A modified dialyzer with vitamin E and antioxidant defense parameters

Abstract

Oxidative stress, increased lipid peroxidation, and decreased activity of antioxidant systems may contribute to the accelerated development of atherosclerosis in patients receiving hemodialysis therapy for chronic renal failure. We investigated the influence of vitamin E on antioxidant defense parameters in hemodialysis patients who were using a modified dialyzer. In eight hemodialyzed patients, erythrocyte antioxidant enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GPX), plasma total antioxidant capacity (TAC), the concentration of plasma malondialdehyde (MDA), and vitamins A, E, and C were investigated. Each parameter was measured before and after hemodialysis. The study was divided into three periods. Each period lasted three weeks, and during this time, 10 hemodialyses were performed. The first and second periods were carried out using the conventional dialyzer, Terumo CL-S15, but during the second period, patients received vitamin E 400 mg perorally after each hemodialysis. The third period was carried out using a modified dialyzer with vitamin E, Terumo CL-E15. All hemodialyzed patients were treated by erythropoietin and received vitamin C 50 mg/day and pyridoxine 20 mg/day during the entire study. The peroral administration of vitamin E led to a significant increase of serum vitamin E (22%), and no influence on other antioxidant defense parameters was found. The modified dialyzer with vitamin E led to a significant increase of serum vitamin E (33%) and TAC and to the significant decrease of plasma MDA. The results of our study suggest that the modified dialyzer with vitamin E provided more effective antioxidant defense than peroral administration of vitamin E in our hemodialysis patients.