Influence of dialysis on plasma lipid peroxidation products and antioxidant levels

Abstract

In patients with end-stage renal failure (ESRF), the incidence of atherosclerosis and cancer is increased. The importance of lipid peroxidation (LPO) products in the pathogenesis of these complications has recently been emphasized. The LPO products malondialdehyde (MDA) and hexanal, lipophilic antioxidants and erythrocyte glutathione (GSH) were estimated in 10 pediatric hemodialysis (HD) patients before and after HD and in 11 peritoneal dialysis (CPD) patients. Before HD, MDA was elevated [median (interquartile range): 384.5 (110 to 501) nM; normal < 150 nM], whereas plasma hexanal levels were normal in all patients [130.5 (88 to 222) nM; < 320 nM]. HD decreased MDA concentrations on average by 88% but did not change hexanal levels. CPD patients exhibited high plasma MDA concentrations [371 (287 to 468) nM], whereas hexanal was in the low normal range [56 (51 to 81) nM]. Antioxidants were normal in both groups and unchanged during HD. GSH decreased slightly during HD. We hypothesize that MDA may accumulate in ESRF due to reduced plasma clearance. Our results argue against a general increase of LPO in uremia.

Determination of Prooxidant and Antioxidant Balance, Clinical Parameters and Nutrient Intakes in Hemodialysis Patients

“…In our previous studies [6,20], we indicated a defective antioxidant defense during the process of HD, due to the reduction of antioxidants and elevated lipid peroxidation in patients on HD in agreement with the other studies [7,9,[12][13][14]21]. However, a study has shown decrease in the serum levels of MDA compared to control group [22]. While in some studies, antioxidants activity [23] and lipid peroxidation have no change [24].…”

Hemodialysis Does Not Influence the Peroxidative State Already Present in Uremia

“…This process could lead to the peroxidative stress during HD. This oxidative effect of HD, however, is still controversial [8, 9, 10]. Many of the previous studies in this field evaluated lipid peroxidation using TBARS.…”

Effect of Olmesartan on Oxidative Stress in Hemodialysis Patients

“…Until recently, direct evidence for in vivo oxidative stress in HD patients was almost entirely limited to the measurement of lipid peroxidation by-products such as malondialdehyde and other thiobarbituric acid-reactive substances (22). Despite the observation that proteins are highly susceptible to oxidative stress, there have been few reports of the production of oxidatively modified proteins in HD procedures.…”