title: Oxidative stress during ex vivo hemodialysis of blood is decreased by a novel hemolipodialysis procedure utilizing antioxidants.
abstract: The high cardiovascular mortality in patients receiving hemodialysis (HD) has been attributed, in part, to oxidative stress. Here we examined the effectiveness of antioxidants introduced by means of a novel hemolipodialysis (HLD) procedure in terms of reducing oxidative stress during ex vivo blood circulation. Oxidative stress was studied in a model HD system resembling the extracorporeal circulation of blood during clinical HD. Blood circulation produced an increase of up to 280% in free hemoglobin levels and an increase of 320% in electronegative LDL (LDL(-)) subfraction. A significant correlation between LDL(-) and free hemoglobin levels confirmed previous findings that LDL(-) formation during ex vivo circulation of blood can be mediated by the oxidative activity of free hemoglobin. These effects were significantly attenuated during HLD using a dialysis circuit containing vitamin E with or without vitamin C. By contrast, HLD with vitamin C alone had a marked pro-oxidant effect. TBARS, lipid hydroperoxides, vitamin E and beta-carotene content in LDL were not significantly altered by the HD procedure. These findings demonstrate the occurrence of oxidative stress in human plasma where lipoproteins are a target and indicate antioxidant-HLD treatment as a specific new approach to decreasing the adverse oxidative stress frequently associated with cardiovascular complications in high-risk populations of uremic patients.
authors.affiliation: Vascular Medicine and Atherosclerosis Unit, Brigham and Women's Hospital, Harvard University, Boston MA, USA.
authors.forename: Ouliana
authors.initials: O
authors.lastname: Ziouzenkova
authors.forename: Liana
authors.initials: L
authors.lastname: Asatryan
authors.forename: Ciro
authors.initials: C
authors.lastname: Tetta
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Wratten
authors.forename: Juliana
authors.initials: J
authors.lastname: Hwang
authors.forename: Alex
authors.initials: A
authors.lastname: Sevanian
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism* / Q000517:prevention & control; D004359:Drug Therapy, Combination; D006801:Humans; D015227:Lipid Peroxidation; D008077:Lipoproteins, LDL / Q000097:blood*; D018384:Oxidative Stress / Q000187:drug effects*; D006435:Renal Dialysis; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D014810:Vitamin E / Q000627:therapeutic use
chemical_list: D000975:Antioxidants; D008077:Lipoproteins, LDL; D017392:Thiobarbituric Acid Reactive Substances; D014810:Vitamin E; D001205:Ascorbic Acid