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Gouroju S, Rao PVLNS, Bitla AR, Vinapamula KS, Manohar SM, Vishnubhotla S. Role of Gut-derived Uremic Toxins on Oxidative Stress and Inflammation in Patients with Chronic Kidney Disease. Indian J Nephrol 2017; 27:359-364. [PMID: 28904431 PMCID: PMC5590412 DOI: 10.4103/ijn.ijn_71_17] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Several cardiovascular disease (CVD) risk factors have been identified among patients with chronic kidney disease (CKD). Gut-derived uremic toxins (GDUT) are important modifiable contributors in this respect. There are very few Indian studies on GDUT changes in CKD. One hundred and twenty patients older than 18 years diagnosed with CKD were enrolled along with forty healthy subjects. The patients were classified into three groups of forty patients based on stage of CKD. Indoxyl sulfate (IS), para cresyl sulfate (p-CS), indole acetic acid (IAA), and phenol were estimated along with the assessment of oxidative stress (OS), inflammatory state, and bone mineral disturbance. All the GDUT increased across the three groups of CKD. All patients had higher levels of malondialdehyde (MDA), ferric reducing ability of plasma (FRAP), high-sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6) as compared to controls. IS and IAA showed positive association with MDA/FRAP corrected for uric acid, whereas IS and p-CS showed positive association with IL-6. IS, IAA, and phenol showed a positive association with calcium × phosphorus product. GDUT increase OS and inflammatory state in CKD and may contribute to CVD risk.
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Affiliation(s)
- S Gouroju
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - P V L N Srinivasa Rao
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - A R Bitla
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - K S Vinapamula
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - S M Manohar
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - S Vishnubhotla
- Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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Georgatzakou HT, Antonelou MH, Papassideri IS, Kriebardis AG. Red blood cell abnormalities and the pathogenesis of anemia in end-stage renal disease. Proteomics Clin Appl 2016; 10:778-90. [PMID: 26948278 DOI: 10.1002/prca.201500127] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/14/2016] [Accepted: 02/29/2016] [Indexed: 12/20/2022]
Abstract
Anemia is the most common hematologic complication in end-stage renal disease (ESRD). It is ascribed to decreased erythropoietin production, shortened red blood cell (RBC) lifespan, and inflammation. Uremic toxins severely affect RBC lifespan; however, the implicated molecular pathways are poorly understood. Moreover, current management of anemia in ESRD is controversial due to the "anemia paradox" phenomenon, which underlines the need for a more individualized approach to therapy. RBCs imprint the adverse effects of uremic, inflammatory, and oxidative stresses in a context of structural and functional deterioration that is associated with RBC removal signaling and morbidity risk. RBCs circulate in hostile plasma by raising elegant homeostatic defenses. Variability in primary defect, co-morbidity, and therapeutic approaches add complexity to the pathophysiological background of the anemic ESRD patient. Several blood components have been suggested as biomarkers of anemia-related morbidity and mortality risk in ESRD. However, a holistic view of blood cell and plasma modifications through integrated omics approaches and high-throughput studies might assist the development of new diagnostic tests and therapies that will target the underlying pathophysiologic processes of ESRD anemia.
