Introduction: The main objective of this study was to investigate abnormalities of serum protein fractions in hemodialysis patients with chronic renal failure (CRF) in Ouagadougou, Burkina Faso. Methods: This was a descriptive cross-sectional study of 48 hemodialysis patients with chronic renal failure (CRF) recruited at the Yalgado Ouedraogo Teaching Hospital (YO-TH), and 48 controls declared fit to donate blood by the Regional Blood Transfusion Center (RBTC) of Ouagadougou. Urea, creatinine, uric acid, and serum proteins were measured on the ARCHITECT C4000 equipment (ABOTT®), while the separating of the different protein fractions was performed on the Helena SAS 3 & 4 automated system. Results: A total of 96 individuals were included in the study. Protein levels were on average higher in controls (75.19 ± 6.56 g/L) than in hemodialysis patients (71.44 ± 12.33 g/L). Low blood albumin was significantly associated with the CRF hemodialysis groups compared to controls (p < 0.000). In terms of globin fractions, a significant increase in alpha-globulin 1, alpha-globulin 2 and gamma-globulin was present in the CRF hemodialysis group compared to controls (p < 0.000); while beta-globulin was on average lower in the CRF hemodialysis group compared to controls without significant difference (p = 0.509). Analysis of the electrophoretic profiles identified 57.17% polyclonal hypergammaglobulinaemia, 33.33% inflammatory profile, 10.42% undernutrition profile and 2.08% nephrotic syndrome in the CRF hemodialysis group. Conclusion: Serum protein electrophoresis is rapidly feasible and low cost. In hemodialysis CKD patients, it can be used to guide therapeutic management and predict morbidity and mortality related to variations in the various protein fractions.
References
[1]
Webster, A.C., Nagler, E.V., Morton, R.L. and Masson, P. (2017) Chronic Kidney Disease. Lancet, 389, 1238-1252. https://doi.org/10.1016/S0140-6736(16)32064-5
[2]
Coulibaly, G., Augustin, D., Roger, K., Aïda, L., Gaoussou, S., Hien, K., et al. (2016) Epidemiological Profile of Chronic Hemodialysis Patients in Ouagadougou. Open Journal of Nephrology, 6, 29-36. https://doi.org/10.4236/ojneph.2016.62004
[3]
El Matri, A. (2015) ESRD Management in Africa during the Last Decade. Clinical Nephrology, 83, 11-13. https://doi.org/10.5414/CNP83S011
[4]
Combe, C., Vendrely, B., Dubus, I., Moreau, K., Lasseur, C., Chauveau, P., et al. (2004) Métabolisme protéique et insuffisance rénale chronique. EMC-Néphrologie, 1, 2-15. https://doi.org/10.1016/j.emcnep.2003.10.001
[5]
Pai, A.Y., Sy, J., Kim, J., Kleine, C.-E., Edward, J., Hsiung, J.-T., et al. (2021) Association of Serum Globulin with All-Cause Mortality in Incident Hemodialysis Patients. Nephrology Dialysis Transplantation, 37, 1993-2003. https://doi.org/10.1093/ndt/gfab292
[6]
Belaïch, R., Boujraf, S. and Benzagmout, M. (2015) Impact du stress oxydatif et de l’inflammation sur les patients hémodialysés. Médecine Thérapeutique, 21, 95-103.
[7]
Wu, P.-P., Hsieh, Y.-P., Kor, C.-T. and Chiu, P.-F. (2019) Association between Albumin-Globulin Ratio and Mortality in Patients with Chronic Kidney Disease. Journal of Clinical Medicine, 8, Article No. 1991. https://doi.org/10.3390/jcm8111991
[8]
KDIGO (2013) KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International Supplements, 3, 1-150.
[9]
Coulibaly, G., Sanou, G., Sanon, M., Lengani, A.H.Y., Bonzi, J.Y. and Semde, A. (2020) Clinical, Paraclinical, and Evolutionary Profiles of Kidney Failure in Gold Miners Hospitalized in a Nephrological Service in a Sub-Saharan African Country. International Journal of Nephrology, 2020, Article ID: 4282969. https://doi.org/10.1155/2020/4282969
[10]
Sempore, W.Y. (2015) Profil de l’insuffisance rénale dans le département de médecin du Centre Hospitalier Universitaire Souro Sanou de Bobo-Dioulasso. Nazi Boni University, Institut Supérieur des Sciences de la Santé (INSSA), Bobo-Dioulasso.
[11]
Saizonou, M. (2003) Profil biologique de l’insuffisance rénale chronique (IRC) au service de Médecine interne du Centre Hospitalier National Yalgado OUEDRAOGO (CHUN-YO) de Ouagadougou. Université de Ouagadougou, Ouagadougou.
[12]
Benazzouz, M. (2017) Les anomalies de l’electrophorèse des protéines sériques chez les insuffisants rénaux chroniques au Sénégal. Universite Cheickh Anta Diop De Dakar, Dakar.
