Q J Med 1994; 87: 679-683
© 1994 Association of Physicians
research-article |
Oxidative stress in haemodialysis
1From the Regional Nephrology Unit, Belfast City Hospital and Departments Belfast, UK 2From the Clinical Biochemistry Belfast, UK 3From the Medicine Queen's University Belfast, UK
Address correspondence to Dr C.M. Loughrey, Research Fellow, Dept of Clinical Biochemistry, Institute of Clinical Science Royal Victoria Hospital, Grosvenor Road, Belfast BT12 68J
Received 31 January 1994 Accepted for publication 25 July 1994.
Patients with chronic renal failure, including those receiving regular long-term haemodialysis, have a high incidence of premature cardiovascular disease. Oxidative stress, which occurs when there is excessive free-radical production or low antioxidant levels, has recently been implicated as a causative factor in atherogenesis. The aim of this study was to determine if chronic renal failure and haemodialysis were associated with increased oxidative stress. Serum malondialdehyde was measured as a marker of lipid peroxidation in 15 patients with conservatively managed chronic renal failure (CRF), 15 patients with CRF undergoing regular haemodialysis and 15 healthy controls. Selenium, glutathione peroxidase and antioxidant vitamins were also measured. Malondialdehyde was elevated in dialysis patients in comparison to CRF and control groups (dialysis 1.16 ±0.08 µmol/l, CRF 0.94±0.07, controls 0.66±0.10). Antioxidants, including vitamin C, selenium and glutathione peroxidase, were decreased in dialysis patients and to a lesser extent in the CRF group (vitamin C—dialysis 16.43 ± 3.76 µmol/l, CRF 34.5 ± 8.6, controls 56.11 ± 7.41; selenium—dialysis 0.77 ± 0.07 µmol/l, CRF 0.69 ± 0.06, controls 1.09 ± 0.06: glutathione peroxidase—dialysis 101±5 U/l, CRF 160±11, controls 290±10). These findings indicate oxidative stress in patients with CRF which is further exacerbated by haemodialysis, as evidenced by increased lipid peroxidation and low antioxidant levels. This stress may play a role in the development of atherosclerosis in these groups.
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