STRUCTURE AND BINDING-PROPERTIES OF SERUM-ALBUMIN IN UREMIC PATIENTS AT DIFFERENT PERIODS OF HEMODIALYSIS

Few diagnostic methods are available that describe uremia related chan ges of the albumin molecule structure in hemodialysis patients. The im paired human serum albumin (HSA) function is an essential part of the uremic syndrome and probably influences the long-term outcome of patie nts on maintenance dialysis. The albumin binding capacity (characteriz ed for different binding centers on the molecule) is one of the releva nt clinical parameters. During the current study, marker substances we re utilized to evaluate center-specific binding capacity. Patients wer e divided into 3 groups depending on the time on hemodialysis (HD) tre atment (in years) with healthy blood donors as control. Compared to he althy persons, results demonstrate a considerable impairment of bindin g characteristics in HD patients. Only in patients on maintenance HD f or more than 5 years did ligand binding properties improve significant ly. A correlation between the time of chronic HD and the recovery in b inding capacity was found for the majority of binding centers of the H SA molecule. Similar results were seen applying such analytical method s as thermography (melting points) and thermofluorescence. Binding cap acity impairment found for specified binding centers on the HSA molecu le as the main serum carrier protein may have a direct impact on diffe rent clinical situations and the HD long-term outcome.