HIGH-AFFINITY INTERACTION OF LONG-CHAIN FATTY-ACIDS WITH SERUM-ALBUMIN IN NEPHROTIC SYNDROME

We have examined the effect of hypoalbuminaemia, a hallmark of nephrot ic syndrome, on the albumin-fatty acid equilibrium in the plasma of 11 adult patients with nephrosis compared with 12 healthy subjects and s ix subjects with normoalbuminaemic hyperlipoproteinaemia. 2, We used a dialysis exchange rate method which allows the evaluation in relative terms of the binding affinity of albumin for plasma fatty acid and th e fatty acid availability, tentatively equated with the unbound fatty acid fraction, 3. In nephrotic patients, an increase (P<0,001) in albu min affinity for fatty acid was seen compared with healthy subjects, w hich was negatively correlated with albuminaemia (r=-0.69, P<0,02), No change in fatty acid availability was seen for the group as a whole, but individual values showed a wide scatter, with the highest values i n four patients with the highest fatty acid-albumin molar ratios. The increase in albumin affinity for fatty acid was specific to nephrotic syndrome since no such effect was seen in subjects with hyperlipoprote inaemia, who only showed a moderate increase (P<0,01) in fatty acid av ailability, 4, The increased albumin affinity for fatty acid in nephro tic syndrome supports the hypothesis that an albumin component with lo wer affinity for fatty acid might filter out through the diseased glom erular membrane and leave the high-affinity albumin in plasma.