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[Clinical evaluation of serum albumin reductivity in patients with renal dysfunction: a comparison between conservative renal failure patients and hemodialysis patients].

We examined the relationship between change in the redox state of the plasma albumin molecule and the metabolic disorder of sulfur amino acid observed being accompanied by reduction of renal function. Thirty-seven cases of pre-dialysis renal failure with conservative treatment and thirteen cases of chronic hemodialysis were selected as the subjects of this examination. The fraction of plasma albumin and the concentration of plasma cysteine and homocysteine were respectively measured by the HPLC and GC/MS (gas chromatography/mass spectrometry) methods. In the case of pre-dialysis renal failure with conservative treatment, the reduction rate of plasma albumin significantly decreased in correspondence with reduction of the glomerular filtration rate (GFR). It is well known that the reduction rate of plasma albumin also decreases with the aging process. However, in regard to chronic hemodialysis, a correlation with aging was not found, where the transient reduction rate of plasma albu- min increased after the hemodialysis session. However, in correspondence with the decrease in renal function, the concentration of plasma cysteine and homocysteine increased. This shows that there was a negative correlation with GFR in cases of pre-dialysis renal failure with conservative treatment. In cases of chronic hemodialysis, the concentration of free cysteine and free homocysteine rapidly decreased after a hemodialysis session. Therefore, a negative correlation was recognized between the reduction rate of plasma albumin and the concentration of plasma cysteine and homocysteine. The result of this examination shows the following mechanisms: plasma albumin plays an important role in the reaction of oxidation/reduction in blood plasma, and sulfur amino acid in blood plasma, especially the abnormality of cysteine concentration, plays an important role in changing the redox state of the blood plasma observed in the decrease in renal function.