Impact of Current Dialysis Techniques on Copper Status and Acute Phase Response in Females

Abstract

The impact of current dialysis techniques on indicators of copper status and acute phase response was investigated in this research study to determine whether differences occurred between females dialysed using maintenance hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD).Methodology: Female subjects with end stage renal disease for less than 5 years receiving either maintenance HD, or CAPD, and healthy female controls consented to participate. HD subjects (n = 11; 5 African-American and 6 Caucasian) ranged in age from 28–77 yr (48.0 ± 18.2 yr). HD subjects were dialyzed using cellulose ester (n=3), cellulose acetate (n=4), and polysulfone (n=4) dialyzers. CAPD subjects (n=l1; 11 Caucasian) ranged from 24–70 yr (53.5 ± 13.2 yr). Control subjects (n=11; 11 Caucasian) ranged in age from 24–64 yr (40.1 ± 12.5 yr). Plasma albumin, plasma creatinine, plasma glucose, and blood urea nitrogen were assayed in controls to confirm normal health status. Plasma was collected in trace element grade tubes to obtain fasting plasma copper (Cu), plasma ceruloplasmin activity (CpA), plasma ceruloplasmin concentration (CpC), ceruloplasmin activity to concentration (CpA:CpC), erythrocyte superoxide dismutase with extracted protein (RBCSOD), and plasma interleukin-6 (IL-6). Indicators of copper status and acute phase response were assayed as follows: Cu using atomic absorption spectrophotometry; CpA and RBCSOD using spectrophotometry, CpC using radial immunodifiusion; and IL-6 using an enzyme-linked immunoabsorbent asssay.Statistical Analyses: All data was expressed as mean ± S.D. using the Statistical Analysis Software Program. ANOVA were calculated and considered statistically significant at P< 05.Maior findings: Plasma Cu (1.0 ± .3ng/mL) was significantly (P< 01; ANOVA) depressed in HD only. CpA was significantly (P<01) depressed in both HD (78.27 ± 22.09U/L) and CAPD (94.55 ± 43.39U/L). CpC (687 ± 254mg/L) was significantly (P<05) depressed in HD only. CpA: CpC was significantly depressed (P<01) in both HD (0.17 ± 44U/mg) and CAPD (0.14 ± .53U/mg). RBCSOD (1952.1 ± 980.3U/mg) was significantly (P<01) elevated in HD only. Plasma interleukin-6, an indicator of acute phase response, was significantly (P<.05) elevated in both HD (3.2 ± 4.3pg/mL) and CAPD (3.0 ± 3.1pg/mL). Comparisons between dialysis treatment groups revealed significantly (P<05) depressed CpC and RBCSOD concentrations in females receiving HD compared to those receiving CAPD.Conclusions: This study suggests that despite technical improvements in maintenance dialysis techniques indicators of copper status and acute phase response are abnormal in females undergoing either HD or CAPD. These findings further suggest fewer copper anomalies occur in females prescribed CAPD compared to HD.