Does dialysis modality influence the oxidative stress of uremic patients?
OBJECTIVE
Since peritoneal membrane is more compatible and residual renal function better preserved during peritoneal dialysis, we questioned whether the oxidative burden in chronic kidney disease (CKD) is influenced by dialysis modality.


METHODS
49 stable CKD patients, 17 on continuous ambulatory peritoneal dialysis (CAPD), 16 on hemodialysis (HD), and 16 non-dialyzed, and 13 healthy subjects were enrolled. Plasma thiobarbituric acid-reactive substances (TBARS; nmol/g protein), serum total antioxidant activity (TAA), total plasma-free thiols (Pt-SH; μmol/g protein), albumin and uric acid were measured by spectrophotometry. Serum residual antioxidant activity (RAA) was calculated.


RESULTS
TBARS were higher in HD (78.3 ± 20.3) versus both non-dialyzed (53.1 ± 27.9, p = 0.007) and CAPD groups (58.3 ± 19.8, p = 0.008). Pt-SH was reduced in CKD patients, but showed comparable values between dialysis groups. TAA and RAA were similarly increased in HD and CAPD patients than in the other two groups.


CONCLUSIONS
Oxidative stress occurs in all CKD patients and worsens as renal function declines. Lipid peroxidation seems more augmented during chronic HD as compared to CAPD, but the plasma antioxidant status did not differ between the investigated dialysis methods. Therefore, dialysis modality appears to influence lipid peroxidation without changing the extracellular antioxidant defense of CKD patients.
Nephrology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. ccalexandr@yahoo.com
Cristina
C
Capusa
Irina
I
Stoian
Elvira
E
Rus
Dana
D
Lixandru
Carmen
C
Barbulescu
Gabriel
G
Mircescu
D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D014511:Uremia / Q000097:blood* / Q000628:therapy*
D017392:Thiobarbituric Acid Reactive Substances