Erythrocyte Membrane Lipid Peroxidation Research Articles

Protection of lipid peroxidation and carbonyl formation in proteins by capsaicin in human erythrocytes subjected to oxidative stress

Capsaicin (8-methyl-N-vanillyl-6-nonemide) is the major pungent principle found in hot peppers of the plant genus Capsicum. The present work was undertaken to investigate the antioxidative property of capsaicin on markers of oxidative stress; membrane lipid peroxidation (formation of malondialdehyde) and membrane carbonyl groups in human erythrocytes. The effect of capsaicin has been compared with l-ascorbic acid. Subjecting erythrocytes to oxidative stress by incubating them with t-BHP caused a significant increase in MDA level and protein carbonyl group content above the basal value. The presence of capsaicin (10 microm) in the incubation medium protected the erythrocytes from t-BHP-induced oxidative stress as evidenced by the decrease in MDA level and protein carbonyl group content, l-ascorbic acid also showed similar protective effect. The results conclusively prove the efficacy of the antioxidant property of capsaicin. This evidence suggests that dietary factors that act as antioxidants to decrease membrane lipid peroxidation and protein carbonyl formation may contribute to a protective effect against cancer, atherosclerosis and age related diseases. This antioxidant effect may, in part, explain the high consumption of capsicum in certain regions of the world.

In Vitro Effect of Fucose-Specific Lectins on Rat Erythrocyte Membranes under Normal Conditions and during Toxic Stress

We studied the effect of various fucose-specific lectins on lipid peroxidation in rat erythrocyte membranes under normal conditions and during exposure to the toxic agent. Under normal conditions parameters of lipid peroxidation in erythrocyte membranes increased after treatment with lectins or cadmium nitrate. Lectins possess biological activity modulated lipid peroxidation in membranes of erythrocytes from experimental animals, which depended on the time of adaptation. Differences were revealed in the effect of bacterial and plant lectins on lipid peroxidation in erythrocytes treated with the test xenobiotic.

Novel synthesized aminosteroidal heterocycles intervention for inhibiting iron-induced oxidative stress

The objective of this study was to elucidate the potential role of novel synthesized aminosteroidal heterocyclic compounds 2, 5, 9b and 10c against iron-induced oxidative stress with particular insight on erythrocyte ghosts in male rats. Chronic iron supplementation (3000 mg kg –1 diet) for 6 weeks significantly increased plasma iron and ferritin levels. It also produced significant increase in plasma TNF-α and NO levels. Lipid metabolism was also affected by excess iron, so that plasma and erythrocyte membrane total cholesterol, triglycerides, phospholipids and total lipid levels were significantly elevated. In consequence, a significant increase in plasma leptin level was detected. Iron overload clearly induces oxidative stress as indicated by the significant increase in both plasma and erythrocyte membrane lipid peroxidation levels. Noteworthy, excess iron not only decreased the mean value of erythrocyte membrane protein but also caused marked alterations in the membrane protein fractions with concomitant inhibition in erythrocyte membrane ATPases activity. On the other hand, treatment with the aminosteriodal heterocyclic compounds especially compounds 5, 2, and 10c in an oral dose of 5 mg kg –1 B.W. per day could ameliorate almost all of the changes in plasma and erythrocyte ghosts components induced by iron overload. The efficacious role of these novel synthesized aminosteriods in preventing iron-induced oxidative stress may be mediated through their iron chelating properties, anti-lipid peroxidation activities and membrane stabilizing actions. The encouraging results obtained in the present study lend credence to substantial investigation to assess the use of these compounds as a potent line of therapy to retard the pathogenesis of iron overload diseases.

Erythrocyte antioxidant defense response against cigarette smoking in humans—the glutathione S‐transferase vulnerability

