The effect of hemodialys on endothelial dysfunction in patients with end-stage
 renal disease

Abstract

Purpose. To study the effect of a single hemodialysis (HD) session on the endothelial structure and function by analyzing the contents of nitric oxide (NO) stable metabolites and circulating endothelial cells (CECs) number, and to establish the interrelation between the oxidative stress (OS) marker malondialdehyde (MDA) and endothelial dysfunction indices in patients with end-stage renal disease (ESRD). Material and methods. The study included 20 chronic HD patients (9 men aged 41,0±3,0 years; HD duration, (40,4±4,8) months). Patients with chronic glomerulonephritis (65%) dominated. Plasma content of MDA, the activity of superoxide dismutase (SOD) and catalase (CT) in erythrocytes, blood content of SH-groups were measured before and after the HD session by standard methods. Plasma content of nitrite-( NO2-) and nitrate anion (NO3-) was estimated by the spectrophotometric method, and CEC amount in platelet-rich plasma ss described by Hladovec J. et al., 1978 in our modification. Results. After the HD session NO2- content decreased by 18,4% (p<0,001), NO3- by 13,4% (p=0,007), while CEC number did not significantly change (p=0,478). Due to HD the content of MDA increased by 10,5% (p=0,007), the activity of SOD, CT increased by 8,9% (p=0,005) and 16,2% (p=0,016) respectively, and the concentration of SH-groups decreased by 20,8% (p<0,001). Significant correlation between the content of MDA and NO2- (Rs=-0,56, p=0,010), CECs amount (Rs=0,52, p=0,018) was established; the CEC number was in turn related to the level of NO2- (Rs=-0,58, p=0,007). Conclusions. The HD session is associated with the development of OS, lack of NO and possibly endothelial damage which confirms practicability of endothelial protection, in particular modulation of the L-arginine-NO system, during HD session in patients with ESRD.