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Díaz-De la Cruz EN, Cerrillos-Gutiérrez JI, García-Sánchez A, Prado-Nevárez CG, Andrade-Sierra J, Jalomo-Martínez B, Banda-López A, Rojas-Campos E, Miranda-Díaz AG. The Influence of Sevelamer Hydrochloride and Calcium Carbonate on Markers of Inflammation and Oxidative Stress in Hemodialysis at Six Months of Follow-Up. Front Med (Lausanne) 2021; 8:714205. [PMID: 34901050 PMCID: PMC8655244 DOI: 10.3389/fmed.2021.714205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Patients with end-stage renal disease (ESRD) present alterations in mineral and bone metabolism. Hyperphosphatemia in ESRD is considered an independent risk factor for cardiovascular disease (CVD), increasing morbidity, and mortality. Sevelamer hydrochloride is a calcium-free, non-absorbable phosphate-chelating polymer. Calcium carbonate chelator is helpful in controlling serum phosphate levels. There is insufficient information on the influence of sevelamer hydrochloride and calcium carbonate on the behavior of oxidative stress (OS) markers and inflammation in patients on hemodialysis (HD). A randomized open clinical trial was carried out on patients to evaluate sevelamer hydrochloride and calcium carbonate influence at 6 months of study follow-up. Levels of oxidants (LPO, NO, and 8-isoprostanes), antioxidants (SOD and TAC), oxidative DNA damage (8-OHdG and hOGG1), pro-inflammatory cytokines (IL-6 and TNF-α), and inflammation markers (ferritin and C-reactive protein) were measured with colorimetric and ELISA methods. We found a significant increase in oxidants LPO and NO, and antioxidants SOD and TAC, and downregulation of IL-6 and TNF-α. Ferritin decrease at 6 months follow-up in the sevelamer hydrochloride group. Increase in C-reactive protein was found in the group of patients treated with calcium carbonate. In conclusion, we found an oxidative state imbalance with increase in LPO and NO oxidants. The activity of the antioxidant enzymes (SOD and TAC) was also found to increase, suggesting a compensatory effect in the face of increase in oxidants. The same phenomenon was observed with increase in the oxidative damage marker to DNA and the increase in the DNA repair enzyme, suggesting a compensatory effect. Pro-inflammatory cytokines were predominantly downregulated by TNF-α in the group that ingested sevelamer hydrochloride in the final determination at 6 months of follow-up. Serum ferritin levels decreased significantly at the end of follow-up in patients on HD in the sevelamer hydrochloride group. The management of hyperphosphatemia with sevelamer hydrochloride appears to have obvious anti-inflammatory and antioxidant benefits.
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Affiliation(s)
| | - José Ignacio Cerrillos-Gutiérrez
- Department of Nephrology and Organ Transplant Unit, National Western Medical Centre, Mexican Institute of Social Security, Specialties Hospital, Guadalajara, Mexico
| | - Andrés García-Sánchez
- Department of Physiology, University Health Sciences Center, Universidad de Guadalajara, Guadalajara, Mexico
| | - Carlos Gerardo Prado-Nevárez
- Department of Nephrology and Organ Transplant Unit, National Western Medical Centre, Mexican Institute of Social Security, Specialties Hospital, Guadalajara, Mexico
| | - Jorge Andrade-Sierra
- Department of Nephrology and Organ Transplant Unit, National Western Medical Centre, Mexican Institute of Social Security, Specialties Hospital, Guadalajara, Mexico
| | - Basilio Jalomo-Martínez
- Department of Nephrology and Organ Transplant Unit, National Western Medical Centre, Mexican Institute of Social Security, Specialties Hospital, Guadalajara, Mexico
| | - Adriana Banda-López
- Department of Nephrology and Organ Transplant Unit, National Western Medical Centre, Mexican Institute of Social Security, Specialties Hospital, Guadalajara, Mexico
| | - Enrique Rojas-Campos
- Department of Nephrology and Organ Transplant Unit, National Western Medical Centre, Mexican Institute of Social Security, Specialties Hospital, Guadalajara, Mexico
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Application of FTIR-ATR Spectroscopy to Determine the Extent of Lipid Peroxidation in Plasma during Haemodialysis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:245607. [PMID: 25961007 PMCID: PMC4417580 DOI: 10.1155/2015/245607] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/29/2015] [Indexed: 11/21/2022]
Abstract
