Optimized Procedures for Testing Plasma Metanephrines in Patients on Hemodialysis

Overview

Journal Sci Rep

Specialty Science

Date 2021 Jul 20

PMID 34282182

Citations 3

Authors

Christina Pamporaki

Aleksander Prejbisz

Robert Malecki

Frank Pistrosch

Mirko Peitzsch

Steffen Bishoff

Petra Mueller

Iris Meyer

Doreen Reimann

Katarzyna Hanus

Andrzej Januszewicz

Stefan R Bornstein

Simon Parmentier

Carola Kunath

Jacques W M Lenders

Graeme Eisenhofer

Jens Passauer

Affiliations

Soon will be listed here.

Abstract

Diagnosis of pheochromocytomas and paragangliomas in patients receiving hemodialysis is troublesome. The aim of the study was to establish optimal conditions for blood sampling for mass spectrometric measurements of normetanephrine, metanephrine and 3-methoxytyramine in patients on hemodialysis and specific reference intervals for plasma metanephrines under the most optimal sampling conditions. Blood was sampled before and near the end of dialysis, including different sampling sites in 170 patients on hemodialysis. Plasma normetanephrine concentrations were lower (P < 0.0001) and metanephrine concentrations higher (P < 0.0001) in shunt than in venous blood, with no differences for 3-methoxytyramine. Normetanephrine, metanephrine and 3-methoxytyramine concentrations in shunt and venous blood were lower (P < 0.0001) near the end than before hemodialysis. Upper cut-offs for normetanephrine were 34% lower when the blood was drawn from the shunt and near the end of hemodialysis compared to blood drawn before hemodialysis. This study establishes optimal sampling conditions using blood from the dialysis shunt near the end of hemodialysis with optimal reference intervals for plasma metanephrines for the diagnosis of pheochromocytomas/paragangliomas among patients on hemodialysis.

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