Identification of end stage renal disease metabolic signatures from
human perspiration
Abstract
End stage renal disease (ESRD), characterized by cessation in kidney
function, has been linked to severe metabolic disturbances, caused by
buildup of toxic solutes in blood. To remove these solutes, ESRD
patients undergo dialysis. As a proof of concept, we tested whether
ESRD-related metabolic signatures can be detected in perspiration
samples using a combined methodology. Our rapid methodology involves
swabbing a glass slide across the patient’s forehead, detecting the
metabolites in the imprint using desorption electrospray ionization mass
spectrometry, and identifying the key differences using machine learning
methods. Based on collecting 42 healthy and 27 ESRD samples, we find
saturated fatty acids are consistently suppressed in ESRD patients, with
little change after dialysis. Also, our method enables the detection of
uremic solutes, where we find elevated levels of uric acid (6.7 fold
higher on average) that sharply decrease after dialysis. Beyond the
study of individual metabolites, we find that a lasso model, which
selects for 8 m/z fragments from 24,602 detected analytes, achieves area
under the curve performance of 0.85 and 0.87 on training (n=52) and
validation sets (n=17) respectively. Together, these results suggest
that this methodology is promising for detecting signatures relevant for
Precision Health.