A multivitamin infusion prevents lipid peroxidation and improves transplantation performance

Abstract

The objective of this study was to test the hypothesis that ischemia reperfusion damage in kidney transplantation is associated with lipid peroxidation and that inhibition of lipid peroxidation by antioxidants improves the function of the transplanted kidney. Lipid peroxidation was assessed by measuring the plasma malonaldehyde content (as thiobarbituric acid reaction product) with high-performance liquid chromatography. Kidney function was assessed by plasma creatinine and creatinine clearance. Thirty patients of an ongoing series were randomly selected into two groups, with 14 controls and 16 patients in the antioxidant therapy group. Therapy consisted of two ampoules of Omnibionta (which contains vitamins C, E, A and B complex) diluted in 500 ml physiological sodium chloride, which was infused intravenously prior to reperfusion onset. No significant differences existed for the age of the patients in the control (43.00 +/- 9.86 years) and the therapy group (41.56 +/- 14.14 years) nor in the kidney preservation time, which was 24.12 +/- 8.73 and 18.43 +/- 9.97 hours in the control and therapy group, respectively. The controls showed a transient increase of plasma lipid peroxides as measured by malonaldehyde with a peak one hour after onset of reperfusion. Compared to the baseline value of 0.74 +/- 0.26 (mean +/- SD) the one hour malonaldehyde value increased to 1.46 +/- 0.22 nmol/ml (P < 0.001). In the therapy group the plasma malonaldehyde level did not increase, but slightly decreased by about 20% compared to the baseline value. The difference of plasma malonaldehyde between the two groups one hour after reperfusion onset was highly significant (P > 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

A Novel Antioxidant, EPC-K1, Stimulates Endothelial Nitric Oxide Production and Scavenges Hydroxyl Radicals

“…26 EPC-K1 is a novel antioxidant synthesized from phosphate linkage of vitamin C and vitamin E. Clinically, both of these vitamins have demonstrated some protective benefit against development of coronary artery disease 27 and graft dysfunction following organ transplantation. 28 The water-soluble vitamin C can inactivate aqueous peroxyl radicals as well as other species, while the lipidsoluble vitamin E can react with lipid peroxyl radicals, interrupting radical chain reactions. 9 EPC-K1 may be advantageous because it maintains both hydrophilic and lipophilic properties.…”

Antioxidants: A Possible Role in Kidney Protection

“…In a prospective, randomized study, multivitamin cocktail infusion prevented ischemia/reperfusion injury in renal graft, improving graft viability and function [91]. In a case report, the course of idiopathic membranous nephropathy, resistant to conventional therapy, was ameliorated by multidrug antioxidant regimen, including vitamin C, ·-tocopherol, ß-carotene, selenium and N-acetylcysteine [92].…”

Antioxidant and Oxidative Stress Indices in Dialysis-Dependent Acute Renal Failure

“…In patients with ARF, this was even more pronounced and associated with high plasma malondialdehyde (MDA) levels, a marker of oxidative stress and lipid peroxidation [5]. Further, administration of a multivitamin infusion to kidney transplant recipients results in lower frequency of ARF and better immediate allograft function [6]. Several factors may be operative in ARF in the depletion of antioxidant defenses and induction of oxidative stress.…”