously in both haemodialysis and peritoneal dialysis patients. The study showed significant tryptophan depletion, as well as kynurenine and quinolinic acid accumulation for both groups. No significant differences were found between the patient groups other than higher kynurenine levels in the haemodialysis group. The quality of life (SF-36) was largely similar in the two patient groups. This decrease in the quality of life strongly correlated with the degree of tryptophan depletion. Chemical Pathology unrestricted 2013-09-07T14:25:18Z 2009-04-29 2013-09-07T14:25:18Z 2008-09-03 2008-04-29 2008-10-21 Dissertation Bipath, P 2008, Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis, MSc dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://hdl.handle.net/2263/28884 > E1189/ag http://hdl.handle.net/2263/28884 http://upetd.up.ac.za/thesis/available/etd-10212008-135418/ © 2008 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria
spellingShingle Tryptophan
Kynurenine
Quinolinic acid
Chronic renal failure
Haemodialysis
Peritoneal dialysis
Quality of life
Gas chromatography – mass spectrometry
Method validation
UCTD
Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis
title Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis
title_full Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis
title_fullStr Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis
title_full_unstemmed Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis
title_short Tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis
title_sort tryptophan and the kynurenine pathway in chronic renal failure patients on dialysis
topic Tryptophan
Kynurenine
Quinolinic acid
Chronic renal failure
Haemodialysis
Peritoneal dialysis
Quality of life
Gas chromatography – mass spectrometry
Method validation
UCTD
url http://hdl.handle.net/2263/28884
http://upetd.up.ac.za/thesis/available/etd-10212008-135418/