Parameters of oxidative stress and echocardiographic indexes in patients on dialysis therapy.
OBJECTIVE
Quantity of oxidative stress (OS) is enhanced in every stage of chronic renal failure (CRF). OS and its effects on echocardiographic indexes in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) were evaluated.


METHODS
Thirty-nine patients on CAPD, 32 patients on HD, and 30 healthy individuals with similar demographic features were included. Patients with diabetes mellitus and chronic inflammatory diseases were excluded. Blood samples were collected to examine hematological and biochemical parameters and levels of malonyldialdehyde (MDA), glutathione peroxidase (GSH-px), and superoxide dismutase (SOD) after a 12-hour fasting period in the middle of dialysis week. OS parameters were compared with ejection fraction (EF), interventricular septum diameter (IVSd), left ventricular posterior wall diameter (LVPWd), and left atrium diameter (LAd) determined in M-mod echocardiographic examination.


RESULTS
No significant difference was observed between MDA and GSH-px levels of patients and control group; however, SOD levels of patients group were significantly lower (p<0.0001). SOD levels of patients on HD were lower than that of patients on CAPD (p=0.039). Negative correlation was detected between MDA and EF (r=-0.380, p=0.001); SOD has negative correlation with systolic blood pressure (r=-0.265, p=0.011), diastolic blood pressure (r=-0.230, p=0.028), phosphorus (r=-0.327, p=0.001), intact parathyroid hormone (iPTH) (r=-0.259, p=0.013), C-reactive protein (CRP) (r=-0.235, p=0.024), fibrinogen (r=-0.342, p=0.001), and total cholesterol (r=-0.249, p=0.017); and positive correlation with hemoglobin (r=0.414, p<0.001) and albumin (r=0.367, p<0.001). MDA was independently related with age (beta=-0.258, p=0.035), male gender (beta=-0.312, p=0.004), and EF (beta=-0.461, p<0.001). No correlation was determined between antioxidants and cardiac indexes.


CONCLUSIONS
SOD levels decreased significantly especially in patients on HD, and it was observed that lower levels of SOD would lead to OS in patients on HD and CAPD when compared to healthy individuals; MDA levels were independently influenced from EF.
Kayabasi
Hasan
H
Department of Nephrology, Faculty of Medicine, Dicle University, and Department of Internal Medicine, Silvan State Hospital, Diyarbakir, Turkey. drkayabasi@yahoo.com
Sit
Dede
D
Atay
A Engin
AE
Yilmaz
Zulfukar
Z
Kadiroglu
Ali Kemal
AK
Yilmaz
M Emin
ME
D004452:Echocardiography; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000000981:diagnostic imaging*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D018384:Oxidative Stress; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D013482:Superoxide Dismutase / Q000097:blood
D008315:Malondialdehyde; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase