Is oxidative stress an issue in peritoneal dialysis?

Roumeliotis, Stefanos; Eleftheriadis, Theodoros; Liakopoulos, Vassilios

doi:10.1111/sdi.12818

Cited by 45 publications

(65 citation statements)

References 28 publications

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“…During the past few decades, OS has emerged as a novel risk factor for CV disease [ 19 , 20 ] and progression of renal function in CKD [ 21 ]. Ox-LDL plays a pivotal role in the development of diabetic CKD [ 22 ]; not only does the onset of diabetic CKD trigger the generation of ox-LDL molecules [ 23 ], but also diabetics with albuminuria exhibit increased plasma ox-LDL levels [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Association of dp-ucMGP with Cardiovascular Morbidity and Decreased Renal Function in Diabetic Chronic Kidney Disease

Roumeliotis

Στάμου

et al. 2020

IJMS

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We aimed to investigate the possible association of the inactive, dephosphorylated, uncarboxylated matrix Gla protein (dp-ucMGP) with oxidized low-density lipoprotein (ox-LDL) and all-cause/cardiovascular (CV) mortality and renal function in diabetic chronic kidney disease (CKD). Ox-LDL and dp-ucMGP were determined in 66 diabetic CKD patients. All patients were prospectively followed for seven years, or until the occurrence of death, or a composite renal outcome of 30% estimated glomerular filtration rate (eGFR) reduction or progression to end-stage renal disease (ESRD) requiring dialysis occurred. Secondary outcomes were the occurrence of CV events. Kaplan–Meier curves showed that patients with plasma dp-ucMGP levels above the median (≥656 pM) had a significantly higher risk for all study endpoints. After adjustment for several well-known cofounders, multivariate Cox analysis showed that high plasma dp-ucMGP levels were associated with all-cause mortality (Hazard ratio-HR = 2.63, 95% Confidence Interval-CI = 1.17–5.94, p = 0.02), CV mortality (HR = 2.82, 95% CI = 1.07–7.49, p = 0.037) and progression of CKD (HR = 4.02, 95% CI = 1.20–13.46, p = 0.024). Circulating dp-ucMGP is associated with mortality and decreased renal function in diabetic CKD.

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Section: Discussionmentioning

confidence: 99%

The Association of dp-ucMGP with Cardiovascular Morbidity and Decreased Renal Function in Diabetic Chronic Kidney Disease

Roumeliotis

Στάμου

et al. 2020

IJMS

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“…In HD patients, several factors, such as duration of dialysis, biocompatibility of dialyzer membrane and dialysate, intravenous iron administration, activation of leukocytes, retention of uremic toxins, or anemia, contribute to the development and accumulation of oxidative products. In addition, the composition of PD dialysate solutions (such as increased osmolarity, low pH, high-glucose content, and presence of lactate buffer) can trigger oxidative stress in PD patients (Liakopoulos et al, 2017Roumeliotis et al, 2019a). However, PD is considered to be more biocompatible than HD.…”

Section: Changes In Cellular Balance Of Reactive Oxygen Species Can Cmentioning

confidence: 99%

“…However, PD is considered to be more biocompatible than HD. Indeed, HD shows increased accumulation of pro−oxidants and depletion of antioxidants compared with PD (Liakopoulos et al, 2017Roumeliotis et al, 2019a). Table 1 lists clinical studies on triggers of oxidative stress and damage in patients with CKD and ESRD undergoing HD or DP.…”

Section: Changes In Cellular Balance Of Reactive Oxygen Species Can Cmentioning

confidence: 99%

“…In addition to formation and accumulation of pro-oxidant molecules, CKD patients, especially those undergoing dialysis, can also suffer a considerable downregulation in antioxidative and defensive mechanisms. This is associated with several factors, such as malnutrition, dietary restrictions, or loss of vitamins and trace elements occurring during HD or PD (Liakopoulos et al, 2017Roumeliotis et al, 2019a). Implementing lifestyle interventions, such as administration of exogenous antioxidants, in patients with CKD on dialysis may downregulate the inflammation and oxidative stress associated with CVD-linked morbidity and mortality even in early stages of CKD (Liakopoulos et al, 2019a,b;Roumeliotis et al, 2019b).…”

Section: Changes In Cellular Balance Of Reactive Oxygen Species Can Cmentioning

confidence: 99%

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Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence

Carracedo

Alique

Vida

et al. 2020

Front. Cell Dev. Biol.

