Erythrocyte Transketolase Activity in Dialyzed Patients

Abstract

Abstract Predialysis erythrocyte transketolase activity was depressed in 10 of 12 patients receiving chronic dialysis. Five patients had evidence of neuropathy. Dialysis effected a 43.0 per cent improvement in transketolase activity. Predialysis plasma inhibited normal activity by an average of 34.2 per cent, but post-dialysis plasma had little inhibiting effect. A low-molecular-weight (less than 501) substance, or substances, isolated from the dialysate of chronic uremics inhibited transketolase activity by 45.0 per cent. Two patients having the longest courses of dialysis had no neuropathy and showed no depression of activity, and their plasma failed to inhibit normal activity. Since transketolase has been shown to have an important role in myelin maintenance, it is suggested that accumulation of a low-molecular-weight toxin (or toxins) that depresses transketolase activity may lead to myelin-sheath degeneration, with subsequent neuropathy. Dialysis, by removing the inhibitor (or inhibitors) may permit ...