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Hirayama A, Akazaki S, Nagano Y, Ueda A, Chang-il Lee M, Aoyagi K, Oowada S, Sato K. Hemodialysis raises oxidative stress through carbon-centered radicals despite improved biocompatibility. J Clin Biochem Nutr 2021; 69:44-51. [PMID: 34376913 PMCID: PMC8325767 DOI: 10.3164/jcbn.20-141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/06/2020] [Indexed: 12/13/2022] Open
Abstract
Leukocyte activation and the resulting oxidative stress induced by bioincompatible materials during hemodialysis impact the prognosis of patients. Despite multiple advances in hemodialysis dialyzers, the prognosis of hemodialysis patients with complications deeply related to oxidative stress, such as diabetes mellitus, remains poor. Thus, we re-evaluated the effects of hemodialysis on multiple reactive oxygen species using electron spin resonance-based methods for further improvement of biocompatibility in hemodialysis. We enrolled 31 patients in a stable condition undergoing hemodialysis using high-flux polysulfone dialyzers. The effects of hemodialysis on reactive oxygen species were evaluated by two methods: MULTIS, which evaluates serum scavenging activities against multiple hydrophilic reactive oxygen species, and i-STrap, which detects lipophilic carbon-center radicals. Similar to previous studies, we found that serum hydroxyl radical scavenging activity significantly improved after hemodialysis. Unlike previous studies, we discovered that scavenging activity against alkoxyl radical was significantly reduced after hemodialysis. Moreover, patients with diabetes mellitus showed a decrease in serum scavenging activity against alkyl peroxyl radicals and an increase in lipophilic carbon-center radicals after hemodialysis. These results suggest that despite extensive improvements in dialyzer membranes, the forms of reactive oxygen species that can be eliminated during dialysis are limited, and multiple reactive oxygen species still remain at increased levels during hemodialysis.
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Affiliation(s)
- Aki Hirayama
- Center for Integrative Medicine, Tsukuba University of Technology, 4-12-7 Kasuga, Tsukuba 305-8521, Japan
| | - Satomi Akazaki
- Department of Clinical Biochemistry, Graduate School of Clinical Pharmacy, Kyushu University of Health and Welfare, 1714-1 Yoshino-cho, Nobeoka 882- 8508, Japan
| | - Yumiko Nagano
- Center for Integrative Medicine, Tsukuba University of Technology, 4-12-7 Kasuga, Tsukuba 305-8521, Japan
| | - Atsushi Ueda
- University of Tsukuba Hospital Hitachi Medical Education and Research Center, 2-1-1 Jonan-cho, Hitachi 317-0077, Japan
| | - Masaichi Chang-il Lee
- Yokosuka-Shonan Disaster Health Emergency Research Center & ESR Laboratories, Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan
| | - Kazumasa Aoyagi
- Center for Integrative Medicine, Tsukuba University of Technology, 4-12-7 Kasuga, Tsukuba 305-8521, Japan
| | - Shigeru Oowada
- Asao Clinic, 1-8-10 Manpukuji, Asao-ku, Kawasaki 215-0004, Japan
| | - Keizo Sato
- Department of Clinical Biochemistry, Graduate School of Clinical Pharmacy, Kyushu University of Health and Welfare, 1714-1 Yoshino-cho, Nobeoka 882- 8508, Japan
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