Oxidative stress in haemodialysis: immediate changes caused by passage of blood through the dialyser

Abstract

Oxygen free radicals have been implicated in the long-term complications of maintenance haemodialysis. Studies that have probed into the mechanisms of oxygen radical production have implicated the bio-incompatibility of dialysis membranes. Changes between the arterial (inlet) and venous (outlet) points of a dialyser may give a better picture of blood±membrane interaction. There are very few studies on changes across the dialyser. Hence, it was planned to study the immediate changes that occur due to passage of blood through the dialyser. Changes between the arterial and venous ends of the dialyser after 1 h of dialysis were studied in four combinations of dialysate and membrane. There was a signi®cant decrease in plasma vitamin E concentrations in all the groups during ®rst-use dialysis. This was not observed with re-use dialysis. A decrease in plasma lipid peroxides was also observed in all the groups with both ®rst and re-use dialysis. There was no signi®cant difference in the parameters studied among the four types of dialysis. A less severe, reactive oxygen radical generation was observed with re-use of membranes.

Elimination of Lipid Peroxide during Hemodialysis

“…This time is quite short for the correction of reducing system by HD, which was damaged by uremia, and there remains a possibility that these decreases are brought about by absorption to the dialyzer membranes or the surface of dialysis circuits. One group reported both pro- and anti-oxidative changes occurring immediately and caused by the passage of blood through the dialyzer though the underlying mechanism was still unclear [8, 9]. …”

“…In the nephrological fields, many studies employ LOOH to evaluate oxidative stress in end-stage renal failure, uremia and hemodialysis (HD). Most of these studies identified an increase of LOOH because of increased oxidative stress [2,6,7,8,9,10]. LOOH is commonly treated as the end-product of an oxidative reaction intermediated by reactive oxygen species (ROS) or reactive nitrogen species.…”

Effect of reuse of polysulfone membrane on oxidative stress during hemodialysis

“…[132324] Reuse of membranes is said to be associated with less complement activation than fresh membranes as a result of fixation of plasma proteins to the membranes and hence lead to less ROS production. [12] We found an increase in MDA as a result of reuse of the membrane ( P <0.05).…”

“…[89] Even a single session of hemodialysis increases lipid peroxides and decreases antioxidants. [10–12] However, there are only a few reports on effect of reuse of the dialyzer membrane on oxidative stress. [1314] Most of the studies with the reuse of dialyzer are experimental studies probing into the reactive oxygen species production as an index of the polymorphonuclear leukocyte (PMNL) function[15] and the complement activation[16] as a result of reuse of the dialyzer rather than difference in the oxidative stress situation between fresh and reuse dialysis.…”

Oxidative Stress Modulation Immediately After Hemodialysis

“…17,31,32 In addition, HD membrane materials may activate neutrophils 33 and platelets. 34 The abrupt change of hemodynamic and metabolic balance caused by dialysis may also add to the development of OS.…”