Abstract
Background: Hemodialysis (HD) is a method of chronic therapy for patients with renal failure. Diabetic nephropathy is the most common underlying disease among HD patients in Japan. A characteristic problem associated with this condition is endothelial cell damage. We have been using extracellular superoxide dismutase (EC-SOD) attached to the heparan sulfate on the endothelial cell surface as a marker of vascular damage. Methods: This study examined the pre- and post-HD levels of lipoprotein lipase (LPL). The increase in free fatty acid (FFA) is affected by a type of cytokine-like substances, which induces insulin resistance and causes abnormal lipid metabolism. Results: Pre-HD blood samples showed highly significant correlations between EC-SOD and LPL mass ( r=0.792) and between EC-SOD and FFA ( r=0.675) ( p<0.0001). EC-SOD, LPL mass, and FFA were remarkably high among the patients who had been placed on HD treatment for over 20 years. Conclusion: Because EC-SOD and LPL mass represent heparin-binding proteins, these results were considered to reflect severe vascular damage.
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