Serum Alpha-1-Acid Glycoprotein Levels in Uremic Patients on Hemodialysis

Serum Alpha-1-Acid Glycoprotein Levels in Uremic Patients on Hemodialysis D. Dino Docci F. Fausto Turci Dr. Dino Docci, Dr. Fausto Turci, Servizio di Emodialisi, Ospedale Provinciale M. Bufalini, I-47023 Cesena (Italy) We have read with interest the report by Henriksen et al. [1] concerning serum alpha-1-acid glycoprotein in uremic patients on maintenance hemodialysis. In a similar study [2], carried out on 31 patients dialyzed against Cuprophan membrane (mean time on dialysis: 51.5 months), we found comparable results. The serum alpha-1 -acid glycoprotein was measured by radial immuno-diffusion (M-Partigen alpha-1-acid glycoprotein, Istituto Behring), with normal values ranging from 55 to 140 mg/dl. The mean serum alpha-1acid glycoprotein concentration was higher in our dialysis patients (117.58 ± 36.65 mg/dl) than in controls (98.32 ± 19.5 mg/dl, n = 15; p < 0.05), with levels above normal in 6 cases (19.3%; table I). We found, moreover, a further significant increase in the mean serum alpha-1-acid glycoprotein concentration following a single dialysis, although the behavior was not univocal (22 increase, 2 no change, 7 decrease; table I). We are not fully prepared at present for an explanation of these results. In none of our patients was the serum alpha-1-acid glycoprotein below normal after dialysis. According to Henriksen et al. [1], we concluded, therefore, that it seems unlikely that a lack of alpha-1-acid glycoprotein due to uremia per se or secondary to dialysis may have a role in the patho-genesis of hyperlipidemia in hemodialysis patients. We would like, however, to raise one question about the other conclusion drawn by Henriksen et al. [1]. In fact, having observed serum alpha-1-acid glycoprotein levels above normal in only 19.3% of our patients {Henriksen et al. reported serum levels above normal in 80% of their patients), we think that the alpha-1 -acid glycoprotein measurement maintains its clinical value as an acute phase re-actant also in uremic patients on dialysis. References Henriksen, H. J. O.; Petersen, M. U.; Pedersen, F. B.: Serum alpha-1-acid glycoprotein (orosomucoid) in uremic patients on hemodialysis. Nephron 31: 24-25 (1982). Docci, D.; Turci, F.; Salvi, G.; Cenciotti, L.: II dosaggio della alfa-1-glicoproteina acida sierica nei pazienti in emodialisi perio-dica. Quad. Sclavo Diagn. (in press). Table I. Serum alpha-1-acid glycoprotein levels (mg/dl) before and after dialysis Patients Sex Age Alpha-1-acid glycoprotein before dialysis after dialysis