Imbalance of Oxidants and Antioxidants in Haemodialysis Patients

Abstract

Dialysis-related pathology (DRP) observed in long-term haemodialysis patients is increasingly reported. Among DRP manifestations, cardiovascular disease is the most frequent, being the first cause of mortality in haemodialysis patients. Alterations in lipid metabolism and oxidative stress are recognised as major risk factors that could be prevented or reduced by optimal therapy.In order to evaluate the rationale for preventive intervention against oxidative damage we review the factors that are implied and may be responsible for the imbalance between prooxidative and antioxidative mechanisms in haemodialysis patients. Oxidative stress resulting from this imbalance is responsible for increasing stress markers and enhancing susceptibility to LDL oxidation. Factors implied in this prooxidative state belong to four groups: (1) uremia and comorbid status of the end stage renal disease (ESRD) patient; (2) losses of antioxidant substances via the dialysis; (3) haemoincompatibility of the dialysis system; (4) adjuvant therapy. Such prooxidant status could have further deleterious consequences since it has been recently shown that antioxidant status could modulate cell functions such as reactive oxygen species (ROS) production, adhesive molecule expression and/or cell proliferation.Preventive modalities, including use of biocompatible membrane, ultrapure dialysate, exogenous supplementation of antioxidant vitamins, extracorporeal removal of ROS and oxidatively-modified substances, would appear highly desirable to reduce complications of long-term dialysis patients.

Effect of Hydrogen Peroxide and High Glucose on the Glucose Metabolism of Lymphoma-derived U937 Cells

“…Malignant lymphoma-derived U937 cells provide an in vitro model of blood cells for DM-associated hemodialysis, raising the possibility that high oxidative stress during treatment is worsened in patients with high blood glucose. This in vitro study also proves the importance of strict blood glucose control in order to reduce oxidative stress in hemodialysis patients with various complications such as arteriosclerosis [9][10][11] .…”

Multiple Antioxidants and L-Arginine Modulate Inflammation and Dyslipidemia in Chronic Renal Failure Rats

“…[16][17][18] Other than the abnormalities in NO synthetic pathway, the pro-oxidant and antioxidant capacity is disturbed in CRF, resulting in increased oxidative stress. [19,20] This potentially mediates cardiovascular, neurological, and several other complications of CRF and its byproducts, as advanced glycation end products (AGE), oxidized LDL, and lipoperoxide augment further oxidative damage and inflammation via activation of macrophages. [21] Components of the anti-oxidant defense mechanisms, including vitamins C and E, selenium, and glutathione (GSH) scavenging system, are deficient in patients with CRF, and a protein oxidation patterns consistent with leukocyte myeloperoxidase-mediated events has been demonstrated in these patients.…”

Coenzyme Q10and its Relation with Oxidant and Antioxidant System Markers in Patients with End-Stage Renal Disease

“…7,8 In addition, several markers of the antioxidant system have been studied in CKD patients including vitamins A and E, carotenoids, and glutathione. 9 However, only a few studies evaluated the role of coenzyme Q 10 (CoQ 10 ) as a component of antioxidant system in CKD patients. [10][11][12] To our knowledge, no study in the literature looked at the relation of serum CoQ 10 and markers of oxidative stress and antioxidant system in CKD and dialysis (peritoneal dialysis, PD, and hemodialysis, HD) patients.…”