Effect of phosphate binders on oxidative stress and inflammation markers in hemodialysis patients.
It has been suggested that phosphate binders may reduce the inflammatory state of hemodialysis (HD) patients. However, it is not clear whether it has any effect on oxidative stress. The objective of this study was to evaluate the effect of sevelamer hydrochloride (SH) and calcium acetate (CA) on oxidative stress and inflammation markers in HD patients. Hemodialysis patients were randomly assigned to therapy with SH (n=17) or CA (n=14) for 1 year. Before the initiation of therapy (baseline) and at 12 months, we measured in vitro reactive oxygen species (ROS) production by stimulated and unstimulated polymorphonuclear neutrophils and serum levels of tumor necrosis factor alpha, interleukin-10, C-reactive protein, and albumin. There was a significant reduction of spontaneous ROS production in both groups after 12 months of therapy. There was a significant decrease of Staphylococcus aureus stimulated ROS production in the SH group. There was a significant increase in albumin serum levels only in the SH group. In the SH group, there was also a decrease in the serum levels of tumor necrosis factor alpha and C-reactive protein. Our results suggest that compared with CA treatment, SH may lead to a reduction in oxidative stress and inflammation. Therefore, it is possible that phosphate binders exert pleiotropic effects on oxidative stress and inflammation, which could contribute toward decreasing endothelial injury in patients in HD.
Peres
Aline T
AT
Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil. aline@nefro.epm.br
Dalboni
Maria A
MA
Canziani
Maria E
ME
Manfredi
Silvia R
SR
Carvalho
Jose Tarcisio G
JT
Batista
Marcelo C
MC
Cuppari
Lilian
L
Carvalho
Aluisio B
AB
Moyses
Rosa M A
RM
Guimarães
Nadia
N
Jorgetti
Vanda
V
Andreoli
Maria C
MC
Draibe
Sergio A
SA
Cendoroglo
Miguel
M
D000085:Acetates / Q000627:therapeutic use; D000328:Adult; D015415:Biomarkers / Q000097:blood; D017610:Calcium Compounds / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000188:drug therapy; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D028044:Phosphate-Binding Proteins / Q000627:therapeutic use*; D011073:Polyamines / Q000627:therapeutic use; D017382:Reactive Oxygen Species / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*; D000069603:Sevelamer; D016896:Treatment Outcome
D000085:Acetates; D015415:Biomarkers; D017610:Calcium Compounds; D018836:Inflammation Mediators; D028044:Phosphate-Binding Proteins; D011073:Polyamines; D017382:Reactive Oxygen Species; D000069603:Sevelamer; C120662:calcium acetate