Fat-Soluble Vitamins in Patients with Acute Renal Failure

Druml, Wilfred; Schwarzenhofer, Maria; Apsner, Robert; Hörl, Walter H.

doi:10.1159/000057374

Cited by 62 publications

(29 citation statements)

References 24 publications

(28 reference statements)

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“…Patients with MOF in this study also manifested significantly higher plasma levels of thiobarbituric acid-reactive substances (TBARS), a marker of lipid peroxidation. Likewise, significant deficiencies of fat-soluble antioxidant vitamins such as vitamin A and vitamin E have been observed in patients with ARF as compared to healthy control subjects [4]. In addition, antioxidant defenses are depressed in critically ill patients with multiple organ failure (MOF).…”

Section: Introductionmentioning

confidence: 99%

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

Balakrishnan¹,

Blumberg²,

Pereira³

et al. 2003

Blood Purif

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Background: Experimental animal models and in vitro studies have established a role for reactive oxygen species and the therapeutic potential for free radical scavengers in acute renal failure (ARF). Little is known of the effects of hemodialysis and other clinical variables on antioxidant defenses and oxidative stress among patients with ARF. Methods: We examined antioxidant defenses and oxidative stress status in 24 patients with ARF requiring hemodialysis (HD). Blood samples were drawn prior to the first dialysis session (baseline), as well as before and after the third and sixth dialysis sessions. At each time point, the following parameters were measured: plasma α-tocopherol (vitamin E), plasma glutathione peroxidase (GSH-Px), serum total oxygen radical absorbance capacity (ORAC), plasma thiobarbituric acid reactive substances (TBARS), plasma tumor necrosis factor-α (TNF-α), and interleukin-10 (IL-10). Multivariate linear regression analyses were performed to examine clinical/laboratory variables associated with antioxidant/oxidative stress indices. The changes in antioxidant/oxidative stress indices over time after initiation of hemodialysis was evaluated in a subgroup of patients (n = 11) who completed six dialysis sessions. Intradialytic changes in antioxidant/oxidative stress indices and the differential impact of cellulose acetate vs. polysulfone dialyzers were also evaluated. Results: Factors associated with α-tocopherol level were serum albumin (301 µg/dl ↑ for each 1 g/dl ↑ in albumin) and ORAC (188 µg/dl ↑ for each 1,000 µmol Trolox Eq/l ↑ in ORAC). Age was independently associated with plasma GSH-Px levels (55 U/l ⇓ for each 10-year age ↑ ). Factors associated with ORAC were α-tocopherol (85 µmol Trolox Eq/l ↑ for each 100 µg/dl ↑ in α-tocopherol) and total bilirubin (30 µmol Trolox Eq/l ⇓ for each 1 mg/dl ↑ in total bilirubin). Total bilirubin was independently associated with TBARS (0.2 µM ↑ for each 1 mg/dl ↑ in total bilirubin). GSH-Px and ORAC levels declined over time between baseline and the sixth dialysis session (p < 0.05 for both). Finally, there was a significant intradialytic decline in ORAC levels, which appeared to be more pronounced with use of cellulose acetate compared with polysulfone dialyzer membranes (p < 0.05). Conclusions: These observations indicate that antioxidant and oxidative stress indices in ARF patients are associated with several clinical and laboratory variables as well as the dialysis procedure. Further studies are needed to investigate the therapeutic role of anti-oxidant therapy in these patients.

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Section: Introductionmentioning

confidence: 99%

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

Balakrishnan¹,

Blumberg²,

Pereira³

et al. 2003

Blood Purif

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“…Both of these imbalances can occur in acute renal failure (ARF). Indeed, in recent years, considerable evidence has incriminated ROS in the pathogenesis of both ischemic and nephrotoxic kidney injury (3)(4)(5)(6)(7).…”

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confidence: 99%

NADPH Oxidase p22phox and Catalase Gene Variants Are Associated with Biomarkers of Oxidative Stress and Adverse Outcomes in Acute Renal Failure