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Affiliation(s)
- Hara T Georgatzakou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Marianna H Antonelou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Issidora S Papassideri
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Anastasios G Kriebardis
- Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological and Educational Institute of Athens, Greece
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Guven GS, Altiparmak MR, Trabulus S, Yalin AS, Batar B, Tunckale A, Guven M. Relationship Between Genomic Damage and Clinical Features in Dialysis Patients. Genet Test Mol Biomarkers 2013; 17:202-6. [DOI: 10.1089/gtmb.2012.0301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gulgun S. Guven
- Department of Medical Genetics, Istanbul University, Istanbul, Turkey
| | | | - Sinan Trabulus
- Department of Nephrology, Istanbul University, Istanbul, Turkey
| | - Ayse S. Yalin
- Department of Nephrology, Istanbul University, Istanbul, Turkey
| | - Bahadir Batar
- Department of Medical Biology, Istanbul University, Istanbul, Turkey
| | - Aydin Tunckale
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mehmet Guven
- Department of Medical Biology, Istanbul University, Istanbul, Turkey
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Montazerifar F, Karajibani M, Sanadgol H, Hashemi M. Effect of peritoneal dialysis on antioxidant defense system and oxidative stress. Int J Organ Transplant Med 2012. [DOI: 10.1016/j.hkjn.2012.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sandoval SB, Stoyanova E, Coll E, Pastor S, Reyes J, Andrés E, Ballarin J, Xamena N, Marcos R. Genetic damage in chronic renal failure patients is associated with the glomerular filtration rate index. Mutagenesis 2010; 25:603-8. [PMID: 20884684 DOI: 10.1093/mutage/geq047] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Chronic renal failure (CRF) patients are considered to present genomic instability and, as a consequence, elevated levels of genetic damage. An open question is whether this damage is related to the stage of the pathology. To determine the background levels of genetic damage, a large population of 258 Caucasian adults (201 CRF patients and 57 controls) was analysed using the micronucleus (MN) assay. The frequency of MN in CRF patients was significantly higher than in controls and correlated with the progression of the disease, according to the glomerular filtration rate. In addition, a significant association was observed between genetic damage and serum creatinine levels. Genetic damage, measured as frequency of MN, increases when renal function decreases. The fact that an increased level of MN is already observed in patients' Stage 2 seems to indicate a genetic predisposition on these patients. Nevertheless, part of the observed damage can be attributed to the uraemic state itself.
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Affiliation(s)
- Silvia Berenice Sandoval
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici Cn, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain
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Montazerifar F, Hashemi M, Karajibani M, Dikshit M. Effect of combined vitamins C and E supplementation on oxidant/antioxidant status in hemodialysis patients. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2010. [DOI: 10.1007/s12349-010-0015-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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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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Herman M, Ori Y, Chagnac A, Korzets A, Weinstein T, Malachi T, Gafter U. Spontaneous DNA Repair Increases during Hemodialysis. ACTA ACUST UNITED AC 2008; 108:c188-93. [DOI: 10.1159/000118941] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 11/14/2007] [Indexed: 11/19/2022]
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Okwuosa T, Williams KA. Coronary artery disease and nuclear imaging in renal failure. J Nucl Cardiol 2006; 13:150-5. [PMID: 16580948 DOI: 10.1007/bf02971236] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2006] [Indexed: 11/28/2022]
Affiliation(s)
- Tochi Okwuosa
- Department of Internal Medicine, University of Chicago, Chicago, Ill, USA
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Ece A, Atamer Y, Gürkan F, Davutoğlu M, Bilici M, Tutanç M, Güneş A. Paraoxonase, anti-oxidant response and oxidative stress in children with chronic renal failure. Pediatr Nephrol 2006; 21:239-45. [PMID: 16252096 DOI: 10.1007/s00467-005-2079-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Revised: 07/26/2005] [Accepted: 07/27/2005] [Indexed: 11/29/2022]
Abstract
Increased oxidative stress is believed to contribute to an increased risk of cardiovascular disease in uraemia. In children with chronic renal failure (CRF), an anti-oxidant enzyme, paraoxonase (PON), that inhibits oxidation of LDL-cholesterol, has not been previously investigated. In this study we aimed to investigate PON activity, total anti-oxidant response (TAR), total peroxide (TPX), oxidative stress index (OSI) and some pro-oxidant cytokines in 29 children with CRF [mean age 10.2+/-3.5 years; 19 pre-dialysis, ten on continuous ambulatory peritoneal dialysis (CAPD)] and in 25 control subjects. Children with CRF had lower PON and TAR and higher TPX and OSI values than did controls (P<0.05). Except for lower TAR and serum albumin levels of the CAPD subgroup (P<0.05), other parameters were similar in non-dialysis and CAPD patients (P>0.05). Patients had significant positive correlation between TAR and serum albumin (P<0.05). Serum urea had significant positive correlation with TPX and OSI (P<0.05). Increased oxidative stress and decreased anti-oxidants measured by serum PON activity and TAR were found in children with CRF. We can hypothesize, on the basis of statistical correlations, that low levels of serum albumin and high levels of uraemic metabolites might be responsible for increased oxidative stress in children with CRF. Further studies with larger sample sizes are needed to verify these results.
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Affiliation(s)
- Aydin Ece
- Department of Pediatrics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
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