LIPID PEROXIDATION PRODUCTS IN CHILDREN WITH CHRONIC RENAL INSUFFICIENCY(CRI)

Abstract

225 Reactive oxygen intermediates are suspected to be a common factor implemented in the development of progressive injury in renal pathologies. Antioxidant vitamins decrease tissue damage by trapping organic free radicals, thus inhibitings lipid peroxidation. Nevertheless, supplementation with vitamins A and E in these patients is no recommended because their already increased levels. On the other hand, vitamin A has been incriminated as being responsible of premature atherosclerosis. In 40 children (31 boys and 9 girls, ages 11±5 years), with chronic renal insufficiency (CRI), whose primary renal diseases were uropathies (n=16), polycystic kidney (n=6), nephropathies by reflux (n=8), and others (n=10), and we have investigated whether deterorating renal function is associated with changes in lipid peroxidation products. Renal function was appreciated by creatinine clearance and plasma Cr51-EDTA clearance. From blood sample, serum was used for total cholesterol, lipoprotein (HDL-c and LDL-c), triglycerides, prealbumin and retinol-binding-protein (RBP) assays, and plasma was used for measurements of vitamin E, A and malondialdehyde acid (MDA). Plasma MDA concentrations were high in 79% of children (> 7,5 μmol/L), showing negative correlation(p<0.05) with intake of monoinsatured fat acid. Significant correlation was observed between MDA levels and total caloric and protein intakes (p< 0.05 and p<0.01, respectively), and they were increased significantly(p<0.05) when the creatinine and Cr51-EDTA clearances were decreased(KT/V 2,84 ± 0,84). Cholesterol, triglycerides, HDL-c and LDL-c serum levels were normal. Plasma vitamin A level was significantly higher and above usual values. This was related to the parallel increase of vitamin A carrier(RBP and prealbumin). Vitamin E concentration was normal. Our results lead to the conclusion that CRI patients tend to exhibit an oxidative stress, at least with regard to an increase in lipid peroxidation products, and it is related with intake of fat and protein. We suggest that theses free radicals could be implicated in the incidence of atherosclerosis, increased in these patients when they become adult.