Linkage of some trace elements, peripheral blood lymphocytes, inflammation, and oxidative stress in patients undergoing either hemodialysis or peritoneal dialysis.
BACKGROUND
Changes in essential trace elements may affect the inflammatory and immunological state of patients on hemodialysis (HD) or peritoneal dialysis (PD). Therefore, we aimed to determine trace element content and markers of oxidative stress, inflammation, and immune status in HD and PD patients and to assess the relationships among these parameters.


METHODS
Patients on either HD (n = 20) or PD (n = 20) and age-, sex-, body mass index-matched healthy individuals (n = 20) were enrolled in the study. The trace elements zinc, copper, selenium, and iron; markers of oxidative stress thiobarbituric acid reactive substances (TBARS) and protein carbonyl levels; activities of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase; percentages of CD3 T lymphocytes and the subsets CD4 and CD8; the CD4/CD8 ratio; and C-reactive protein (CRP) were measured.


RESULTS
All dialysis patients had low levels of albumin and hemoglobin. Significantly decreased percentages of CD3 and CD4 T lymphocytes and increased levels of CRP, TBARS, and carbonyl compounds were observed in HD patients. HD patients also had elevated erythrocyte SOD, lower GPx and catalase activities, and decreased levels of Se, Zn, and Fe in comparison to PD patients and healthy subjects. In addition, CRP was positively associated with TBARS and carbonyl levels, but was significantly inversely associated with Zn and Se levels. Positive correlations were found between T lymphocyte CD3 and CD4 percentages and Zn, Se, and Fe levels.


CONCLUSIONS
There were significant decreases in T lymphocyte-related immunological regulation and increased inflammation and oxidative stress in dialysis patients. Essential trace element status was independently related to immune status, inflammation, and oxidative damage.
Guo
Chih-Hung
CH
Institute of Biomedical Nutrition, Hung Kuang University, Taichung, Taiwan, Republic of China. eillyguo@sunrise.hk.edu.tw
Wang
Chia-Liang
CL
Chen
Pei-Chung
PC
Yang
Te-Cheng
TC
D002097:C-Reactive Protein / Q000032:analysis; D015704:CD4 Antigens / Q000097:blood; D003300:Copper / Q000097:blood; D005260:Female; D005979:Glutathione Peroxidase / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000097:blood; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy; D015227:Lipid Peroxidation; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000276:immunology*; D010530:Peritoneal Dialysis; D017455:Receptors, IgE / Q000097:blood; D006435:Renal Dialysis; D012643:Selenium / Q000097:blood; D016176:T-Lymphocyte Subsets / Q000276:immunology; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis; D014131:Trace Elements / Q000097:blood*; D015032:Zinc / Q000097:blood
D015704:CD4 Antigens; D017455:Receptors, IgE; D017392:Thiobarbituric Acid Reactive Substances; D014131:Trace Elements; D003300:Copper; D002097:C-Reactive Protein; D007501:Iron; D005979:Glutathione Peroxidase; D012643:Selenium; D015032:Zinc