Effect of a Hemodiafiltration Session with On-Line Regeneration of the Ultrafiltrate on Oxidative Stress

Abstract

Background: The influence of a dialysis session using hemodiafiltration with on-line regeneration of the ultrafiltrate (HFR) is compared with that of a conventional hemodialysis session with polysulfone (HD-PS) and with a group of healthy individuals. Methods: Total antioxidant capacity (TAC), antioxidants, i.e., superoxide dismutase (SOD) glutathione peroxidase (GPX), reduced glutathione (GSH) and catalase, and biomarkers of oxidative stress were evaluated in plasma, whole blood and lymphocytes. Results: The study showed decreased plasma TAC, decreased activities of antioxidant enzymes and decreased GSH levels along with increased thiobarbituric-acid-reactive substances and 8–hydroxy-2-deoxyguanosine (8-OHdG) levels in lymphocytes. The antioxidants and biomarkers of lipid and protein damage after dialysis sessions with HFR were similar or better than following HD-PS. Thus, the blood GPX activity was comparable to that of healthy controls and significantly better than following HD-PS. An increase in 8-OHdG levels was observed in the HD-PS group after dialysis but not in the HFR group. Conclusions: These results show that HFR induces less oxidative stress than HD-PS.

Monocyte and Neutrophil Chemotactic Activity at the Site of Interstitial Inflammation in Patients on High-Flux Hemodialysis or Hemodiafiltration

“…Also, clearance of cytokines by highflux dialysis treatment has recently gained intense interest, especially in patients with septicemia [24] . HDF and high-flux HD have been associated with better outcomes in large studies [23] and also cause less oxidative stress than HD with low-flux polysulfone membranes [25] . The in vivo data in the present study are in line with our previously reported data on the impact of dialysis membrane permeability on neutrophil transmigration properties in vitro.…”

Pulse Push/Pull Hemodialysis: Convective Renal Replacement Therapy

“…A comparative study of HFR and low-flux bicarbonate HD revealed that HFR reduced not only the plasma level of oxidized low-density lipoprotein (LDL), but also the mRNA production of p22phox and PAI-1 (palsminogen activator inhibitor 1), whose protein expressions are known to be closely related to inflammation and oxidative stress (Calo et al, 2007). Furthermore, plasma total antioxidant capacity (TAC) and antioxidant enzymes activities were found to be lower for HFR than high-flux HD (Gonzalez-Diez et al, 2008). However, contrary results have also been presented.…”

Genomic Damage in Endstage Renal Disease—Contribution of Uremic Toxins

“…Total antioxidant capacity and glutathione peroxidase activity were increased and reactive oxygen metabolites, including pentosidine, advanced oxidation protein products (AOPPs) and oxidized LDL, were decreased in patients undergoing HDF compared to HD [59,60,61,62]. In addition, the p22phox subunit of NADPH oxidase—one of the enzymes possibly partly responsible for the increased oxidative stress—was found to be less expressed in patients on HDF compared to patients on HD [62].…”

“…In addition, the p22phox subunit of NADPH oxidase—one of the enzymes possibly partly responsible for the increased oxidative stress—was found to be less expressed in patients on HDF compared to patients on HD [62]. Last, but not least, the amount of the oxidative 8-oxodG base modification, quantified in lymphocytes after a dialysis session, was significantly lower in HDF than in HD [60], supporting the hypothesis that the HDF procedure is superior not only in eliminating molecules generating oxidative stress or produced by oxidative stress, but itself causes less oxidative stress than HD [63]. …”