Perianayagam

Liangos

Kolyada

et al. 2007

Journal of the American Society of Nephrology

123

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Reactive oxygen species are important mediators of injury in acute renal failure (ARF). Although polymorphisms that affect key pro-and antioxidant enzymes might alter the susceptibility to oxidative stress-mediated injury, the use of genetic epidemiology for the study of oxidative stress-related genes has received little attention in ARF. The relationship of single-nucleotide polymorphisms in the coding region (C to T substitution at position ؉242) of the pro-oxidant enzyme NADPH oxidase p22phox subunit gene and in the promoter region (C to T substitution at position ؊262) of the antioxidant enzyme catalase gene to adverse clinical outcomes was evaluated prospectively in a cohort of 200 hospitalized patients with established ARF of mixed cause and severity. Genomic DNA was extracted from peripheral blood leukocytes and analyzed with a restriction fragment length polymorphism PCR method. Genotype-phenotype associations were characterized by measuring circulating nitrotyrosine and catalase activity. Observed and expected genotype frequencies were not significantly different, and overall baseline characteristics were not significantly different according to the various genotype groups. A genotype-phenotype association was demonstrable between the NADPH oxidase p22phox genotypes and plasma nitrotyrosine level (P ‫؍‬ 0.06), as well as between the catalase genotypes and whole-blood catalase activity (P < 0.001). Compared with the NADPH oxidase p22phox CC genotype group, the T-allele group had a higher cumulative probability of remaining hospitalized (P ‫؍‬ 0.03). Compared with the NADPH oxidase p22phox CC genotype, the T-allele carrier state was associated with 2.1-fold higher odds for dialysis requirement or hospital death (P ‫؍‬ 0.01). This association persisted with 2.0-to 2.2-fold higher odds for this composite outcome after adjustment for race; gender; age; and the Acute Physiology and Chronic Health Evaluation II score (P ‫؍‬ 0.03), the Multiple Organ Failure score (P ‫؍‬ 0.01), or presence of sepsis (P ‫؍‬ 0.02). The polymorphism in the gene that encodes the NADPH oxidase p22phox subunit at position ؉242 is associated with dialysis requirement or hospital death among patients with ARF. Larger studies are needed to confirm these relationships.

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“…Based on the fact that calcitriol results in a significant improvement in the oral glucose tolerance of human diabetics, the use of calcitriol as an adjuvant to the conventional therapy in DM has been suggested (57). Further, the ability of calcitriol to improve insulin resistance is being exploited in patients with chronic renal failure, though its role in acute renal failure awaits evaluation (58,59).…”

Section: Nonclassical Systemic Effectsmentioning

confidence: 99%

Vitamin D: Actions for the new millennium

Lai

Pandey

Aggarwal

2000

Indian J Clin Biochem

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The past two decades have witnessed new facets in vitamin D metabolism. Free vitamin D3 till now considered to be limited to animal sources, has been shown to occur in plants. Further, the extrarenal synthesis of active vitamin D3 or calcitriol has been documented in physiological as well as in certain pathological conditions. At the cellular level, calcitriol acts through a dual mechanism.The genomic pathway involves the vitamin D receptor (VDR) which is of ubiquitous distribution and linked with various diseases. Besides, a nongenomic VDR -independent pathway also exists. The biological effects of calcitriol can no longer be dismissed by merely referring to calcium/bone homeostasis. It enhances the perinatal growth and suppresses the abnormal growth, as well. The effects on the endocrine, immune, cardiovascular, reproductive and nervous systems have also been characterized. It is compelling to believe that calcitriol and/or its analogues will find extensive applications at least in the treatment of osteoporosis, perinatal growth retardation, neoplasia, psoriasis, insulin resistance and transplantation.

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Fat-Soluble Vitamins in Patients with Acute Renal Failure

Cited by 62 publications

References 24 publications

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

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

NADPH Oxidase p22phox and Catalase Gene Variants Are Associated with Biomarkers of Oxidative Stress and Adverse Outcomes in Acute Renal Failure

Vitamin D: Actions for the new millennium

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