Cigarette smoking leads to uptake of a multitude of reactive chemicals including many electrophiles and may also give rise to oxidative stress. Human red blood cells are important targets for electrophilic and oxidant foreign compounds. We investigated the oxidative stress in erythrocytes upon cigarette smoking, and the response of antioxidant defense system against it. With this aim, simultaneous determination of erythrocyte superoxide dismutase (SOD), selenium dependent glutathione peroxidase (Se-GPx), catalase (CAT), glutathione S-transferase (GST) activities and plasma levels of thiobarbituric acid reactive substances (TBARS), and the degree of erythrocyte membrane lipid peroxidation (EMLP) were carried out in blood samples of smokers and their controls. Plasma TBARS levels and EMLP in smokers were significantly higher than the control levels (p < 0.01 and p < 0.005, respectively). SOD activity was diminished in smokers compared to nonsmoker controls (p < 0.005). Erythrocyte Se-GPx activity was also found significantly diminished in smokers (p < 0.005), while plasma Se-GPx activity was not changed. We observed that erythrocyte CAT activity was not different in smokers compared to nonsmoker controls. We found that the erythrocyte GST activity is significantly lower in young adult smokers (3.03 +/- 0.18 U/mg protein; mean +/- SEM; n = 46) than in nonsmoking contemporaries (3.98 +/- 0.26 U/mg protein; mean +/- SEM; n = 41). Together with previously reported data, it can be concluded that the decrease in GST activity leads to extra GST synthesis during erythrocyte proliferation. The same data were also analyzed for the sex differences. The statistically significant differences remained the same between nonsmoker and smoker females. Only EMLP degree and SOD activity were significantly different between nonsmoker and smoker males; however, when compared the parameters between male and female nonsmokers, GST activity was found to be significantly higher in females than that of males.

Lipid Peroxidation in Blood Plasma and Erythrocyte Membranes of Footballers Varying in Performance

The metabolic reorganizations taking place in footballers varying in performance were shown to be accompanied by intensified lipid peroxidation (LPO). The most intense generation of primary and end LPO products was observed during immediate adaptation to a physical load, especially in poorly qualified footballers. It was assumed that the metabolic pathways of lipid utilization switch over to more active use of primary LPO products as energy and structural substrates under conditions of increased energy consumption (immediate adaptation).

Effect of lipoic acid on the oxidoreductive status of red blood cells in rats subject to oxidative stress by chronic administration of adriamycin.

One of the most intriguing phenomena observed during adriamycin (ADR) toxicity has been attributed to ADR-induced oxidative stress. The study was aimed to assess the protective effect of lipoic acid (LA) against ADR-induced damage to erythrocytes. Male albino rats (Wistar strain) were subjected to ADR (1 mg/kg body weight/day i.v.) once a week for a period of 12 weeks. Haematological indices like haemoglobin levels (Hb) and haematocrit (Ht) were also lowered along with a marked increase in the activities of serum glutamate pyruvate transaminase (SGPT) and serum glutamate oxaloacetate transaminase (SGOT). These rats demonstrated enhanced erythrocyte membrane lipid peroxidation (LPO) and an onslaught in the antioxidant defence armoury, witnessed by lowered activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), vitamin A, vitamin C and vitamin E. Rats administered with ADR showed a marked decline in the activities of membrane-bound ATPases. Abnormal LPO and decreased deformability led to increased osmotic fragility of the red blood cells. Pretreatment with LA (35 mg/kg body weight/day i.p.) 24 hours prior to the administration of ADR once a week for a period of 12 weeks was effective in counteracting these biochemical disturbances, thereby minimizing the toxic side effects of ADR.

Green tea metabolite EGCG protects membranes against oxidative damage in vitro

Green tea polyphenols like epigallocatechin gallate (EGCG) have been proposed as a cancer chemopreventative. Several studies have shown that EGCG can act as an antioxidant by trapping proxyl radicals and inhibiting lipid peroxidation. The main propose of this study is to investigate the antioxidant capacity of EGCG using erythrocyte membrane-bound ATPases as a model. The effects of EGCG on t-butylhydroperoxide-induced lipid peroxidation and the activity of membrane-bound ATPases in human erythrocyte membranes were studied. The extent of oxidative damage in membranes was assessed by measuring lipid peroxidation, (TBARS, thiobarbituric acid reactive substances formation) and the activity of ATPases (Na +/K +, Ca 2+, and CaM-activated Ca 2+ pump ATPases). EGCG blocked t-BHP induced lipid peroxidation in erythrocyte membranes, significantly (0.45 ± 0.02 vs 0.20 ± 0.01; t-BHP vs t-BHP + EGCG respectively, μm/L TBARS) (p < 0.05). EGCG also protected ATPases against t-BHP induced damage; for Na/K ATPase (2.4 ± 0.2 vs 1.6 ± 0.1 vs 2.44 ± 0.2, nmol Pi/min/mg protein, control vs t-BHP vs t-BHP and EGCG respectively), for Ca ATPase (5.8 ± 0.4 vs 3.9 ± 0.3 vs 5.6 ± 0.34, nmol Pi/min/mg protein, control vs t-BHP vs t-BHP and EGCG respectively) and for CaM-Ca ATPase (14.7 ± 0.7 vs 7.3 ± 0.4 vs 11.6 ± 0.55, nmol Pi/min/mg protein, control vs t-BHP vs t-BHP and EGCG respectively) (p < 0.05). In conclusion our results indicate that EGCG is a powerful antioxidant that is capable protecting erythrocyte membrane-bound ATPases against oxidative stress.

