Sulphur containing amino acids in chronic renal failure with particular reference to homocystine and cysteine‐homocysteine mixed disulphide

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Abstract
Plasma sulfur amino acids were measured in 22 patients with chronic renal failure and the findings were compared with those obtained in 22 normal subjects. In fasting blood cysteine-homocysteine mixed disulfide was significantly increased in the renal patients, mean values (.+-. SD) being 8.2 .+-. 3.4 and 3.1 .+-. 1.0 .mu.mol/l, respectively (P < 0.001). The increase was positively correlated with reduced renal function, as assessed by serum creatinine (r [correlation coefficient] = 0.62; P < 0.01). Homocystine was detected in 19 patients, the mean concentration (.+-. SD) being 1.7 .+-. 0.6 .mu.mol/l; it was not found in any normal subject. Methionine levels were not different, but there were significant increases in cystine (P < 0.001) and taurine (P < 0.05) in the patients. Similar values for these amino acids were found in a 2nd blood sample drawn at 1600 h. Changes in the other neutral and acidic amino acids measured were in agreement with those reported in chronic azotemia. Plasma levels of all the principal sulfur amino acids except methionine are elevated in chronic renal failure, emphasizing the importance of the kidney in sulfur excretion. Prolonged accumulation of homocysteine and cysteine-homocysteine mixed disulfide may be relevant to the development of accelerated vascular disease in patients with chronic renal failure by producing endothelial damage.

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