During a haemodialysis (HD), because of the contact of blood with the surface of the dialyser, the immune system becomes activated and reactive oxygen species (ROS) are released into plasma. Particularly exposed to the ROS are lipids and proteins contained in plasma, which undergo peroxidation. The main breakdown product of oxidized lipids is the malondialdehyde (MDA). A common method for measuring the concentration of MDA is a thiobarbituric acid reactive substances (TBARS) method. Despite the formation of MDA in plasma during HD, its concentration decreases because it is removed from the blood in the dialyser. Therefore, this research proposes the Fourier Transform Infrared Attenuated Total Reflectance (FTIR-ATR) spectroscopy, which enables determination of primary peroxidation products. We examined the influence of the amount of hydrogen peroxide added to lipid suspension that was earlier extracted from plasma specimen on lipid peroxidation with use of TBARS and FTIR-ATR methods. Linear correlation between these methods was shown. The proposed method was effective during the evaluation of changes in the extent of lipid peroxidation in plasma during a haemodialysis in sheep. A measurement using the FTIR-ATR showed an increase in plasma lipid peroxidation after 15 and 240 minutes of treatment, while the TBARS concentration was respectively lower.
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Bossola M, Tazza L. Wishful Thinking: The Surprisingly Sparse Evidence for a Relationship between Oxidative Stress and Cardiovascular Disease in Hemodialysis Patients. Semin Dial 2015; 28:224-30. [PMID: 25641650 DOI: 10.1111/sdi.12345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The increased frequency of cardiovascular disease observed in hemodialysis patients is secondary to the combination of many traditional (age, male sex, hypertension, smoking, diabetes mellitus, and dyslipidemia) and novel and uremia-related (inflammation, uremic toxins, adipokine imbalance, coagulation disorders, protein-energy wasting, volume overload, endothelial dysfunction, hyperparathyroidism, and subclinical hypothyroidism) risk factors. Usually, in the latter group, oxidative stress is included. However, after decades of research, it remains essentially unknown if oxidative stress has a causative role in the development of cardiovascular disease in long-term hemodialysis patients because adequate longitudinal studies are lacking. Data deriving from cross-sectional studies suggest that biomarkers of oxidative stress are associated with cardiovascular disease prevalence. Conversely, conflicting and inconclusive results have been obtained on the association between oxidative stress and coronary artery calcification, atherosclerosis, and all-cause and cardiovascular disease-related outcome. It is desirable that further studies are conducted on this topic in the near future.
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Affiliation(s)
- Maurizio Bossola
- Hemodialysis Unit, Division of Transplantation, Catholic University of the Sacred Heart, "Agostino Gemelli" University Hospital, Rome, Italy
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Cighetti G, Bamonti F, Aman CS, Gregori D, De Giuseppe R, Novembrino C, de Liso F, Maiavacca R, Paroni R. Oxidative status in different settings and with different methodological approaches compared by Receiver Operating Characteristic curve analysis. Clin Biochem 2014; 48:73-8. [PMID: 25305628 DOI: 10.1016/j.clinbiochem.2014.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 09/19/2014] [Accepted: 09/30/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To test the performance of different analytical approaches in highlighting the occurrence of deregulated redox status in various physio-pathological situations. DESIGN AND METHODS 35 light and 61 heavy smokers, 19 chronic renal failure, 59 kidney transplanted patients, and 87 healthy controls were retrospectively considered for the study. Serum oxidative stress and antioxidant status, assessed by spectrophotometric Reactive Oxygen Metabolites (d-ROMs) and Total Antioxidant Capacity (TAC) tests, respectively, were compared with plasma free (F-MDA) and total (T-MDA) malondialdehyde, both quantified by isotope-dilution-gas chromatography-mass spectrometry (ID-GC-MS). Sensitivity, specificity and cut-off points of T-MDA, F-MDA, d-ROMs and TAC were evaluated by both Receiver Operating Characteristic (ROC) analyses and area under the ROC curve (AUC). RESULTS Only T-MDA assay showed a clear absence of oxidative stress in controls and significant increase in all patients (AUC 1.00, sensitivity and specificity 100%). Accuracy was good for d-ROMs (AUC 0.87, sensitivity 72.8%, specificity 100%) and F-MDA (AUC 0.82, sensitivity 74.7%, specificity 83.9%), but not high enough for TAC to show in patients impaired antioxidant defense (AUC 0.66, sensitivity 52.0%, specificity 92.9%). CONCLUSIONS This study reveals T-MDA as the best marker to detect oxidative stress, shows the ability of d-ROMs to identify modified oxidative status particularly in the presence of high damages, and evidences the poor TAC performance. d-ROMs and TAC assays could be useful for routine purposes; however, for an accurate clinical data evaluation, their comparison versus a "gold standard method" is required.
