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말기 신부전에서 시안산의 영향

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Affiliated Author(s)
문교철곽춘식한승엽김현철
Alternative Author(s)
Mun, Kyo CheolKwak, Chun SikHan, Seung YeupKim, Hyun Chul
Journal Title
Keimyung Medical Journal
Issued Date
2005
Keyword
CyanateEnd-stage renal diseaseUrea
Abstract
During advanced renal failure, particularly in patients with end-stage renal disease (ESRD), proteins are carbamylated as a result of a reaction with cyanate. Some or all of the cyanate is derived from urea. In aqueous solution there is partial and spontaneous decomposition of urea to ammonia, carbonate and cyanate. Cyanate then subsequently reacts irreversibly with the N-terminal groups of amino acids, peptides and many proteins by a process known as carbamylation. Under physiological pH and body temperature conditions 0.8% of the molar concentration of urea is spontaneously converted to cyanate at equilibrium. An extensively studied carbamylated protein is hemoglobin. In chronic renal failure and ESRD proteins are known to be easily carbamylated as a result of reactions with cyanate due to high levels of cyanate concentration in the plasma. According to previous studies, cyanate is known to carbamylate erythropoietin, and carbamylated erythropoietin is less biologically active than is normal erythropoietin. And cyanate can induce hemolysis via direct contact with erythrocytes. Thus, cyanate is considered as one of the factors for anemia in patients with ESRD. In peritoneum, cyanate can induce chronic inflammation and fibrosis via TCF-β expression. In osteoblast, cyanate appears to play a role as a trigger for apoptosis by activating proapoptotic signals, thus contributes renal osteodystrophy. In neutrophils, cyanate can activate the neutrophils, thus considered to contribute tissue damages. According to these results, cyanate form urea must be viewed as a strong uremic toxin, rather than a surrogate. Targeting dialysis doses specifically to cyanate and urea concentrations may be more important than previously considered.
Alternative Title
Cyanate in End-Stage Renal Disease
Department
Dept. of Biochemistry (생화학)
Dept. of Internal Medicine (내과학)
Kidney Institute (신장연구소)
Publisher
Keimyung University School of Medicine
Citation
문교철 et al. (2005). 말기 신부전에서 시안산의 영향. Keimyung Medical Journal, 24(2), 120–126.
Type
Article
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/15348
Appears in Collections:
2. Keimyung Medical Journal (계명의대 학술지) > 2005
1. School of Medicine (의과대학) > Dept. of Biochemistry (생화학)
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
3. Research Institutues (연구소) > Kidney Institute (신장연구소)
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