Inflammation and oxidative stress in patients on hemodiafiltration.
BACKGROUND
Chronic inflammation and oxidative stress are common features in hemodialysis patients. However, research results on the long-term influence of hemodiafiltration (HDF) on oxidative stress and inflammation are limited.


METHODS
We studied changes of inflammatory and oxidative stress biomarkers in 9 stable patients on post-dilution HDF for 9 months. Total antioxidant capacity (TAC), reactive oxygen metabolites (d-ROMs) and superoxide dismutase (SOD) measured by spectrophotometry were used as oxidative stress biomarkers. High-sensitivity CRP (hs-CRP) and IL-6 measured by ELISA were used as inflammation biomarkers.


RESULTS
d-ROMs showed significant reduction at 3 months (323.0 +/- 81.9 vs. 275.0 +/- 62.0 U, p < 0.008) and remained low (267.9 +/- 45.8 U) to the end of the study. At the end of the study there was a significant increase in TAC levels (1.3 +/- 0.1 vs. 1.4 +/- 0.1 mmol/l, p < 0.03), while SOD rise did not reach statistical significance (13.1 +/- 9.8 vs. 18.7 +/- 9.4 U/ml, p = 0.06). hs-CRP values at the end of the study decreased significantly (16.3 +/- 11.4 vs. 6.0 +/- 5.1 microg/ml, p < 0.02), while IL-6 levels showed a non-significant reduction (16.9 +/- 9.3 vs. 12.0 +/- 7.3 pg/ml, p = 0.2).


CONCLUSIONS
Our results suggest that post-dilution HDF for 9 months suppresses oxidative stress by rapid lowering of d-ROMs and improves antioxidant capacity by increasing TAC, while it reduces inflammation by decreasing hs-CRP.
Filiopoulos
Vasilis
V
Nephrology Department, A. Fleming Hospital, Athens, Greece. filiopoulos1970@hotmail.com
Hadjiyannakos
Dimitrios
D
Metaxaki
Polixeni
P
Sideris
Vasilis
V
Takouli
Lambrini
L
Anogiati
Angeliki
A
Vlassopoulos
Dimosthenis
D
D000368:Aged; D000975:Antioxidants / Q000494:pharmacology; D015415:Biomarkers / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D018384:Oxidative Stress; D006435:Renal Dialysis / Q000379:methods; D013482:Superoxide Dismutase / Q000378:metabolism
D000975:Antioxidants; D015415:Biomarkers; D015850:Interleukin-6; D013482:Superoxide Dismutase