Oxidative stress in haemodialysis – intradialytic changes

Rao, P. Venkata; Dakshinamurty, Kaligotla Venkata; Saibaba, K. S. S.; Raghavan, Mythili; Vijayabhaskar, M.; Sreekrishna, V.; Ambekar, Jeevan G; Jayaseelan, L

doi:10.1179/135100001101536445

Cited by 11 publications

(10 citation statements)

References 33 publications

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“…The lowest levels were observed in children on maintenance HD. These results are consistent with the data obtained in adult patients with CRF [28, 29]. Moreover, Taccone-Gallucci et al [30] demonstrated the beneficial effect of vitamin E supplementation by decreasing MDA in erythrocytes of uremic patients.…”

Section: Discussionsupporting

confidence: 82%

Vitamins A, E and C as Non-Enzymatic Antioxidants and Their Relation to Lipid Peroxidation in Children with Chronic Renal Failure

Zwołińska

Grzeszczak²,

Szczepańska³

et al. 2005

Nephron Clin Pract

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Background: Increased lipid peroxidation (LP) and reduced enzymatic antioxidant defense have been observed in predialysis patients with advanced chronic renal failure (CRF) and in patients on maintenance hemodialysis (HD). To extend these observations, we evaluated the plasma, erythrocyte and dialysate levels of vitamins A and E and the plasma and dialysate levels of vitamin C as exogenous non-enzymatic antioxidants in children with CRF treated conservatively and on HD. The data obtained were related to LP monitored by erythrocyte malonyldialdehyde (E-MDA) and plasma organic hydroperoxide (OHP) concentrations. Patients: Forty-six predialysis children were enrolled in the study and divided into 2 groups: group I = moderate CRF (plasma creatinine <265.3 µmol/l), and group II = plasma creatinine ≧265.3 µmol/l. Group III consisted of 21 HD children. 27 age-matched healthy subjects served as a control group. Results: The plasma levels of vitamin A and vitamin C were significantly reduced in all CRF patients when compared to the controls, with the lowest values observed in children on maintenance HD (group III). Significant differences were also noted between the moderate CRF (group I) and HD (group III). Plasma levels of vitamin E were significantly decreased in moderate CRF (group I) and HD (group III) as compared to controls. In contrast, the erythrocyte vitamin A and vitamin E levels of predialysis children and HD patients were not different from the controls. The E-MDA and OHP concentrations in the 3 groups of CRF children were significantly higher than in healthy subjects. The concentration of plasma vitamin C was significantly inversely correlated with E-MDA, plasma OHP and creatinine in group I. In group II we found a significant correlation of plasma vitamin E levels with creatinine and E-MDA and a correlation of the plasma vitamin C concentration with E-MDA. Conclusion: CRF in children is associated with decreased concentrations of plasma antioxidant vitamins. This reduction is most expressed in children on maintenance HD and particularly concerns plasma vitamin C and erythrocyte vitamin E concentrations. The low levels of plasma vitamin A, E and C might result in reduced activity of the non-enzymatic antioxidant defense system and might be responsible for increased oxidative stress occurring in children with CRF.

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Section: Discussionsupporting

confidence: 82%

Vitamins A, E and C as Non-Enzymatic Antioxidants and Their Relation to Lipid Peroxidation in Children with Chronic Renal Failure

Zwołińska

Grzeszczak²,

Szczepańska³

et al. 2005

Nephron Clin Pract

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“…However a signifi cant increase of the OS value was noted immediately after hemodialysis. These results are in accordance with other researchers [19][20][21][22] who reported that OS was exacerbated by the dialysis session. Other researchers reported having the opposite result.…”

