title: Effect of renal transplantation on biomarkers of inflammation and oxidative stress in end-stage renal disease patients.
abstract: BACKGROUND
  Chronic kidney disease patients have a high prevalence of inflammation and oxidative stress, and this has been associated with the excess cardiovascular morbidity and mortality observed in this population. Because maintenance hemodialysis is ineffective in controlling these factors, we hypothesized that restoration of kidney function by transplantation would be required to improve uremic inflammation and oxidative stress.
  
  
  METHODS
  This was a prospective cohort study evaluating time-dependent changes in biomarkers of inflammation and oxidative stress before and after renal transplantation. Nineteen end-stage renal disease (ESRD) patients (age 38.3+/-13.7 years, 58% male, 95% white, 21% diabetic) undergoing living-donor renal transplantation were enrolled. C-reactive protein (CRP), interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-alpha, protein-associated carbonyl content, and F2-isoprostanes were assessed at 1 week pretransplantation and at 1 week and 2 months posttransplantation.
  
  
  RESULTS
  Pretransplant levels of the pro-inflammatory proteins IL-6, TNF-alpha, and CRP, as well as the oxidative stress markers plasma protein carbonyls and F2-isoprostanes, were significantly elevated in ESRD patients compared with healthy control subjects. We observed rapid and significant declines in all of these biomarkers after transplantation that persisted for 2 months.
  
  
  CONCLUSIONS
  Our findings indicate that restoration of renal function by transplantation improves the chronic inflammation and increased oxidative stress associated with uremia, which may contribute to the improved survival afforded to ESRD patients by renal transplantation.
authors.affiliation: Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Edith M
authors.initials: EM
authors.lastname: Simmons
authors.forename: Anthony
authors.initials: A
authors.lastname: Langone
authors.forename: M Tugrul
authors.initials: MT
authors.lastname: Sezer
authors.forename: John P
authors.initials: JP
authors.lastname: Vella
authors.forename: Peter
authors.initials: P
authors.lastname: Recupero
authors.forename: Jason D
authors.initials: JD
authors.lastname: Morrow
authors.forename: T Alp
authors.initials: TA
authors.lastname: Ikizler
authors.forename: Jonathan
authors.initials: J
authors.lastname: Himmelfarb
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism* / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress
chemical_list: D015415:Biomarkers