title: Effects of hemodialysis, dialyser type and iron infusion on oxidative stress in uremic patients.
abstract: Uremic patients undergoing hemodialysis (HD) are considered to face an elevated risk for atherosclerosis and cancer. This has been attributed in part to an increased oxidative stress. In this pilot study, oxidative cell damage in blood of HD-patients was compared to those of controls: total DNA damage (basic and specific oxidative DNA damage), modulation of glutathione levels (total and oxidized glutathione) and of lipid peroxidation were monitored via the Comet assay (with and without FPG), a kinetic photometric assay and HPLC quantification of plasma malondialdehyde (MDA), respectively. In some samples, leukocytes were analysed for malondialdehyde-deoxyguanosine-adducts (M1dG) with an immunoslot blot technique. HD-patients (n=21) showed a significant increase of total DNA damage (p<10(-12)), compared to controls (n=12). In a subset of patients and controls, GSSG levels and M1dG, however, only increased slightly, while tGSH and MDA levels did not differ. The influence of different low flux HD-membranes was tested in a pilot study with nine patients consecutively dialysed on three membrane types for four weeks each. In addition to the individual disposition of the patient, the dialyser membrane had a significant impact on oxidative stress. Total DNA damage was found to be almost identical for polysulfone and vitamin E coated cellulosic membranes, whereas a slight, but significant increase was observed with cellulose-diacetate (p<0.001). In patients receiving iron infusion during HD, MDA-formation (n=11) and total DNA damage (n=10) were additionally increased (p<0.005). Our results show an increased oxidative damage in HD-patients, compared to healthy volunteers. Significant influences were found for the dialyser membrane type and iron infusion.
authors.affiliation: Department of Chemistry, Division of Food Chemistry and Environmental Toxicology, Technical University of Kaiserslautern, Kaiserslautern, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Müller
authors.forename: Gerhard
authors.initials: G
authors.lastname: Eisenbrand
authors.forename: Martina
authors.initials: M
authors.lastname: Gradinger
authors.forename: Thomas
authors.initials: T
authors.lastname: Rath
authors.forename: Franz Werner
authors.initials: FW
authors.lastname: Albert
authors.forename: Jörg
authors.initials: J
authors.lastname: Vienken
authors.forename: Rajinder
authors.initials: R
authors.lastname: Singh
authors.forename: Peter B
authors.initials: PB
authors.lastname: Farmer
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Stockis
authors.forename: Christine
authors.initials: C
authors.lastname: Janzowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002482:Cellulose / Q000031:analogs & derivatives* / Q000378:metabolism; D002851:Chromatography, High Pressure Liquid; D020552:Comet Assay; D018736:DNA Adducts; D004249:DNA Damage; D003849:Deoxyguanosine / Q000378:metabolism; D005978:Glutathione / Q000378:metabolism; D006397:Hematinics; D006801:Humans; D007262:Infusions, Intravenous; D007501:Iron / Q000008:administration & dosage*; D007700:Kinetics; D015227:Lipid Peroxidation; D008315:Malondialdehyde / Q000378:metabolism; D008566:Membranes / Q000737:chemistry*; D008875:Middle Aged; D010084:Oxidation-Reduction; D018384:Oxidative Stress; D010865:Pilot Projects; D011108:Polymers / Q000737:chemistry; D006435:Renal Dialysis; D013450:Sulfones / Q000737:chemistry; D014511:Uremia / Q000235:genetics / Q000378:metabolism*; D014810:Vitamin E / Q000737:chemistry
chemical_list: D018736:DNA Adducts; D006397:Hematinics; D011108:Polymers; D013450:Sulfones; D014810:Vitamin E; C017662:polysulfone P 1700; D008315:Malondialdehyde; D002482:Cellulose; C026170:cellulose diacetate; D007501:Iron; D003849:Deoxyguanosine; D005978:Glutathione