Lipid peroxidation, vitamins C, E and reduced glutathione levels in patients with pulmonary tuberculosis.

The present study examined the relationship between lipid peroxidation and vitamin C, vitamin E and reduced glutathione levels in plasma, erythrocytes and erythrocyte membranes of pulmonary tuberculosis patients and an equal number of age-and sex-matched healthy subjects. Enhanced plasma, erythrocytes and erythrocyte membrane lipid peroxidation with concomitant decline in vitamin C, vitamin E and reduced glutathione levels were found in pulmonary tuberculosis patients. The elevated lipid peroxidation and decreased vitamin C, vitamin E and reduced glutathione levels indicate the potential of oxidative damage to erythrocytes and erythrocyte membranes of pulmonary tuberculosis patients.

THE BENEFICIAL EFFECT OF THREE FLAVONOLS AGAINST OXIDATIVE DAMAGE

The ability of three related naturally occurring flavonols in inhibiting Hb oxidation and lipid peroxidation of human erythrocyte membranes was evaluated. The flavonols tested exhibited the following order of potency to inhibit tert-butyl hydroperoxide-induced Hb oxidation: quercetin > rutin > morin. The Hb oxidation was estimated by the extent of metHb and hemichrome formation induced by tert-butyl hydroperoxide. Quercetin or rutin (0.5 mM) increased oxyHb levels about 33% and 10%, respectively. Morin (0.5 mM) was pro-oxidant, decreasing the oxyHb about 7%. Despite the pro-oxidant action on Hb oxidation, morin offered greater protection against lipid peroxidation than rutin, preventing the formation of TBA reactive substances by 33.1%, at 0.2 mM. However, quercetin (0.2 mM) provided approximately 50% protection against TBARS formation. The results show that the flavonoids tested are protective for Hb oxidation and lipid peroxidation on erythrocyte membrane subjected to oxidative stress. Quercetin in particular, may be useful in diminishing oxidative damage to red blood cells

Combined efficacies of lipoic acid and meso-2,3-dimercaptosuccinic acid on lead-induced erythrocyte membrane lipid peroxidation and antioxidant status in rats.

One of the most intriguing phenomenon observed during lead toxicity has been attributed to lead-induced oxidative stress. The combined effect of DL-alpha-lipoic acid (LA) and meso-2,3-dimercaptosuccinic acid (DMSA) on lead-induced alterations in selected parameters, which are indicators of oxidative stress in erythrocytes, have been studied. Lead acetate (Pb, 0.2%) was administered in drinking water for 5 weeks to induce toxicity. LA (25 mg/ kg body weight per day i.p.) and DMSA (20 mg/kg body weight per day i.p.) were administered individually and also in combination during week 6. Clinical evidence of toxic exposure was evident from the elevated blood lead levels (BPb) along with lowered levels of haemoglobin (Hb) and haematocrit (Ht). Lead-exposed animals showed enhanced membrane lipid peroxidation (LPO) in the erythrocytes. Damage to the erythrocyte membrane was evident from the decline in the activities of the transmembrane enzymes, viz., Na+, K(+)-ATPase, Ca(2+)-ATPase and Mg(2+)-ATPase. Lead-exposed rats also suffered an onslaught on the antioxidant defence system witnessed by lowered activities of catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and reduced glutathione (GSH). Serum glutamic-oxoloacetic transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT) were also elevated in lead-exposed rats. Treatment with either LA or DMSA reversed the lead-induced biochemical disturbances encountered by the erythrocytes, but combined treatment with LA and DMSA was very effective in mitigating all the parameters indicative of oxidative stress.

