Creatol, an oxidative product of creatinine in hemodialysis patients

Creatol (CTL) is a product resulting from the reaction of creatinine (Cr) with the hydroxyl radical and is identified as a precursor of methylguanidine (MG), a uremic toxin. In this study, we investigated serum CTL levels together with those of Cr and MG in 66 patients who were on maintenance hemodialysis (HD). Prior to dialysis, the mean serum levels of Cr, CTL and MG were 967 (=11.1 mg/dl) ±267 μM, 11.1 ± 4.8μM and 5.8±2.9 μM, respectively. The mean CTL level was about 1.1% that of Cr, and the CTL plus MG level was about 1.4% that of the Cr level. The reduction rates of Cr, CTL and MG by a single HD were 62.6±6.1%, 71.0±10.3% and 51.9±11.6%, respectively. The CTL level at 0.5, 1 and 6h after HD increased rapidly by 20.7±8.7%, 31.7±14.7% and 80.1±27.3%, respectively. There was a significant correlation between CTL or CTL/Cr and parathyroid hormone in patients who had just undergone parathyroidectomy. No significant correlation was found between CTL or CTL/Cr and those factors which seems to be related to...