Effect of hemodialysis on the oxidative stress and antioxidants.
Oxidative stress plays a role in many disease states. These diseases have an increased incidence in uremia, and particularly in hemodialysis (HD) patients. This suggests an increased exposure to oxidative stress. An imbalance between oxidants and antioxidants has been suggested in uremic patients on HD. However, the respective influence of uremia and dialysis procedure has not been evaluated. It is postulated that antioxidant capacity in uremic patients is reduced, yet the mechanism remains unclear. We have determined the levels of lipid peroxidation expressed as thiobarbituric acid-reactive substances. We assessed oxidative protein damage by carbonyl content and activities of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) in predialysis uremic patients and in end-stage renal disease (ESRD) patients before and after hemodialysis. Vitamin E and vitamin C levels, reduced glutathione and sulfhydryl content were also studied. We found enhanced oxidative stress in ESRD patients undergoing HD and in predialysis uremic patients. This was mostly due to defective antioxidant enzyme levels. Preventive modalities, including use of biocompatible membranes, ultrapure dialysate, exogenous supplementation of antioxidant vitamins, extracorporeal removal of reactive oxygen species (ROS) and oxidatively modified substances, would appear highly desirable to reduce complications in the long-term dialysis patients.
Dursun
Evrim
E
Department of Biochemistry, Akdeniz University, Medical Faculty, Antalya, Turkey.
Ozben
Tomris
T
Süleymanlar
Gültekin
G
Dursun
Belda
B
Yakupoglu
Gülsen
G
D000975:Antioxidants / Q000378:metabolism* / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000378:metabolism; D002374:Catalase / Q000378:metabolism; D004912:Erythrocytes / Q000201:enzymology; D005979:Glutathione Peroxidase / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D018384:Oxidative Stress / Q000187:drug effects / Q000502:physiology*; D006435:Renal Dialysis / Q000009:adverse effects*; D013482:Superoxide Dismutase / Q000378:metabolism; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis; D014511:Uremia / Q000378:metabolism / Q000503:physiopathology*; D014810:Vitamin E / Q000378:metabolism / Q000627:therapeutic use
D000975:Antioxidants; D017392:Thiobarbituric Acid Reactive Substances; D014810:Vitamin E; D002374:Catalase; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase; D001205:Ascorbic Acid