Section: Discussionsupporting

confidence: 83%

Oxidative Stress Modulation Immediately After Hemodialysis

Alamdari

Honarmand

Sarrafnejad

et al. 2009

Dialysis & Transplantation

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AIMThe aim of this study was to estimate oxidative stress (OS) before and after dialysis in hemodialysis (HD) patients and correlate this stress with routine biochemical parameters.METHODSera of patients (n = 21), under regular HD, were collected 5 minutes before and after an HD session. Oxidative stress was estimated using the pro‐oxidant‐antioxidant assay (PAB), along with routine biochemical parameters in the same sera.RESULTSA significant increase of OS value was observed in HD patients 5 minutes after dialysis. Before HD, a significant correlation was established between the PAB values and fasting blood sugar, calcium, and C‐reactive protein (CRP); and an inverse correlation between the PAB values and uric acid, serum creatinine, albumin, and albumin/globulin ratio. This correlation was not obvious after HD. PAB value, after dialysis, correlated significantly only with serum iron and inversely with alanine transaminase.CONCLUSIONThis study found that the already‐increased OS in HD patients is further increased immediately after dialysis. However, factors influencing post‐dialysis OS may be different from pre‐dialysis factors.

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“…Elevated NO levels in CRF patients, which significantly decreased after dialysis, and evidence for production of oxygen free radicals during HD have been reported. 25,26,27 The present study showed increased levels of FFAs, TG, TC and decreased HDL-C and Ph-lipids in predialysis samples as a consequence of carnitine deficiency with no significant changes after dialysis. After L-carnitine supplementation the FFAs, TC and HDL-C returned to control levels while TG and Ph-lipids continued to be significantly different from controls.…”

Section: Discussionmentioning

confidence: 84%

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

2003

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Background: Secondary carnitine deficiency may develop in chronic renal failure (CRF) patients undergoing longterm hemodialysis (HD), with a resulting higher incidence of cardiovascular diseases, dyslipidemia and oxidative stress. We studied the efficacy of 12 months of L-carnitine supplementation on the amelioration of dyslipidemia, oxidative stress and cardiac dysfunction in 24 CRF children undergoing long-term HD compared with 24 age-and sex-matched controls. Methods: Plasma samples were analyzed spectrophotometerically before and after dialysis sessions and after 2-month supplementation with oral L-carnitine (50 mg/kg/day) for free carnitine (FC), the lipid profile, and oxidative stress markers. Echocardiography the day following dialysis measured cardiac diameters, wall thicknesses, left ventricular mass index (Ml), end diastole and systole volume indices and functions. Results: The pre-dialysis FC concentration was substantially lower than controls and decreased significantly at the end of the dialysis session. Pre-and post-dialysis plasma levels of free fatty acids (FFAs), trigyleride (TG), total cholesterol (TC) and oxidative stress markers significantly increased while high-density lipoprotein cholesterol (HDL-C) and phospholipids significantly decreased compared to controls. Echocardiography detected a significant increase in cardiac diameters and thickness, and systolic and diastolic cardiac dysfunction. After L-carnitine supplementation, plasma levels of FC increased to normal levels. FFAs, TC and HDL-C returned to control levels while TG, phospholipids, and the oxidative stress markers decreased but remained significantly higher than controls. There was a significant decrease in cardiac diameters and an increase in left ventricular diastolic function (E/A ratio), but no correlation between FC levels and echocardiographic parameters. Pre-dialysis, post-dialysis and after treatment, plasma FC level showed a significant positive correlation with HDL-C and phospholipids and a significant negative correlation with each of oxidative stress markers, FFAs, TG and TC. On the other hand, FFAs showed a significant positive correlation with TG, TC, DC, NO and a significant negative correlation with HDL-C and phospholipids. Conclusion: This study demonstrates that CRF children under regular HD suffer from a decrease in the level of plasma FC, dyslipidemia, oxidative stress, and an increase in cardiac diameters and thickness with impairment of cardiac functions. Oral L-carnitine supplementation at a dose of 50 mg/kg for 2 months can increase plasma FC level, improve dyslipidemia, decrease oxidative stress with reduction of cardiac diameters and increase in diastolic function.

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Oxidative stress in haemodialysis – intradialytic changes

Cited by 11 publications

References 33 publications

Vitamins A, E and C as Non-Enzymatic Antioxidants and Their Relation to Lipid Peroxidation in Children with Chronic Renal Failure

Vitamins A, E and C as Non-Enzymatic Antioxidants and Their Relation to Lipid Peroxidation in Children with Chronic Renal Failure

Oxidative Stress Modulation Immediately After Hemodialysis

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

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