Changes of plasma free choline and choline-containing compounds' concentrations and choline loss during hemodialysis in ESRD patients

Abstract

Objectives: This study was undertaken to determine the changes in plasma free choline and choline-containing compounds in end stage renal disease (ESRD) and to determine if they were lost into the dialysate during hemodialysis.

Design and methods: Plasma and dialysate free choline, phosphocholine and phospholipid, phosphatidylcholine-, sphingomyelin-bound choline were measured before, during and after hemodialysis.

Results: Plasma free and bound choline concentrations (mean +/- standard error of the mean) were 12.9 +/- 0.6 and 2697 +/- 57 muM or 37.3 +/- 0.9 and 2792 +/- 98 muM in controls or in ESRD patients, respectively. Free choline concentrations were correlated (r = 0.598 p < 0.001) with the time the patients were subjected to hemodialysis. Plasma free choline and phosphocholine concentrations a-re decreased by a total of -8.1 +/- 0.6 μmol/L and -88 +/- 8 μmol/L, respectively: phospholipid- phosphatidylcholine- and sphingomyelin-bound choline are increased, during hemodialysis. Patients lost about 350 μmoles of choline into the dialysate during hemodialysis.

Conclusion: Plasma free choline concentrations are elevated in ESRD. and a considerable amount of choline is lost into the hemodialysate.