Oxidative Stress Markers and C-Reactive Protein in Pediatric Patients on Hemodialysis

Elshamaa, Manal F.; Sabry, Samar; Nabih, Mohamed; Elghoroury, Eman A.; El-Saaid, Gamila S.; Ismail, Amany A.G.

doi:10.1159/000245938

Cited by 17 publications

(7 citation statements)

References 66 publications

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“…Animal experiments have demonstrated that administration of an antioxidant and plasma peroxidation inhibitor to 5/6 nephrectomy rats with increased plasma markers of oxidative stress partially attenuates HTN, and that HTN recurs in the absence of the inhibitor [45]. Pediatric ESRD patients have increased levels of plasma markers of oxidative stress compared to healthy controls, which is consistent with findings in adults [46]. There is no data demonstrating the relationship between ROS and BP in the pediatric ESRD population.…”

Section: Pathophysiologymentioning

confidence: 66%

Hypertension and hemodialysis: pathophysiology and outcomes in adult and pediatric populations

Buren

Inrig

2011

Pediatr Nephrol

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Hypertension is prevalent in adult and pediatric end-stage renal disease patients on hemodialysis. Volume overload is a primary factor contributing to hypertension, and attaining true dry weight remains a priority for nephrologists. Other contributing factors to hypertension include activation of the sympathetic and renin–angiotensin–aldosterone systems, endothelial cell dysfunction, arterial stiffness, exposure to hypertensinogenic drugs, and electrolyte imbalances during hemodialysis. Epidemiologic studies in adults show that uncontrolled hypertension results in cardiovascular morbidity, but reveal increased mortality risk at low blood pressure, so that it remains unclear what the target blood pressure should be. Despite the lack of a definitive BP target, gradual dry weight reduction should be the first intervention for BP control. Renin–angiotensin–aldosterone system inhibitors have been shown to improve cardiovascular morbidity and mortality and are recommended as the initial pharmacologic therapy for hypertensive hemodialysis patients. Short-daily or nocturnal hemodialysis are also good therapeutic options for these patients. It is already established that hypertension in pediatric hemodialysis patients is associated with adverse cardiovascular outcomes, and there is emerging evidence that the mechanisms causing hypertension are similar to adults. Hypertension in adult and pediatric hemodialysis patients warrants aggressive management, although clinical trial evidence of a target BP that improves mortality does not currently exist.

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Section: Pathophysiologymentioning

confidence: 66%

Hypertension and hemodialysis: pathophysiology and outcomes in adult and pediatric populations

Buren

Inrig

2011

Pediatr Nephrol

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“…4 In addition, the circulating biomarkers of oxidative stress and chronic inflammatory cytokines such as malondialdehyde (MDA), C-reactive protein (CRP) or interleukin-6 (IL-6) are significantly elevated in maintenance HD patients. 5,6 There is increasing evidence that increased oxidative stress and inflammatory cytokines play a key role in the pathogenesis of malnutrition, 7 resistance to erythropoietin, 8 …”

Section: Introductionmentioning

confidence: 99%

Effects of vitamin E-coated dialysis membranes on anemia, nutrition and dyslipidemia status in hemodialysis patients: a meta-analysis

