Scandinavian Journal of Clinical and Laboratory Investigation
ISSN: 0036-5513 (Print) 1502-7686 (Online) Journal homepage: http://www.tandfonline.com/loi/iclb20
Serum methylmalonic acid in uraemia L. Moelby, K. Rasmussen & H. Højgaard Rasmussen To cite this article: L. Moelby, K. Rasmussen & H. Højgaard Rasmussen (1992) Serum methylmalonic acid in uraemia, Scandinavian Journal of Clinical and Laboratory Investigation, 52:4, 351-354, DOI: 10.1080/00365519209088369 To link to this article: http://dx.doi.org/10.1080/00365519209088369
Published online: 29 Mar 2011.
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Date: 14 April 2016, At: 04:15
Scand J Clin Lab Invest 1992; 52: 351-354
Serum methylmalonic acid in uraemia L. MOELBY, K. RASMUSSEN* & H. H B J G A A R D RASMUSSEN Department of Medicine C , Aalborg Hospital, Aalborg, and "University Department of Clinical Chemistry, Skejby Hospital, Aarhus, Denmark
Downloaded by [UNSW Library] at 04:15 14 April 2016
Moelby L, Rasmussen K , Rasmussen H H . Serum methylmalonic acid in uraemia. Scand J Clin Lab Invest 1992: 52: 351-354. During a 3 month period we measured serum methylmalonic acid concentrations monthly in 37 patients, all on chronic haemodialysis because of end-stage kidney disease. Concentrations of methylmalonic acid in serum were above the upper reference limit in 36 of the 37 subjects. All patients were in regular cobalamin therapy, with intramuscular injections every third month, and all had normal to very high values of serum cobalamin. We found no normalization of serum methylmalonic acid during the examination period after cobalamin injections, and we could not demonstrate any relationship between concentrations of methylmalonic acid and creatinine, cobalamin and creatinine or methylmalonic acid and cobalamin in serum of these subjects. We conclude that an elevated serum methylmalonic acid concentration is a general finding in uraemic patients, and so the assay cannot be used to establish the diagnosis of tissue cobalamin deficiency in these patients.
Key words: haemodialysis; terminal renal insufficiency; tissue cobalamin deficiency Dr L. Moelby, Department of Medicine C, Aalborg Sygehus Syd (Aalborg Hospital), DK-9100 Aalborg, Denmark
An elevated level of serum methylmalonic acid (MMA) and increased excretion of MMA in the urine strongly suggest a deficiency of tissue cobalamin [ 1- 131, and accumulation of MMA is believed to be an early indicator of cobalamin deficiency [14-16). W e recently reported that linear relationships exist between the concentrations of MMA in serum and urine [16] in clinical cobalamin-deficient patients. We have also shown that the serum MMA assay appropriately discriminates between cobalamin deficiency and non-cobalamin deficiency [ 151. Increased serum MMA levels fall to normal after treatment with cyanocobalamin [ 151. Lindenbaum et a f . [I] noted, however, that
elevated values of serum M M A did not decline after treatment with cobalamin in a cobalamindeficient patient who had chronic renal insufficiency. But studies on serum MMA in uraemic patients with terminal renal failure have not been reported. A preliminary study in our laboratory provided evidence for an inverse correlation between glomerular filtration rates (GFR) and serum MMA, and a linear relationship between concentrations of creatinine and MMA in serum in predialytic patients with renal failure (5 ml min-'
ISSN: 0036-5513 (Print) 1502-7686 (Online) Journal homepage: http://www.tandfonline.com/loi/iclb20
Serum methylmalonic acid in uraemia L. Moelby, K. Rasmussen & H. Højgaard Rasmussen To cite this article: L. Moelby, K. Rasmussen & H. Højgaard Rasmussen (1992) Serum methylmalonic acid in uraemia, Scandinavian Journal of Clinical and Laboratory Investigation, 52:4, 351-354, DOI: 10.1080/00365519209088369 To link to this article: http://dx.doi.org/10.1080/00365519209088369
Published online: 29 Mar 2011.
Submit your article to this journal
Article views: 5
View related articles
Citing articles: 2 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=iclb20 Download by: [UNSW Library]
Date: 14 April 2016, At: 04:15
Scand J Clin Lab Invest 1992; 52: 351-354
Serum methylmalonic acid in uraemia L. MOELBY, K. RASMUSSEN* & H. H B J G A A R D RASMUSSEN Department of Medicine C , Aalborg Hospital, Aalborg, and "University Department of Clinical Chemistry, Skejby Hospital, Aarhus, Denmark
Downloaded by [UNSW Library] at 04:15 14 April 2016
Moelby L, Rasmussen K , Rasmussen H H . Serum methylmalonic acid in uraemia. Scand J Clin Lab Invest 1992: 52: 351-354. During a 3 month period we measured serum methylmalonic acid concentrations monthly in 37 patients, all on chronic haemodialysis because of end-stage kidney disease. Concentrations of methylmalonic acid in serum were above the upper reference limit in 36 of the 37 subjects. All patients were in regular cobalamin therapy, with intramuscular injections every third month, and all had normal to very high values of serum cobalamin. We found no normalization of serum methylmalonic acid during the examination period after cobalamin injections, and we could not demonstrate any relationship between concentrations of methylmalonic acid and creatinine, cobalamin and creatinine or methylmalonic acid and cobalamin in serum of these subjects. We conclude that an elevated serum methylmalonic acid concentration is a general finding in uraemic patients, and so the assay cannot be used to establish the diagnosis of tissue cobalamin deficiency in these patients.
Key words: haemodialysis; terminal renal insufficiency; tissue cobalamin deficiency Dr L. Moelby, Department of Medicine C, Aalborg Sygehus Syd (Aalborg Hospital), DK-9100 Aalborg, Denmark
An elevated level of serum methylmalonic acid (MMA) and increased excretion of MMA in the urine strongly suggest a deficiency of tissue cobalamin [ 1- 131, and accumulation of MMA is believed to be an early indicator of cobalamin deficiency [14-16). W e recently reported that linear relationships exist between the concentrations of MMA in serum and urine [16] in clinical cobalamin-deficient patients. We have also shown that the serum MMA assay appropriately discriminates between cobalamin deficiency and non-cobalamin deficiency [ 151. Increased serum MMA levels fall to normal after treatment with cyanocobalamin [ 151. Lindenbaum et a f . [I] noted, however, that
elevated values of serum M M A did not decline after treatment with cobalamin in a cobalamindeficient patient who had chronic renal insufficiency. But studies on serum MMA in uraemic patients with terminal renal failure have not been reported. A preliminary study in our laboratory provided evidence for an inverse correlation between glomerular filtration rates (GFR) and serum MMA, and a linear relationship between concentrations of creatinine and MMA in serum in predialytic patients with renal failure (5 ml min-'
