ABSTRACT
BACKGROUND: The influence of dialysis modality on oxidative stress (OS) and inflammation is not yet clear. Elucidating this influence could provide novel therapy concepts for cardiovascular diseases. AIM: To compare protein OS, antioxidant vitamins and inflammation in patients undergoing either hemodialysis (HD) or peritoneal dialysis (PD). METHODS: A cross-sectional study was performed with 19 PD and 21 HD patients treated for ≥ 6 months. The control group was composed of 17 healthy individuals. Advanced oxidation protein products (AOPP), advanced glycation end products (AGEs), vitamins C, A and E, C-reactive protein and interleukin 6 were measured in plasma samples. RESULTS: OS was higher in the dialysis group when compared with controls, but HD patients showed higher AOPP compared with PD (HD:141.9 ± 75.2 µmol/L; PD: 112.5 ± 69.3 µmol/L, P< 0.01) and AGEs (HD: 32.2 ± 10.6 AU x10³; PD: 26.6 ± 4.9 AUx10³, P< 0.05). There was no difference in inflammation and vitamin levels among dialysis patients. In HD patients, AGEs correlated moderately with serum vitamin C (r = 0.46; P< 0.05). CONCLUSION: The dialysis modality adopted influences protein OS, but it has no effect on antioxidant status or inflammation. Hemodialysis probably exacerbates OS due to the increased bioincompatibility of the dialysis procedure, and this scenario seems to be related to the intravenous supplementation of vitamin C. Peritoneal dialysis allows for a better oxidative balance, which may reduce cardiovascular risk.
Subject(s)
Antioxidants/metabolism , Inflammation/metabolism , Oxidative Stress , Peritoneal Dialysis , Renal Dialysis , Vitamins/metabolism , Case-Control Studies , Female , History, 16th Century , History, 17th Century , History, 18th Century , Humans , Male , Vitamins/classificationABSTRACT
Our aim was to investigate and determine the associations between oxidative stress (OS), dyslipidemia and inflammation in patients treated with continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) using observational cross-sectional study. Twenty patients in CAPD and 48 in HD for at least 8 weeks and aged ≥18 years were included in the study. Individuals with malignant or acute inflammatory disease were excluded. A control group of 17 healthy individuals was also recruited. The biochemical parameter evaluations were analyzed using colorimetric kits for albumin, serum glucose, total cholesterol (TC) and lipid fractions. To determine the inflammatory status, CRP, IL-6 and TNF-α were analyzed by automated chemiluminescence kits. Plasma advanced oxidation protein products (AOPP) were determined by spectrophotometry. Mean AOPP levels were significantly higher for the HD group compared to the control, and there was no difference in AOPP concentrations between the control and CAPD groups. Dialysis patients had levels of inflammatory parameters higher than controls, and showed a high prevalence of patients with dyslipidemia, especially in CAPD. In the HD group, AOPP was positively correlated with triglycerides (TG) and inversely associated with HDL. Also the HD group was observed to have negative associations between TNF-α and HDL, LDL and TC. In the CAPD group, CRP was inversely correlated with HDL. Hemodialysis patients had increased protein OS and associations of inflammation and dyslipidemia were also observed in these dialysis groups. A more detailed characterization of the relations between oxidative stress and other more traditional risk factors has therapeutic importance, since cardiovascular diseases are the leading cause of death among dialysis patients.