Antioxidant activity of heartwood extracts of Papua New Guinean woods

Antioxidant effects of methanol extracts from the heartwood of 23 Papua New Guinea (PNG) wood species were examined. The extract ofAmoora sp. (Meliaceae) showed the strongest antioxidant activity against lipid peroxidation in rabbit erythrocyte membrane and linoleic acid autoxidation. Also, the extract ofAmoora sp. showed potent 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicalscavenging activity. These results showed that the heartwood ofAmoora sp. is a possible source of antioxidative agents. The result of antioxidant activity-guided fractionation suggested that gallic acid, protocatechuic acid, and hydrolyzable tannins in the extract ofAmoora sp. caused the potent antioxidant activity.

Space flight and oxidative stress

Space flight is associated with an increase in oxidative stress after return to 1 g. The effect is more pronounced after long-duration space flight. The effects lasts for several weeks after landing. In humans there is increased lipid peroxidation in erythrocyte membranes, reduction in some blood antioxidants, and increased urinary excretion of 8-iso-prostaglandin F 2α and 8-oxo-7,8 dihydro-2 deoxyguanosine. Isoprostane 8-iso-prostaglandin F 2α and 8-oxo-7,8 dihydro-2 deoxyguanosine are markers for oxidative damage to lipids and DNA, respectively. The changes have been attributed to a combination of the energy deficiency that occurs during flight and substrate competition for amino acids occurring between repleting muscle and other tissues during the recovery phase. The observations in humans have been complemented by rodent studies. Most rodent studies showed increased production of lipid peroxidation products postflight and decreased antioxidant enzyme activity postflight. The rodent observations were attributed to the stress associated with reentry into Earth’s gravity. Decreasing the imbalance between the production of endogenous oxidant defenses and oxidant production by increasing the supply of dietary antioxidants may lessen the severity of the postflight increase in oxidative stress.

Lipid peroxidation and antioxidant status in cervical cancer patients.

The present study examined the relationship between lipid peroxidation and antioxidant status in plasma, erythrocyte and erythrocyte membrane of cervical cancer patients and an equal number of age and sex matched normal subjects as well as patients with cervicitis. Lipid peroxidation was significantly increased with concomitant decrease in antioxidant levels in cervical cancer patients as compared to normal subjects and patients with cervicitis. The elevated lipid peroxidation and disturbed antioxidant status was also noticed in cervicitis patients as compared to normal subjects. This increase in lipid peroxidation can be attributed to possible breakdown of antioxidant mechanisms in cervicitis and cervical cancer patients.

Useful markers for detecting decreased serum antioxidant activity in hemodialysis patients.

This study evaluates a novel application of a method for measuring serum antioxidant activity, based on the detection of erythrocyte membrane lipid peroxidation in cases of uremia. A human erythrocyte ghost membrane in Tris-HCl was mixed with adenosine 5'-diphosphate and iron chloride (FeCl3; ADP/Fe3+) solution (at a molar ratio of 17:1), and the mixture was incubated under aerobic conditions at 37 degrees C for 2 hours. The concentration of erythrocyte membrane thiobarbituric acid-reactive substances increased proportionally with respect to ADP/Fe3+ concentration, and this increase was inhibited by serum albumin in a dose-dependent manner. In patients undergoing chronic hemodialysis therapy, predialytic sera contained in this reaction mixture were weaker than postdialytic sera in terms of inhibitory effect against erythrocyte membrane lipid peroxidation, whereas serum albumin contents remained at levels equivalent to those of the normal control. A gradual increase in human mercaptalbumin nonmercaptalbumin ratio during hemodialysis treatment might be one of the major factors that leads to the recovery of decreased serum antioxidant activity. We clearly showed that the serum scavenging activity against erythrocyte membrane lipid peroxidation in hemodialysis patients decreases markedly, and this pathological condition is improved by hemodialysis.