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Affiliation(s)
- Giuliana Cighetti
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milano, Italy
| | - Fabrizia Bamonti
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italy; U.O. Ematologia e CTMO, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Caroline S Aman
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milano, Italy
| | - Dario Gregori
- Unità di Biostatistica, Epidemiologia e Salute Pubblica, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi di Padova, Padova, Italy
| | - Rachele De Giuseppe
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milano, Italy; U.O. Ematologia e CTMO, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Cristina Novembrino
- Laboratorio di Chimica Clinica e Microbiologia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Federica de Liso
- Laboratorio di Chimica Clinica e Microbiologia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Rita Maiavacca
- Laboratorio di Chimica Clinica e Microbiologia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Rita Paroni
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, H San Paolo, Milano, Italy.
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Ersson C, Odar‐Cederlöf I, Fehrman‐Ekholm I, Möller L. The effects of hemodialysis treatment on the level of
DNA
strand breaks and oxidative
DNA
lesions measured by the comet assay. Hemodial Int 2012; 17:366-73. [DOI: 10.1111/hdi.12008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Clara Ersson
- Department of Biosciences and NutritionKarolinska Institutet Huddinge Sweden
| | | | | | - Lennart Möller
- Department of Biosciences and NutritionKarolinska Institutet Huddinge Sweden
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Kaya Y, Ari E, Demir H, Soylemez N, Cebi A, Alp H, Bakan E, Gecit I, Asicioglu E, Beytur A. Accelerated atherosclerosis in haemodialysis patients; correlation of endothelial function with oxidative DNA damage. Nephrol Dial Transplant 2011; 27:1164-9. [PMID: 21821836 DOI: 10.1093/ndt/gfr443] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Accelerated atherosclerosis is the major cause of mortality in patients on chronic haemodialysis (HD). The aim of this study was to evaluate the relationship between oxidative DNA damage [8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG ratio)], oxidative stress biomarkers and endothelial function in HD patients as an indicator of atherosclerosis. METHODS Forty-four chronic HD patients without known atherosclerotic disease and 55 age- and sex-matched healthy individuals were included in the study. Plasma malondialdehyde (MDA) levels and 8-OHdG/dG ratio were determined as oxidative stress markers. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured as antioxidants. Endothelial function was assessed by ultrasonography. RESULTS 8-OHdG/dG ratio and MDA levels were higher in HD patients than controls while SOD and GPx activities were lower in HD patients compared to controls. Flow-mediated dilatation FMD% in HD patients were lower than the control group (7.28 ± 0.79 versus 11.18 ± 0.82, P < 0.001). There was a significant negative correlation between FMD% and 8-OHdG/dG ratio (r = -0.678, P < 0.01) and MDA levels (r = -0.517, P < 0.01), while there was a significant positive correlation between FMD% and SOD (r = 0.538, P < 0.01) and GPx levels (r = 0.720, P < 0.01). CONCLUSIONS Our data have demonstrated that HD patients exhibit increased oxidative DNA damage and decreased antioxidant activity. We propose that endothelial function is negatively correlated with 8-OHdG/dG ratio and positively correlated with antioxidant enzymes. To our knowledge, this is the first study to demonstrate the inverse relationship between endothelial function and plasma oxidative DNA damage in HD patients.