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Cardiovascular diseases (CVDs), especially those involving a systemic inflammatory process such as atherosclerosis, remain the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). CKD is a systemic condition affecting approximately 10% of the general population. The prevalence of CKD has increased over the past decades because of the aging of the population worldwide. Indeed, CVDs in patients with CKD constitute a premature form of CVD observed in the general population. Multiple studies indicate that patients with renal disease undergo accelerated aging, which precipitates the appearance of pathologies, including CVDs, usually associated with advanced age. In this review, we discuss several aspects that characterize CKD-associated CVDs, such as etiopathogenic elements that CKD patients share with the general population, changes in the cellular balance of reactive oxygen species (ROS), and the associated process of cellular senescence. Uremiaassociated aging is linked with numerous changes at the cellular and molecular level. These changes are similar to those observed in the normal process of physiologic aging. We also discuss new perspectives in the study of CKD-associated CVDs and epigenetic alterations in intercellular signaling, mediated by microRNAs and/or extracellular vesicles (EVs), which promote vascular damage and subsequent development of CVD. Understanding the processes and factors involved in accelerated senescence and other abnormal intercellular signaling will identify new therapeutic targets and lead to improved methods of diagnosis and monitoring for patients with CKD-associated CVDs.

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“…This markedly heavy CV burden that accompanies CKD cannot be solely explained by classic risk factors. Novel uremia and dialysis-related factors such as oxidative stress, inflammation and impaired calcium/phosphorus metabolism have been shown to promote vascular calcification (VC) and CVD in ESRD patients (4)(5)(6)(7)(8). VC is present even at early CKD stages, is gradually increased with disease progression and is an undisputed independent risk factor for CVD and mortality in uremia.…”

Section: Introductionmentioning

confidence: 99%

Vascular Calcification in Chronic Kidney Disease: The Role of Vitamin K- Dependent Matrix Gla Protein

et al. 2020

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Arterial calcification is highly prevalent in chronic kidney disease (CKD) patients and is associated with cardiovascular (CV) morbidity and mortality. Patients at early CKD stages are more likely to suffer a fatal CV event than to develop end-stage renal disease and require hemodialysis treatment. The heavy CV burden of these patients cannot be solely explained by traditional calcification risk factors. Moreover, the pathophysiologic mechanisms underlying this association are complex and yet not fully understood. Although vascular calcification was regarded as a passive degenerative process for over a century, this theory changed by recent evidence that pointed toward an active process, where calcification promoters and inhibitors were involved. Matrix Gla Protein (MGP) has been established as a strong inhibitor of calcification both in vitro and in vivo. Not only it prevents mineralization of the arterial wall, but it is the only factor that can actually reverse it. To become fully active, MGP must undergo carboxylation of specific protein bound glutamate residues, a process fully dependent on the availability of vitamin K. Low vitamin K status leads to inactive, uncarboxylated forms of MGP and has been repeatedly associated with accelerated vascular calcification. Aim of this review is to present the pathophysiologic mechanisms underlying the activation and function of MGP and review the existing, accumulating data regarding the association between vitamin K, MGP and vascular calcification/CV disease in CKD patients.

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Is oxidative stress an issue in peritoneal dialysis?

Cited by 45 publications

References 28 publications

The Association of dp-ucMGP with Cardiovascular Morbidity and Decreased Renal Function in Diabetic Chronic Kidney Disease

The Association of dp-ucMGP with Cardiovascular Morbidity and Decreased Renal Function in Diabetic Chronic Kidney Disease

Mechanisms of Cardiovascular Disorders in Patients With Chronic Kidney Disease: A Process Related to Accelerated Senescence

Vascular Calcification in Chronic Kidney Disease: The Role of Vitamin K- Dependent Matrix Gla Protein

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