Role of proteases in hypercatabolic patients with renal failure
Hörl, W.H.; Stepinski, J.; Schäfer, R.M.; Wanner, C.; Heidland, A.
Kidney International. Supplement 16: S37-S42
1983
ISSN/ISBN: 0098-6577 PMID: 6204101 Document Number: 216807
Proteolytic enzymes exist in plasma ultrafiltrates, concentrated dialysates and urine fractions of patients with acute renal failure (ARF) aftr trauma, in urine fractions of patients with nephrotic syndrome and in concentrated dialysates of patients on routine dialysis (RD). Differences in the digestion pattern of phosphorylase kinase suggest the existence of different proteases. Plasma trypsin-binding capacity is less in RD patients and is much less in patients with ARF after trauma than in healthy subjects. Protein catabolism of plasma fractions of patients with ARF after trauma is inhibited in vitro by alpha 2-macroglobulin. Urinary alpha 1-antitrypsin inactivates added kallikrein in urine fractions of patients with ARF after trauma or nephrotic syndrome. Proteases may also be involved in the disturbances of carbohydrate metabolism of uraemic patients. The role of proteolytic degraded phosphorylase kinase, muscle contractile proteins, hormone receptors or pancreas islets on the pathogenesis of changed carbohydrate metabolism in uraemia is discussed.