Cypermethrin-induced plasma membrane perturbation on erythrocytes from rats: reduction of fluidity in the hydrophobic core and in glutathione peroxidase activity

The effects of treatment with the synthetic insecticide cypermethrin on plasma membrane fluidity, lipid peroxidation and antioxidant status in rat erythrocytes were investigated. Rats were treated by gavage with a low dose (12.5 mg/kg body weight per day) of cypermethrin in corn oil for 60 days. DPH and TMA-DPH fluorescence anisotropy experiments show that cypermethrin treatment, compared with controls, induced a significant decrease in erythrocyte membrane fluidity measured by DPH, while no changes were observed using TMA-DPH. Cypermethrin treatment also induced a significant increase in the lipid peroxidation, measured by the formation of conjugated dienes. The increased oxidative stress resulted in a significant decrease in the acitivity of glutathione peroxidase. The results are discussed in terms of preferential localization of cypermethrin in the hydrophobic core of the membrane, where it increases lipid packing and consequently decreases membrane fluidity.

Efficient scavenging of hydroxyl radicals and inhibition of lipid peroxidation by novel analogues of 1,3,7-trimethyluric acid

New water-soluble analogues of 1,3,7-trimethyluric acid with N-1 methyl replaced by various groups were prepared and evaluated for their ability to scavenge hydroxyl radicals as well as their protective potential against lipid peroxidation in erythrocyte membranes. The deoxyribose degradation method indicates that all the analogues tested effectively scavenge hydroxyl radicals and some of them show better activity than uric acid and methyluric acids. These effects are shown to be concentration dependent and are more potent at low concentrations (10–50 μM). Among the analogues tested, 1-butenyl-, 1-propargyl- and 1-benzyl-3,7-dimethyluric acids show high hydroxyl radical scavenging property with a reaction rate constant (Ks) of 3.2–6.7 × 10 10 M −1 S −1, 2.3–3.7 × 10 10 M −1 S −1 and 2.4–3.7 × 10 10 M −1 S −1, respectively. The effectiveness of these analogues as hydroxyl radical scavengers appears to be better than mannitol (Ks, 1.9–2.5 × 10 9 M −1 S −1). With the exception of 1-pentyl- and 1-(2′-oxopropyl)-3,7-dimethyluric acids, all other analogues tested are effective inhibitors of tert-butylhydroperoxide-induced lipid peroxidation in human erythrocyte membranes. All the analogues tested are susceptible to peroxidation in the presence of hemoprotein and hydrogen peroxide. The present study has pointed out that it is possible to significantly enhance the antioxidant property of 1,3,7-trimethyluric acid by structural modification at N-1 position. Such compounds may be useful as antioxidants in vivo.

Antioxidant and Radical Scavenging Properties of 8-Oxo Derivatives of Xanthine Drugs Pentoxifylline and Lisofylline

The antioxidant and radical scavenging properties of 8-oxo derivatives of pentoxifylline, lisofylline, enprofylline (3-propyl xanthine), and 1,7-dimethyl enprofylline were studied in vitro. The results show that 8-oxopentoxifylline and 8-oxolisofylline are significantly better hydroxyl and peroxyl radical scavengers and more potent inhibitors of t-butylhydroperoxide-induced lipid peroxidation in human erythrocyte membranes than the parent drugs. The hydroxyl radical scavenging property of 8-oxoenprofylline and its analogue 1,7-dimethyl-8-oxoenprofylline is marginally better than their corresponding xanthines. Interestingly, 1,7-dimethyl-8-oxoenprofylline is an effective inhibitor of lipid peroxidation whereas enprofylline, 1,7-dimethylenprofylline, and 8-oxoenprofylline exhibit significantly less activity. All the 8-oxo derivatives tested are better hydroxyl radical scavengers than uric acid, a natural antioxidant and a free radical scavenger in humans. The rate constant for the reaction between 8-oxopentoxifylline and hydroxyl radical is 1.6–4.2 × 1010 M−1 s−1 which is comparable to that of dimethyl sulfoxide (1.4–1.6 × 1010 M−1 s−1) and better than that of mannitol (1.9–2.5 × 109 M−1 s−1), the known hydroxyl radical scavengers. Both 8-oxo pentoxifylline (IC50, 1.8 ± 0.08 μM) and 8-oxolisofylline (IC50, 2.2 ± 0.13 μM) are as efficient peroxyl radical scavengers as uric acid (IC50, 1.9 ± 0.05 μM). The results presented clearly indicate that the anti-inflammatory property of pentoxifylline and lisofylline is exerted more through their 8-oxo derivatives than through the parent drugs.

