Changes in antioxidant status associated with haemodialysis in chronic kidney disease.

Adeyemi Ogunleye,Damilola A Akinfaderin,Tosin T Oluwafemi,Akinwumi A Akinbodewa,Oluseyi A Adejumo

doi:10.4314/gmj.v52i1.6

Adeyemi Ogunleye, Damilola A Akinfaderin + Show 3 more

Open Access

https://doi.org/10.4314/gmj.v52i1.6

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Abstract

We evaluated the effects of one session of HD on the antioxidant capacity and lipid peroxidation in CKD patients. Thirty-six CKD patients requiring HD were recruited into this study. Participants were naïve to HD and each completed a session of three hours using polysulfone membrane dialyzers. Blood samples were collected before and after dialysis. Total antioxidant capacity (TAC) was measured by ferric reducing antioxidant power (FRAP) while malondialdehyde (MDA) was measured using thiobarbituric acid-reactive substance (TBARS). Comparison was made between pre-HD and post-HD values of TAC and MDA respectively, p value of <0.05 was taken as significant. Mean age and estimated glomerular filtration rate of subjects were 45 ±15 years and 6.3± 4.7mls/1.73m2 respectively. There was significant decrease in the mean TAC from 1232.2 ± 495.6 µmol Trolox equiv/ to 832.4 ± 325.7 µmol Trolox equiv/L post-dialysis (p< 0.001) while MDA values were similar before and after HD (11.8 ± 1.8 vs 11.8 ± 2.331)µmol/L (p> 0.05). There was no significant association between changes in antioxidant status following HD with blood flow rate, ultrafiltration volume nor dialyzer per size. A session of HD in patients with CKD is associated with significant reduction of the total antioxidants capacity; and no effect on MDA levels. No external funding received.

Highlights

Oxidative stress has been described to play an important role in disease progression and development of cardiovascular complications in chronic kidney disease (CKD) patients
A number of mechanisms have been postulated as being responsible for oxidative stress in these subjects; certain studies suggested an alteration of the oxidative stress phenomenon, by production of reactive oxygen species on the surface of dialysis membranes and activation of polymorphonuclear leukocytes in patients undergoing hemodialysis (HD)[2,3], another study suggested loss of antioxidant during the course of HD through the dialyzer membranes4,while some studies claim uremia is generally associated with increased oxidative stress.[5]
A total of 36 CKD patients requiring HD participated in this study, 29 were males and 7 were females

Summary

Introduction

Oxidative stress has been described to play an important role in disease progression and development of cardiovascular complications in chronic kidney disease (CKD) patients. CKD is characterized by an imbalance between pro-oxidant and anti-oxidant factors in favor of oxidants which predisposes them to increased risk of cardiovascular disease and increased mortality.[1]. Haemodialysis, the commonest renal replacement therapy in developing countries, has been reported to induce repetitive bouts of oxidative stress primarily through membrane bio-incompatibility.[6,7] While CKD is a pro-oxidant state, HD may contribute significantly to oxidative stress in these patients A number of mechanisms have been postulated as being responsible for oxidative stress in these subjects; certain studies suggested an alteration of the oxidative stress phenomenon, by production of reactive oxygen species on the surface of dialysis membranes and activation of polymorphonuclear leukocytes in patients undergoing hemodialysis (HD)[2,3], another study suggested loss of antioxidant during the course of HD through the dialyzer membranes4 ,while some studies claim uremia is generally associated with increased oxidative stress.[5]

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