Lipophilic Antioxidants and Iron Status in ESRD Patients on Hemodialysis

Abstract

Cardiovascular disease remains the major cause of mortality in hemodialysis patients. Abnormal oxidative stress and impaired antioxidant defense may contribute to accelerated atherogenesis associated with uremia. As oxidative modification of lipids appears to be a prerequisite for the development of atherosclerotic lesions, lipophilic antioxidants may be protective. The aim of this study was to determine the plasma levels of lipophilic antioxidants in 82 hemodialysis patients and 30 controls and to investigate the influence of body iron status on the levels of lipophilic antioxidants. The patients were categorized into 3 groups according to their serum ferritin levels. We found that the plasma levels of lycophene, δ-tocopherol, γ-tocopherol and retinol of hemodialysis patients were lower than those of controls. On the other hand, both absolute and lipid-normalized plasma lycophene levels were significantly reduced in those patients in the groups with higher ferritin levels as compared to those with lower ferritin levels. In addition, our study showed that the lipid-normalized plasma levels of β-carotene and α-carotene of hemodialysis patients with higher ferritin levels were lower than those of the patients with lower levels. These data suggest that the plasma levels of lipophilic antioxidants are altered in end-stage renal disease on hemodialysis and may be considered as markers of oxidative stress in these patients. Most importantly, elevated serum ferritin levels may affect the levels of these lipophilic antioxidants.

Iron Therapy, Advanced Oxidation Protein Products, and Carotid Artery Intima-Media Thickness in End-Stage Renal Disease

“…In keeping with this, an increased total body iron level in patients receiving long-term HD was shown to exacerbate lycopene deficiency, an antioxidant whose deficiency is present even in the absence of iron excess. 32 Our results show that the annual dose of intravenous iron was significantly correlated with serum ferritin and AOPP concentrations. This association was independent of serum C-reactive protein, which was used as a marker of systemic inflammation.…”

Effect of Different Stages of Chronic Kidney Disease and Renal Replacement Therapies on Oxidant-Antioxidant Balance in Uremic Patients

“…Uremic patients have both traditional cardiovascular (CV) risk factors (i.e., old age, hypertension, diabetes, smoking, dyslipidemia, heart failure, and physical inactivity) and nontraditional CV risk factors, including malnutrition, anemia, hyperhomocysteinemia, neuropathy, hyperparathyroidism, and chronic inflammation [3–5]. Patients with end-stage renal disease (ESRD) undergoing renal replacement therapy (RRT), either hemodialysis (HD) or peritoneal dialysis (PD), may face a partial loss of some low-molecular-weight plasma factors (i.e., vitamins A, C, and E) [6, 7] that normally contrast inflammation by neutralizing reactive oxygen species (ROS) [8]. Indeed, the latter are increased during the two therapies [9].…”

Dyslipidemia, Oxidative Stress and Cardiac Dysfunction in Children with Chronic Renal Failure: Effects of L-Carnitine Supplementation

“…7 This may contribute to the accelerated atherogenesis associated with uremia. 8 In dialysis patients abnormal carnitine metabolism may be associated with clinical problems such as skeletal myopathies, intradialytic symptoms, and reduced cardiac function. 6 Trials to demonstrate that exogenous administration of L-carnitine improves uremia-induced subpathologies, have yielded inconsistent results in humans and animals, with some studies reporting clinical benefits.…”