title: Electrolyzed-reduced water reduced hemodialysis-induced erythrocyte impairment in end-stage renal disease patients.
abstract: Chronic hemodialysis (HD) patients increase erythrocyte susceptibility to hemolysis and impair cell survival. We explored whether electrolyte-reduced water (ERW) could palliate HD-evoked erythrocyte impairment and anemia. Forty-three patients undergoing chronic HD were enrolled and received ERW administration for 6 month. We evaluated oxidative stress in blood and plasma, erythrocyte methemoglobin (metHb)/ferricyanide reductase activity, plasma metHb, and proinflammatory cytokines in the chronic HD patients without treatment (n=15) or with vitamin C (VC)- (n=15), vitamin E (VE)-coated dialyzer (n=15), or ERW treatment (n=15) during an HD course. The patients showed marked increases (15-fold) in blood reactive oxygen species, mostly H(2)O(2), after HD without any treatment. HD resulted in decreased plasma VC, total antioxidant status, and erythrocyte metHb/ferricyanide reductase activity and increased erythrocyte levels of phosphatidylcholine hydroperoxide (PCOOH) and plasma metHb. Antioxidants treatment significantly palliated single HD course-induced oxidative stress, plasma and RBC PCOOH, and plasma metHb levels, and preserved erythrocyte metHb /ferricyanide reductase activity in an order VC>ERW>VE-coated dialyzer. However, ERW had no side effects of oxalate accumulation easily induced by VC. Six-month ERW treatment increased hematocrit and attenuated proinflammatory cytokines profile in the HD patients. In conclusion, ERW treatment administration is effective in palliating HD-evoked oxidative stress, as indicated by lipid peroxidation, hemolysis, and overexpression of proinflammatory cytokines in HD patients.
authors.affiliation: Department of Family Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: K-C
authors.initials: KC
authors.lastname: Huang
authors.forename: C-C
authors.initials: CC
authors.lastname: Yang
authors.forename: S-P
authors.initials: SP
authors.lastname: Hsu
authors.forename: K-T
authors.initials: KT
authors.lastname: Lee
authors.forename: H-W
authors.initials: HW
authors.lastname: Liu
authors.forename: S
authors.initials: S
authors.lastname: Morisawa
authors.forename: K
authors.initials: K
authors.lastname: Otsubo
authors.forename: C-T
authors.initials: CT
authors.lastname: Chien
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D000975:Antioxidants / Q000008:administration & dosage; D001205:Ascorbic Acid / Q000008:administration & dosage; D015415:Biomarkers; D002470:Cell Survival; D004572:Electrolysis; D004912:Erythrocytes / Q000166:cytology* / Q000378:metabolism; D005260:Female; D006400:Hematocrit; D015312:Hemodialysis Solutions / Q000009:adverse effects / Q000737:chemistry*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008567:Membranes, Artificial; D008706:Methemoglobin / Q000378:metabolism; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects; D017382:Reactive Oxygen Species / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D014810:Vitamin E / Q000008:administration & dosage; D014867:Water / Q000737:chemistry
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D015312:Hemodialysis Solutions; D008567:Membranes, Artificial; D017382:Reactive Oxygen Species; D014867:Water; D014810:Vitamin E; D008706:Methemoglobin; D001205:Ascorbic Acid