Strenuous endurance training in humans reduces oxidative stress following exhausting exercise.

The aim of this study was to evaluate whether high-intensity endurance training would alleviate exercise-induced oxidative stress. Nine untrained male subjects (aged 19-21 years) participated in a 12-week training programme, and performed an acute period of exhausting exercise on a cycle ergometer before and after training. The training programme consisted of running at 80% maximal exercise heart rate for 60 min.day-1, 5 days.week-1 for 12 weeks. Blood samples were collected at rest and immediately after exhausting exercise for measurements of indices of oxidative stress, and antioxidant enzyme activities [superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT)] in the erythrocytes. Maximal oxygen uptake (VO2max) increased significantly (P < 0.001) after training, indicating an improvement in aerobic capacity. A period of exhausting exercise caused an increase (P < 0.01) in the ability to produce neutrophil superoxide anion (O2.-) both before and after endurance training, but the magnitude of the increase was smaller after training (P < 0.05). There was a significant increase in lipid peroxidation in the erythrocyte membrane, but not in oxidative protein, after exhausting exercise, however training attenuated this effect. At rest, SOD and GPX activities were increased after training. However, there was no evidence that exhausting exercise enhanced the levels of any antioxidant enzyme activity. The CAT activity was unchanged either by training or by exhausting exercise. These results indicate that high-intensity endurance training can elevate antioxidant enzyme activities in erythrocytes, and decrease neutrophil O2.- production in response to exhausting exercise. Furthermore, this up-regulation in antioxidant defences was accompanied by a reduction in exercise-induced lipid peroxidation in erythrocyte membrane.

Oxidative stress and antioxidants in epilepsy

In the present study, erythrocyte membrane lipid peroxidation, the percentage hemolysis, erythrocyte enzymes superoxide dismutase (SOD), glutathione peroxidase (GP), glutathione reductase (GR), catalase, and plasma vitamin C, vitamin E, vitamin A and ceruloplasmin activities and concentrations were determined in 29 epileptic patients and 50 normal controls. Ten patients who were treated with phenobarbital and who did not get convulsions for 1 year were considered for followup. Lipid peroxidation and percentage hemolysis in patients with epilepsy was significantly higher when compared to controls. Moreover, plasma ceruloplasmin concentrations were also markedly increased in these cases. Erythrocyte GR and plasma vitamin C and A concentrations were significantly lower in epileptics when compared to controls. In the followup patients, the erythrocyte GR was significantly higher than their pre-treated condition. Furthermore, the plasma vitamin A, E and C concentrations have attained the normal range. This study indicates that the antioxidant status in blood of epileptic patients which was low compared to controls, improved after treatment, suggesting that free radicals may be implicated in epilepsy.

Studies on the relationship between serum albumin concentration and lipid peroxidation in the erythrocyte membrane of maintenance hemodialysis patients

We conducted a study on the long-term prognosis of maintenance hemodialysis patients with and without diabetes mellitus(144 cases). As a result, significant differences were observed in the long-term prognosis over a 15-year period between those with a serum albumin concentration of more than 3.8 g/dl and those with a serum albumin concentration of less than 3.8 g/dl. The group with a serum albumin concentration of more than 3.8 g/dl showed a better prognosis than the group with a concentration of less than 3.8 g/dl. We investigated the levels of thiobarbituric acid-reactive substances (TBA-RS) in the erythrocyte membrane of maintenance hemodialysis patients(23 cases), pre-dialysis uremic phase patients(12 cases) and healthy controls(7 cases). TBA-RS in the erythrocyte membrane of pre-dialysis uremic phase patients was higher than that observed in the other groups. The TBA-RS in the erythrocyte membrane in the maintenance hemodialysis without diabetes mellitus group was lower than that in the pre-dialysis uremic phase group. The TBA-RS in the erythrocyte membrane in the maintenance hemodialysis without diabetes mellitus group thus indicated an inverse relationship with the serum albumin concentration, Kt/V and erythrocyte tocopherol contents. These results suggested that serum albumin protects against erythrocyte membrane lipid peroxidation, and that this function is related to hemodialysis. We thus conclude that hypoalbuminemia appears to increase the oxidative damage and acceleration of arteriosclerosis, while it also worsens the long-term prognosis of maintenance hemodialysis patients.