Abstract
Oxidative stress seems to be involved in the path physiology of cardiovascular complications of chronic kidney disease (CKD). In this study, we determined the effect of different stages of CKD and substitutive therapies on oxidative stress. One hundred sixty-seven patients (age: 44 ± 06 years; male/female: 76/91) with CKD were divided into 6 groups according to the National Kidney Foundation classification. Prooxidant status was assessed by assaying thiobarbituric acid reactive substances, hydroperoxides, and protein carbonyls. Antioxidant defence was performed by analysis of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, vitamin E, Iron, and bilirubin. TBARS and LPO were higher in HD patients compared to other groups (P < 0.001), while protein carbonyls were more increased in PD patients. The antioxidant enzymes were declined already at severe stage of CKD and they were declined notably in HD patients (P < 0.001). Similar observation was found for vitamin E, Fe, and bilirubin where we observed a significant decrease in the majority of study groups, especially in HD patients (P < 0.001). The evolution of CKD was associated with elevated OS. HD accentuates lipid, while PD aggravates protein oxidation. However, the activity of antioxidant enzymes was altered by impaired renal function and by both dialysis treatments.
Highlights
Cardiovascular diseases (CVD) constitute the major risk of morbidity and mortality in chronic kidney disease (CKD) patients [1, 2]
Results showed that the levels of lipid oxidative product (TBARS and LPO) and protein carbonyls were significantly increased in HD and peritoneal dialysis (PD) patients compared to the others’ stage of CKD (P < 0.001) (Table 2)
Our results showed a considerable increase on protein carbonyls in PD patients
Summary
Cardiovascular diseases (CVD) constitute the major risk of morbidity and mortality in chronic kidney disease (CKD) patients [1, 2]. Patients with end-stage renal disease (ESRD) undergoing renal replacement therapy (RRT), either hemodialysis (HD) or peritoneal dialysis (PD), may face a partial loss of some lowmolecular-weight plasma factors (i.e., vitamins A, C, and E) [6, 7] that normally contrast inflammation by neutralizing reactive oxygen species (ROS) [8]. The latter are increased during the two therapies [9]. Various extracellular antioxidants, such as reduced glutathione (GSH), bilirubin, uric acid, and iron (Fe), prevent free radical (FR) reaction by sequestering transition metal ions by chelation in plasma [10]
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