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Serum methylmalonic acid in uraemia
L Moelby1, K Rasmussen, H H Rasmussen
1Department of Medicine C, Aalborg Hospital, Denmark.
Summary
Elevated serum methylmalonic acid is common in patients with end-stage kidney disease undergoing dialysis. This finding suggests the methylmalonic acid assay is not reliable for diagnosing cobalamin deficiency in these individuals.
Area of Science:
- Nephrology
- Clinical Chemistry
Background:
- Patients with end-stage kidney disease (ESKD) often have metabolic alterations.
- Serum methylmalonic acid (MMA) is a biomarker sometimes used to assess cobalamin (vitamin B12) status.
Purpose of the Study:
- To investigate serum methylmalonic acid levels in patients undergoing chronic hemodialysis.
- To determine if cobalamin therapy normalizes elevated MMA levels in this population.
Main Methods:
- Monthly serum MMA concentrations were measured over 3 months in 37 hemodialysis patients.
- Serum cobalamin and creatinine levels were also monitored.
Main Results:
- 36 out of 37 patients had elevated serum MMA above the reference limit.
- Despite regular cobalamin injections and normal to high serum cobalamin levels, MMA did not normalize.
- No significant correlation was found between MMA and creatinine or cobalamin levels.
Conclusions:
- Elevated serum MMA is a prevalent finding in uremic patients on chronic hemodialysis.
- The MMA assay is not a reliable diagnostic tool for identifying tissue cobalamin deficiency in this patient group.