Use of Serum Transthyretin in Chronic Renal Failure Patients

Abstract

Transthyretin (prealbumin) is a protein secreted by the liver that is involved in the assessment of undernutrition and nutritional intake. Undernutrition in hemodialysis patients is associated with a worsening of vital prognosis. The main objective of this study was to investigate the transthyretin profile in hemodialysis patients with chronic kidney disease (CKD) in the absence of inflammation in Bobo-Dioulasso, Burkina Faso. Material and methods: This was a prospective study of CKD hemodialysis patients recruited at the CHU-SS from 1er January 2022 to 28 February 2022. Socio-demographic data were obtained after examination of the medical records of hemodialysis CKD patients. All biochemical parameters were measured on the COBAS® 6000 automated system. Colorimetric methods were used to measure urea (urease/Glutamate dehydrogenase), creatinine (modified Jaffé) and albumin (bromocresol green). CRP, alpha-1-glucoprotein acid and transthyretin were determined by the immunoturbidimetric method. Results and discussion: A total of 41 hemodialysis patients were included in the study. The mean age was 42.93±12.21 years with extremes ranging from 22 to 72 years. There was a male predominance with a sex ratio (M/F) of 1.56. The mean BMI of the patients was 20.70±2.87 kg/m² with extremes from 14.45 to 28.28 kg/m². Mean transthyretin was 0.47±0.13 g/L. Significant positive correlations were observed with albumin (r=0.77; p=0.0000) and alpha 1 glycoprotein acid (r=0.43; p= 0.004). In the absence of inflammation in the patient group, only one patient (2.44%) presented with hypotranthyretinemia. Conclusion: Transthyretin provides quantitative and clinically useful data for better management of undernutrition and, above all, for predicting the morbidity and mortality associated with protein-energy undernutrition