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Affiliation(s)
- Yuksel Kaya
- Department of Cardiology, Van Yuksek Ihtisas Hospital, Van, Turkey
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İmge EB, KiliçoĞlu B, Devrim E, Çetin R, Durak İ. Effects of mobile phone use on brain tissue from the rat and a possible protective role of vitamin C – a preliminary study. Int J Radiat Biol 2010; 86:1044-9. [DOI: 10.3109/09553002.2010.501838] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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İmge Ergüder B, Çetin M, Namuslu M, Kılıçoğlu S, Devrim E, Çetin R, Durak İ. High osmolar contrast medium causes mild oxidation in liver, bladder, and ovary tissues from rats: vitamin C has protective role. Med Chem Res 2010. [DOI: 10.1007/s00044-009-9207-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Stoyanova E, Sandoval SB, Zuniga LA, El-Yamani N, Coll E, Pastor S, Reyes J, Andres E, Ballarin J, Xamena N, Marcos R. Oxidative DNA damage in chronic renal failure patients. Nephrol Dial Transplant 2009; 25:879-85. [DOI: 10.1093/ndt/gfp575] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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De Vecchi AF, Bamonti F, Novembrino C, Ippolito S, Guerra L, Lonati S, Salini S, Aman CS, Scurati-Manzoni E, Cighetti G. Free and total plasma malondialdehyde in chronic renal insufficiency and in dialysis patients. Nephrol Dial Transplant 2009; 24:2524-9. [PMID: 19264746 DOI: 10.1093/ndt/gfp102] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Available data about oxidative status in patients with end-stage renal disease (ESRD) or on dialysis are contradictory. The present cross-sectional study aimed to investigate the role of renal insufficiency and dialysis on lipid peroxidation. To separate the effects of uraemia from dialysis-induced stress, we enrolled 26 patients with renal insufficiency on conservative treatment (ESRD), 23 on peritoneal dialysis (PD), 30 on haemodialysis (HD) and 30 controls. METHODS Plasma malondialdehyde (MDA) levels, both total (tMDA) and free (fMDA), were measured as indexes of oxidative stress by gas chromatography-mass spectrometry. Bound MDA (bMDA) levels were calculated as the difference between tMDA and fMDA. RESULTS Total and bMDA concentrations were significantly higher in patients than in controls (ESRD > HD > PD). In PD and HD patients, fMDA levels were similar and significantly higher than in ESRD. Multivariate analysis, with tMDA, fMDA and bMDA as dependent variables, showed similar and significant tMDA and bMDA relations with residual renal function (t = -2.160, P = 0.035) and albumin (t = -2.049, P = 0.045). Erythropoietin dose affected only fMDA values (t = -2.178, P = 0.034). CONCLUSIONS Free and bMDA concentrations identified different MDA patterns. Bound MDA, not excreted by kidneys, accounts alone for high tMDA concentrations in ESRD patients, while both fMDA and bMDA contribute to tMDA values in dialysis patients. These findings show that increased tMDA could be indicative not only of recent lipid peroxidation, and they also highlight the importance of evaluating free, bound and total MDA in patients with reduced renal function in order to assess their oxidative status.
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Avci A, Atli T, Ergüder IB, Varli M, Devrim E, Turgay SAM, Durak I. Effects of apple consumption on plasma and erythrocyte antioxidant parameters in elderly subjects. Exp Aging Res 2008; 33:429-37. [PMID: 17886017 DOI: 10.1080/03610730701525352] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The effects of apple consumption on plasma and erythrocyte antioxidant parameters of elderly subjects were investigated in this study. Fifteen elderly subjects (mean age 71.86 +/- 4.17) participated in the study. They consumed an apple a day for 1 month. Before and after this period, fasting blood samples were obtained, and oxidant (malondialdehyde [MDA]) and antioxidant (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], catalase [CAT], and antioxidant potential [AOP]) parameters were studied. MDA and AOP levels were studied in plasma, and SOD, GSH-Px, and CAT activities and MDA levels were measured in the erythrocytes. In the erythrocytes, GSH-Px and SOD activities were found to be higher (p < .001 and p < .01), but MDA levels were lower in the second samples relative to the first ones. In the plasma, AOP value was found to be higher in the second samples relative to first ones (p < .001). No differences were found, however, between the routine blood parameters such as total cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, high-density-lipoprotein cholesterol, and triglyceride levels. The results show that consumption of apple leads to significant increases in the activities of some antioxidant enzymes and in the antioxidant potential values of the blood, and that decreases oxidation reactions in the body in significant amount. It is quite possible that reduced peroxidation processes owing to consumption of this fruit may play a part in some of their beneficial effects in the elderly subjects.