[13]
Oualla, J. (2018) Profil d’électrophorèse des protéines sériques chez une population des hémodialysés chroniques. Universite Cadi Ayyad, Marrakech.
[14]
Laboux, T. and Azar, R. (2019) Contrôle diététique de l’acidose métabolique chez le patient insuffisant rénal chronique. Néphrologie & Thérapeutique, 15, 491-497. https://doi.org/10.1016/j.nephro.2018.12.001
[15]
Hanna, R.M., Ghobry, L., Wassef, O., Rhee, C.M. and Kalantar-Zadeh, K. (2020) A Practical Approach to Nutrition, Protein-Energy Wasting, Sarcopenia, and Cachexia in Patients with Chronic Kidney Disease. Blood Purification, 49, 202-211. https://doi.org/10.1159/000504240
[16]
Velarde, E.C., Pacora, G.M. and Llajaruna, S.G. (2020) Asociación entre hipoalbuminemia e hipofosfatemia con desnutrición en pacientes con Enfermedad Renal Crónica en hemodiálisis. Revista de la Facultad de Medicina Humana, 20, 381-387.
[17]
Kalantar-Zadeh, K., Ficociello, L.H., Bazzanella, J., Mullon, C. and Anger, M.S. (2021) Slipping through the Pores: Hypoalbuminemia and Albumin Loss during Hemodialysis. International Journal of Nephrology and Renovascular Disease, 14, 11-21. https://doi.org/10.2147/IJNRD.S291348
[18]
Nagai, K., Tsuchida, K., Hirose, D., Michiwaki, H., Hann, M., Kanayama, H.-O., et al. (2016) The Effect of Albumin Leakage in Hemodialysis Patients on Redox Status of Serum Albumin. Journal of Artificial Organs, 19, 310-314. https://doi.org/10.1007/s10047-016-0900-2
[19]
Hassan, K., Kristal, B., Hassan, F., Abo Saleh, S. and Michelis, R. (2016) The Impact of Oxidized Serum Albumin on the Oncotic Pressure and Hydration Status of Peritoneal Dialysis Patients. Therapeutics and Clinical Risk Management, 12, 463-469. https://doi.org/10.2147/TCRM.S102311
[20]
Valdiguié, P. (2000) Biochimie Clinique. 2nd Edition, Médicales Internationales, French.
[21]
Jolliff, CR. (1982) Classification and Interpretation of Paragon Serum Protein Electrophoresis Patterns. Beckman Coulter, Brea.
[22]
Simon, N., Bouillet, L. and Deroux, A. (2017) étiologies des hypergammaglobulinémies polyclonales dans un CHU. La Revue de Médecine Interne, 38, A133-A134. https://doi.org/10.1016/j.revmed.2017.03.169
[23]
Cho, E.-M., Moon, H.-H., Hwang, Y.-J., Lee, S.-J., Ko, C.W. and Cho, M.H. (2013) Polyclonal Gammopathy Related to Renal Bleeding in a Peritoneal Dialysis Patient. Korean Journal of Pediatrics, 56, 304-307. https://doi.org/10.3345/kjp.2013.56.7.304
[24]
Cobo, G., Lindholm, B. and Stenvinkel, P. (2018) Chronic Inflammation in End-Stage Renal Disease and Dialysis. Nephrology Dialysis Transplantation, 33, iii35-iii40. https://doi.org/10.1093/ndt/gfy175
[25]
Harlacher, E., Wollenhaupt, J., Baaten, C.C.F.M.J. and Noels, H. (2022) Impact of Uremic Toxins on Endothelial Dysfunction in Chronic Kidney Disease: A Systematic Review. International Journal of Molecular Sciences, 23, Article No. 531. https://doi.org/10.3390/ijms23010531
[26]
Lu, P.-H., Yu, M.-C., Wei, M.-J. and Kuo, K.-L. (2021) The Therapeutic Strategies for Uremic Toxins Control in Chronic Kidney Disease. Toxins, 13, Article No. 573. https://doi.org/10.3390/toxins13080573
[27]
Cohen, G. (2020) Immune Dysfunction in Uremia 2020. Toxins, 12, Article No. 439. https://doi.org/10.3390/toxins12070439
[28]
Ghorbani, A., Hayati, F., Karandish, M. and Sabzali, S. (2020) The Prevalence of Malnutrition in Hemodialysis Patients. Journal of Renal Injury Prevention, 9, e15. https://doi.org/10.34172/jrip.2020.15
[29]
Ikizler, T.A., Pupim, L.B., Brouillette, J.R., Levenhagen, D.K., Farmer, K., Hakim, R.M., et al. (2002) Hemodialysis Stimulates Muscle and Whole Body Protein Loss and Alters Substrate Oxidation. American Journal of Physiology—Endocrinology and Metabolism, 282, E107-E116. https://doi.org/10.1152/ajpendo.2002.282.1.E107
