Hypoxia and Oxidative Stress Biomarkers in Hemodialysis Pediatric Patients with Chronic Renal Failure

Abstract

Background: Chronic renal failure (CRF) is responsible for high morbidity and mortality. Tissue injury due to hypoxia and/or free radicals is common in a variety of disease processes.Objectives: This prospective study aimed to investigate effect of CRF and hemodialysis (HD) on hypoxia and oxidative stress biomarkers.Methods: Forty pediatric patients with CRF on HD and 20 healthy children were recruited. Plasma hypoxia induced factor-la (HIF-la), vascular endothelial growth factor (VLGF) were measured by ELISA kits. Total antioxidant capacity (TAC). total peroxide (TPX). pyruvate and lactate by chemical colorimetric methods. Oxidative stress index (OSI) and lactate/pyruvate (L/P) ratio were calculated.Results: TAC was significantly lower while TPX, OSI, VEGF were higher in patients with pre- and post-dialysis session than controls. Lactate, HIF-la levels were significantly higher in pre-dialysis session than controls. Before dialysis, l4'( and LIP ratio were lower than post-dialysis. In controls, LIP ratio correlated positively with ТАС; HIF-le correlated positively with each of LIP ratio and ТАС; VEGF correlated positively with each of TPX and OSI. In post-dialysis, IIF-la correlated negatively with each of ТРХ and OSI. In pre-dialysis session, HIF-la correlated positively with each of dialysis duration and plasma creatinine: VEGF correlated positively with each of dialysis duration, pyruvate and HIF-la, but, negatively with РО,; and, OSI correlated positively with ГРХ, but, negatively with each of TAC and hemoglobin.Conclusion: CRF patients to succumb considerable hypoxia with oxidative stress Hemodialysis ameliorated hypoxia but lowered antioxidants as evidenced by decreased levels of HIF-la and TAC in pre- compared to post-dialysis levels.