Proteomics of Human Dialysate and Ultrafiltrate Fluids Yielded by Renal Replacement Therapy

This chapter discusses different methods for determining proteins and peptides present in human dialysate and ultrafiltrate fluids. The main focus is on separation-coupled MS techniques such as gel electrophoresis-MS, LC-MS, and CE-MS. The increasing number of patients on renal replacement therapy shows the need for techniques that may improve the dialysis process and consequently the quality of life as well as life expectancy of these patients. Dialysate and ultrafiltrate fluids are a rich source of information on relevant peptides and proteins, especially the uremic toxins. Furthermore, these liquids are available in high amounts compared with serum or plasma. The different proteomic methods such as HPLC separation of samples and subsequent MALDI-TOF-MS and 2D-PAGE followed by MALDI-TOF-MS or LC-MS, in combination with MS/MS methods, as well as CE-MS are reviewed, and some of the most recent papers are summarized. The knowledge obtained by proteome analysis holds great promise to allow improvements in current dialysis techniques.