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Affiliation(s)
- Aslihan Avci
- Department of Biochemistry, Ankara University School of Medicine, Ankara, Turkey
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Pai AB, Boyd AV, McQuade CR, Harford A, Norenberg JP, Zager PG. Comparison of Oxidative Stress Markers After Intravenous Administration of Iron Dextran, Sodium Ferric Gluconate, and Iron Sucrose in Patients Undergoing Hemodialysis. Pharmacotherapy 2007; 27:343-50. [PMID: 17316146 DOI: 10.1592/phco.27.3.343] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVE To compare non-transferrin-bound iron and markers of oxidative stress after single intravenous doses of iron dextran, sodium ferric gluconate, and iron sucrose. DESIGN Prospective, open-label, crossover study. SETTING University-affiliated general clinical research center. PATIENTS Twelve ambulatory patients undergoing hemodialysis. INTERVENTION Patients received 100 mg of intravenous iron dextran, sodium ferric gluconate, and iron sucrose in random sequence, with a 2-week washout period between treatments. MEASUREMENTS AND MAIN RESULTS Serum samples for transferrin saturation, non-transferrin-bound iron, and malondialdehyde (MDA; marker of lipid peroxidation) were obtained before (baseline) and 30, 60, 120, and 360 minutes and 2 weeks after each iron infusion. A serum sample for hemeoxygenase-1 (HO-1) RNA was obtained at baseline and 360 minutes after infusion. Non-transferrin-bound iron values were significantly higher 30 minutes after administration of sodium ferric gluconate and iron sucrose compared with iron dextran (mean +/- SEM 10.1 +/- 2.2, 3.8 +/- 0.8, and 0.23 +/-0.1 microM, respectively, p<0.001 for sodium ferric gluconate vs iron dextran, p = 0.002 for iron sucrose vs iron dextran). A significant positive correlation was noted between transferrin saturation and the presence of non-transferrin-bound iron for sodium ferric gluconate and iron sucrose (r2 = 0.37 and 0.45, respectively, p<0.001) but not for iron dextran (r2 = 0.09). After sodium ferric gluconate, significantly more samples showed increases in MDA levels from baseline compared with iron sucrose and iron dextran (p = 0.006); these increased levels were associated with the presence of non-transferrin-bound iron, baseline transferrin saturation above 30%, baseline transferrin levels below 180 mg/dl, and ferritin levels above 500 ng/ml (p<0.05). However, only a transferrin level below 180 mg/dl was independently associated (odds ratio 4.8, 95% confidence interval 1.2-15.3). CONCLUSION Iron sucrose and sodium ferric gluconate were associated with greater non-transferrin-bound iron appearance compared with iron dextran. However, only sodium ferric gluconate showed significant increases in lipid peroxidation. The relationship between non-transferrin-bound iron from intravenous iron and oxidative stress warrants further exploration.
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Affiliation(s)
- Amy Barton Pai
- College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA.