Huang

et al. 2015

Renal Failure

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Background: This was controversial whether vitamin E-coated dialyzer therapy was beneficial for the complications associated with hemodialysis. Therefore, we performed this systematic review to evaluate the effects of vitamin E-coated dialyzer. Methods: Related trials were searched from multiple electronic databases. We conducted meta-analysis to assess changes in the predefined outcomes using RevMan 5.3 software. Results: Meta-analysis showed vitamin E-coated dialyzer therapy could decrease erythropoietin (EPO) resistance index (SMD, À0.24; 95% CI, À0.47 to À0.01; p ¼ 0.04). However, pooled-analysis showed vitamin E-coated dialyzer therapy could not decrease weekly EPO dose (SMD, À0.11; 95% CI, À0.32 to 0.09; p ¼ 0.28) and intima-media thickness (IMT) of the carotid artery (MD, À0.09; 95% CI, À0.2 to 0.01; p ¼ 0.09), and vitamin E-coated dialyzer therapy did not improve the serum hemoglobin (MD, À0.03; 95% CI, À0.18 to 0.13; p ¼ 0.74), albumin levels (SMD, À0.64; 95% CI, À1.62 to 0.34; p ¼ 0.2), in addition, there was no significant difference in serum cholesterol (SMD, À0.07; 95% CI, À0.45 to 0.31; p ¼ 0.71), triglycerides (MD, À2.77; 95% CI, À32.42 to 26.87; p ¼ 0.85), high density lipoprotein (HDL) (SMD, 0.24; 95% CI, À0.14 to 0.62; p ¼ 0.22) and low density lipoprotein (LDL) (SMD, 0.00; 95% CI, À0.38 to 0.37; p ¼ 0.98) levels. Conclusions: Vitamin E-coated dialyzer may reduce the EPO resistance, but there is no conclusive evidence that vitamin E-coated dialyzer can improve the renal anemia, malnutrition, dyslipidemia and atherosclerosis status in hemodialysis (HD) patients. However, high-quality trials with hard clinical endpoints are required to fully elucidate the clinical value of vitamin E-coated dialyzer therapy.

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“…Hemodialysis (HD) patients have a higher oxidative state, which results in the reduction of total antioxidant capacity and increased inflammation . HD patients experience numerous complications such as atherosclerosis and malnutrition, which may partly result from excess reactive oxygen species and/or decreased antioxidant activity . There is growing evidence from experimental and clinical studies that oxidative stress may be involved in the pathogenesis of malnutrition .…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6] HD patients experience numerous complications such as atherosclerosis and malnutrition, which may partly result from excess reactive oxygen species and/or decreased antioxidant activity. [7][8][9][10][11][12][13] There is growing evidence from experimental and clinical studies that oxidative stress may be involved in the pathogenesis of malnutrition. 9,12 Malnutrition, which is a significant adverse risk factor for poor patient prognosis, is associated with surrogate markers of oxidative stress.…”

Section: Introductionmentioning

confidence: 99%

The relationship between glutathione peroxidase and bioimpedance parameters in nondiabetic hemodialysis patients

Çelik

Yöntem

Cilo

et al. 2011

Hemodialysis International

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There is growing evidence from experimental and clinical studies that oxidative stress is involved in the pathogenesis of malnutrition. This cross-sectional study aimed to investigate the relationship between glutathione peroxidase (GPx) levels as a marker of antioxidant status and the nutritional status assessed by bioimpedance analysis (BIA). Ninety-seven nondiabetic stable outpatient uremic adults undergoing chronic hemodialysis (HD) were recruited for this study. Impedance measurements were performed using a multifrequency bioelectrical impedance analyzer after dialysis. GPx levels correlated with intracellular water (ICW) (r = 0.341, P = 0.011), ICW/total body weight (r = 0.320, P = 0.017), lean body mass (r = 0.300, P = 0.026) and total body cell mass (r = 0.339, P = 0.011). When patients were divided into two groups according to mean GPx levels (83.9 U/gr hemoglobin), the patients with higher GPx (GPx > 83.9 U/gr hemoglobin) had higher albumin (P = 0.038), lean body mass (P = 0.026), ICW (P = 0.011), and total body cell mass (P = 0.011) compared with those with lower GPx (GPx ≤ 83.9 U/gr hemoglobin). Furthermore, in the patients with higher GPx, body fat; extracellular water/total body water; illness marker and body fat mass index were lower than other group. In conclusion, our results reveal correlation indicating a relationship between antioxidant status (as measured by GPx) and nutritional status as assessed by BIA in nondiabetic HD patients.

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Oxidative Stress Markers and C-Reactive Protein in Pediatric Patients on Hemodialysis

Cited by 17 publications

References 66 publications

Hypertension and hemodialysis: pathophysiology and outcomes in adult and pediatric populations

Hypertension and hemodialysis: pathophysiology and outcomes in adult and pediatric populations

Effects of vitamin E-coated dialysis membranes on anemia, nutrition and dyslipidemia status in hemodialysis patients: a meta-analysis

The relationship between glutathione peroxidase and bioimpedance parameters in nondiabetic hemodialysis patients

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