Effect of renal transplantation on biomarkers of inflammation and oxidative stress in end-stage renal disease patients.
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.
Simmons
Edith M
EM
Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA.
Langone
Anthony
A
Sezer
M Tugrul
MT
Vella
John P
JP
Recupero
Peter
P
Morrow
Jason D
JD
Ikizler
T Alp
TA
Himmelfarb
Jonathan
J
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
D015415:Biomarkers