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Alvares Delfino VD, de Andrade Vianna AC, Mocelin AJ, Barbosa DS, Mise RA, Matsuo T. Folic acid therapy reduces plasma homocysteine levels and improves plasma antioxidant capacity in hemodialysis patients. Nutrition 2007; 23:242-7. [PMID: 17321110 DOI: 10.1016/j.nut.2007.01.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 01/04/2007] [Accepted: 01/04/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We evaluated the effects of folic acid on homocysteine levels and oxidative stress in 46 stable patients on hemodialysis. METHODS This double-blind, placebo-controlled, randomized trial assessed the effects of 6 mo of 10 mg of folic acid (26 patients) or placebo (20 patients) given three times weekly after each dialysis under nurse supervision on homocysteine levels, total plasma antioxidant capacity, and hydroperoxide plasma levels. RESULTS Folic acid treatment normalized plasma homocysteine levels in most patients, significantly increased total plasma antioxidant capacity levels, but had no significant effect on hydroperoxide levels. Placebo treatment had no statistically significant effect on the three parameters. CONCLUSION The folic acid therapy protocol effectively lowered plasma homocysteine levels and improved the total plasma antioxidant capacity in hemodialysis patients. Further studies are required to assess the usefulness of folic acid for decreasing cardiovascular mortality in patients with chronic kidney disease.
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Samouilidou E, Grapsa E, Karpouza A, Lagouranis A. Reactive Oxygen Metabolites: A Link between Oxidative Stress and Inflammation in Patients on Hemodialysis. Blood Purif 2007; 25:175-8. [PMID: 17215574 DOI: 10.1159/000098521] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Accepted: 10/21/2006] [Indexed: 11/19/2022]
Abstract
Oxidative stress plays a significant role in the development of inflammation in patients undergoing hemodialysis (HD). This study intends to evaluate the relationship between C-reactive protein (CRP) and the newly established marker of lipid peroxidation, d-ROMs (reactive oxygen metabolites), in comparison with different indicators of oxidative stress. Plasma total antioxidant capacity (TAC), lipid peroxidation products malonaldehyde (MDA) and 4-hydroxyalkenals, as well as d-ROMs, were determined in 24 patients before HD and in 21 normal controls (NC). It was found that HD patients had higher levels of d-ROMs than NC (p = 0.033). A highly significant positive correlation was observed between logCRP and d-ROMs concentrations (p < 0.0001, r = 0.85) in patients, but not in NC. The concentrations of TAC and MDA were not associated with CRP in HD or in NC individuals. It is concluded that d-ROMs concentration is a potent marker of oxidative injury that is strongly indicative of the inflammatory status in HD patients.
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Affiliation(s)
- E Samouilidou
- Biochemical Department, Alexandra Hospital, Athens, Greece.
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15
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Palleschi S, De Angelis S, Diana L, Rossi B, Papa V, Severini G, Splendiani G. Reliability of oxidative stress biomarkers in hemodialysis patients: a comparative study. ACTA ACUST UNITED AC 2007; 45:1211-8. [PMID: 17635073 DOI: 10.1515/cclm.2007.266] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Oxidative stress (OS) is considered to play a major role in the development of end-stage renal disease (ESRD) complications. However, conflicting and inconsistent data have been reported on OS in ESRD patients. Our aim was to investigate the reliability of the most popular non-enzymatic plasma OS biomarkers in ESRD. METHODS Vitamins A (VitA), E and C (VitC), uric acid, plasma antioxidant and ferric-reducing potential (PAP and PRP), thiols (SH), malondialdehyde (MDA) and lipid hydroperoxides (HPO) were determined before and after dialysis in plasma from 33 ESRD patients on hemodialysis, hemodiafiltration or peritoneal dialysis and 20 control subjects. RESULTS In ESRD patients, high PRP and normal PAP values were positively correlated with VitC levels. After dialysis, PRP levels decreased, while unchanged PAP levels correlated positively with high VitA and transiently recovered SH values. All patients showed high levels of both MDA and cholesterol-normalized HPO. However, while the former significantly decreased after dialysis, the latter were unaffected by treatment. Paradoxical correlations of MDA with both VitA and HPO were found. CONCLUSIONS Plasma PRP and MDA levels may be dramatically affected by both uremia and dialysis; their use in ESRD patients may therefore lead to OS misevaluation and should be avoided. More reliable results can be obtained using physiologically relevant OS functional tests, such as PAP, and early biomarkers of OS damage, such as SH and HPO.
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Affiliation(s)
- Simonetta Palleschi
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy.
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