Oxidative stress, inflammation and cardiovascular mortality in haemodialysis—role of seniority and intravenous ferrotherapy: analysis at 4 years of follow-up

Bayés, Beatriz; Pastor, M.C.; Bonal, Jordi; Foraster, Andreu; Romero, R.

doi:10.1093/ndt/gfi294

Cited by 56 publications

(56 citation statements)

References 15 publications

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“…It has been shown that intravenous iron therapy in combination with erythropoietin favors the generation of potent prooxidant radicals, which could trigger the development of atherosclerosis. 32,33 However, recent data prove that in the absence of concomitant iron supplementation, erythropoietin therapy exerts no additional influence on endothelial cell damage and oxidative stress markers of HD patients. 34 Treatment of anemia during our study was based on erythropoietin administration and this solely does not seem to activate lipid peroxidation in dialyzed patients.…”

Section: Discussionmentioning

confidence: 99%

Lipid Abnormalities and Oxidized LDL in Chronic Kidney Disease Patients on Hemodialysis and Peritoneal Dialysis

et al. 2011

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Dyslipoproteinemia and oxidative modification of low-density lipoprotein (oxLDL) contribute to the development of oxidative stress and atherosclerosis in chronic kidney disease (CKD). On the contrary, high-density lipoprotein cholesterol (HDL-C), especially HDL3-C subtype, has protective effect against oxidative damage. There is limited evidence referring HDL-C subclass levels in patients on dialysis. This study was designed to compare lipid abnormalities and oxLDL levels in hemodialysis (HD) and peritoneal dialysis (PD) patients. Serum lipids, HDL subclasses, and oxLDL were measured in 55 patients with CKD-stage 5 (31 patients on HD and 24 patients on PD) and in 21 normal controls (NC). The results showed that in dialysis patients, triglycerides were higher than in controls (p < 0.0001) and HDL-C was significantly lower (p < 0.0001). The HDL2-C subclass concentration did not differ significantly between patients and controls, while HDL3-C was lower in patients (11 ± 0.5 mg/dL) than in NC (23 ± 1, p < 0.0001). oxLDL levels were markedly increased in patients (1.92 ± 0.29 mg/L) compared to NC (0.22 ± 0.05, p < 0.0001). Patients on PD had higher levels of cholesterol (p < 0.001) and apolipoprotein B (p < 0.05) than patients on HD. However, HDL-C, HDL-C subclasses, and oxLDL concentrations did not differ significantly between PD and HD patients. It is concluded that patients with CKD have a nearly 10-fold elevation of oxLDL compared with NC. Patients on PD have differences in the lipid profile compared with patients on HD; however, both modalities seem to possess similar potential to atherosclerosis development.

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Section: Discussionmentioning

confidence: 99%

Lipid Abnormalities and Oxidized LDL in Chronic Kidney Disease Patients on Hemodialysis and Peritoneal Dialysis

et al. 2011

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“…7,24,25 Um dos marcadores avaliado neste estudo foi a determinação do dano oxidativo aos lipídios, lipoperoxidação (LPO). A LPO tem-se mostrado envolvida na patogênese de doenças como aterosclerose e câncer, doenças comumente encontradas entre os pacientes renais crônicos que realizam HD.…”

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Efeito de uma sessão de hemodiálise sobre o estresse oxidativo sistêmico de pacientes renais crônicos terminais

Bianchi¹,

Barp²,

Thomé³

et al. 2009

J. Bras. Nefrol.

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Objective: To assess the effect of a hemodialysis (HD) session on systemic oxidative stress of chronic renal patients. Methods and Results: The study comprised 17 patients (10 women and 7 men with mean age of 39.9 ± 13.5 years) undergoing hemodialytic treatment at the Unit of Nephrology of Hospital de Clínicas de Porto Alegre, and a control group formed by 18 healthy individuals (4 women and 14 men with mean age of 34.8 ± 10.1 years). Renal patients had blood samples withdrawn before and after HD session. Means were analyzed by Student t test (p < 0.05). In red blood cells, the activity of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) was assessed. In plasma, the non-enzymatic antioxidant system was assessed by measuring the total reactive antioxidant potential (TRAP). No significant differences were observed between the values of SOD and CAT before and after HD. Comparison with the control group showed a significant reduction in the activity of those enzymes. After HD session, a significant reduction in TRAP was observed. Oxidative damage to membrane lipids was assessed through chemiluminescence (CL), and the damage to proteins through carbonyl assay. No significant difference was observed in the values of CL and carbonyls after HD. However, when compared with the control group, a significant difference was observed, indicating a greater damage to membrane lipids and proteins in renal patients. Conclusions: Chronic renal patients on HD treatment show a reduction in the activity of antioxidant enzymes SOD and CAT, in addition to an increase in oxidative damage, when compared with healthy individuals. One HD session does not change those levels.

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“…The progression of atherosclerosis and PEW in such patients is accelerated by various factors, in particular oxidative stress and inflammation. Oxidative stress is closely associated with advancing atherosclerosis (2) and is a principal risk factor for cardiovascular mortality in patients on HD (3). Such patients develop uremic syndrome per se or factors associated with uremia and an excessively inflamed state with marked hypoalbuminemia (4).…”

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confidence: 99%

Assessment of Myeloperoxidase and Oxidative α1-Antitrypsin in Patients on Hemodialysis

Honda¹,

Ueda²,

Kojima³

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: The present study assesses the effects of the oxidative stress marker, myeloperoxidase (MPO), and the possible MPO-related oxidative stress marker, oxidative ␣ 1 -antitrypsin (oxAT), on carotid intima-media thickness (CIMT) and protein-energy wasting (PEW) in patients on hemodialysis (HD).Design, setting, participants, & measurements: Blood samples were obtained from 383 patients before HD to measure WBC count, serum albumin, lipids, high-sensitivity C-reactive protein (CRP), ␣ 1 -antitrypsin (AT), interleukin-6, oxidative LDL-C, MPO, and oxAT. We assessed both CIMT and the geriatric nutritional risk index (GNRI) in this cross-sectional competitive study.Results: Levels of MPO and oxAT correlated. Myeloperoxidase was associated with max-CIMT, and oxAT correlated with max-CIMT and GNRI. Multivariate linear regression models showed that MPO and oxAT were independent predictors of increasing max-CIMT, whereas oxAT, but not MPO, independently correlated with GNRI. In four combined MPO and oxAT groups classified according to median values, a multinomial logistic regression model showed that high MPO together with high oxAT was independently associated with increased max-CIMT. Moreover, the OR for max-CIMT with positive PEW and high MPO was significantly increased in the four groups with combined MPO and PEW.Conclusions: High MPO with high oxAT and high MPO with PEW seem to contribute to plaque formation in patients on HD, whereas elevated MPO or oxAT alone might not predict increasing CIMT. In contrast, a high oxAT value seems to be an independent predictor of PEW in patients on HD.

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Oxidative stress, inflammation and cardiovascular mortality in haemodialysis—role of seniority and intravenous ferrotherapy: analysis at 4 years of follow-up

Cited by 56 publications

References 15 publications

Lipid Abnormalities and Oxidized LDL in Chronic Kidney Disease Patients on Hemodialysis and Peritoneal Dialysis

Lipid Abnormalities and Oxidized LDL in Chronic Kidney Disease Patients on Hemodialysis and Peritoneal Dialysis

Efeito de uma sessão de hemodiálise sobre o estresse oxidativo sistêmico de pacientes renais crônicos terminais

Assessment of Myeloperoxidase and Oxidative α1-Antitrypsin in Patients on Hemodialysis

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