Lipid Peroxidation and Antioxidant Activity in Chronic Haemodialysis Patients Treated with Recombinant Human Erythropoietin

Abstract

In anaemia of chronic renal failure, the most important factor in the shortened erythrocyte survival may be lipid peroxidation of the cell membrane. Defective antioxidant activity may increase this damage. Although recombinant human erythropoietin (r-HuEPO) can effectively correct anaemia in chronic haemodialysis patients, its actions on lipid peroxidation and antioxidant activity are not clear. These actions were investigated in 13 patients undergoing chronic haemodialysis. Antioxidant activity, including red blood cell superoxide dismutase and total glutathione peroxidase levels and the lipid peroxidation product malondialdehyde, were measured before and 3 months after initiation of r-HuEPO treatment, using heparinized venous whole blood for cell and plasma determinations. Age-matched healthy volunteers were controls. Significantly higher levels of superoxide dismutase and total glutathione peroxidase were found in the patients than in the controls (p < 0.01). Plasma malondialdehyde levels were not affected by r-HuEPO. The results are explained by erythropoiesis and cellular haemoglobin synthesis due to r-HuEPO, followed by increase of circulating young red cells. The membranes of these young cells contain more antioxidant enzymes than the others. Despite r-HuEPO treatment, plasma malondialdehyde levels in haemodialysis patients may be higher than normal because of the uraemic milieu and the chronic haemodialysis.

Long-Term Erythropoietin Therapy Does Not Affect Metalloproteinases and Their Inhibitor Levels, Oxidative Stress and Inflammation in Hemodialyzed Patients

“…This suggests that EPO administration has no influence on the pro-oxidant state in these patients. Our results are in line with others [16, 17] who showed that plasma MDA levels were not affected by erythropoietin. Moreover, in this study we observed the positive relationship between MMP-2/its inhibitors system and oxidative stress marker-MDA in the HD patients, suggesting that their expression is linked.…”

“…MDA [15,16,17,18], but it is still unclear whether EPO can favor or reduce oxidative stress in HD patients, also considering the role of other possible contributors, particularly iron [17] and anemia per se [18]. Several authors postulated that intravenous iron induces SOX in HD patients [19, 20].…”

Oxidative Stress in Renal Anemia of Hemodialysis Patients Is Mitigated by Epoetin Treatment

“…A higher MDA concentration in the plasma of patients with chronic renal failure as a hint for increased LPO has already been reported by other groups [2,3,8,[17][18][19] . Our group started to measure the oxidative stress in patients with chronic renal failure in dependence on the degree of renal anemia by means of MDA and HNE [20,21] .…”

Central Nervous System Frontiers for the Use of Erythropoietin

“…To investigate whether Prevention of glutamate toxicity [23,24,42] Reduction of apoptosis [44,52] Anti-inflammatory effects [25,42] Antioxidant effects [42,[53][54][55] Stimulation of angiogenesis [56] epoetin alfa might exert a neuroprotective effect during spinal cord ischemic injury in vivo, ischemia was induced in rabbits by occlusion of the abdominal aorta for 20 min [48]. Immediately after release of the occlusion, animals received either normal saline or 350, 800, or 1000 U/kg of epoetin alfa [48].…”