Isolation, identification, and analysis of 4-acetylaminophenol-glucuronide in body fluids of dialyzed renal patients; a molecular mass marker for peritoneal diffusive transport

A noncharacteristic solute, appearing in gradient elution liq. chromatog. (HPLC) profile of body fluids of dialyzed renal patients, was isolated and identified by preparative HPLC, b-glucuronidase-induced enzymic peak shift, and mass spectrometry. The compd. was shown to be p-acetylaminophenol (paracetamol)-glucuronide (PG). Serum and peritoneal dialyzate PG concns. were detd. in a no. of patients. Cuprophan in vivo dialyzer clearances were calcd. Peritoneal membrane mass transfer coeffs. (MTC) of PG were calcd. and compared with those of mol. mass markers for peritoneal diffusive mass transport studies (urea, creatinine, uric acid, and inulin). By extrapolation of an MTC vs. mol. mass calibration line for urea, creatinine, and uric acid it is shown that PG behaves as expected from its mol. mass. Thus, mass range between Mr 200 and 500. It may also be used as a marker for diffusive solute transport in hemodialysis treatment. The HPLC gradient elution technique used here appears to be suitable for the simultaneous anal. of the mol. mass markers creatinine, uric acid, and paracetamolglucuronide