Vitamin E as an antioxidant agent in CAPD patients.

Oxidative stress, increased lipid peroxidation and decreased activity of antioxidant systems may contribute to the accelerated development of atherosclerosis in chronic renal failure patients during renal replacement therapy. The aim of the study was to investigate the influence of vitamin E (400 mg/day) on some antioxidant defense parameters in CAPD patients. In fourteen CAPD patients, erythrocyte antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPX) and catalase (CAT), the concentration of plasma malondialdehyde (MDA), vitamin A, vitamin C and vitamin E were investigated. The study was divided into two periods. Each period lasted six weeks. In the first period patients received orally vitamin E 400 mg/day, in the second period they did not receive vitamin E or other antioxidant drugs. Each parameter was determined at the beginning of the study and at the end of each period. Six CAPD patients were treated by erythropoietin (EPO) and received orally pyridoxine 20 mg/day and the others without EPO treatment received pyridoxine 5 mg/day. Six-week treatment by vitamin E (400 mg/day) led to the significant increase of serum vitamin E (from 33.6+/-9.0 to 49.3+/-15.5 micromol/L) and to the significant decrease of MDA (from 2.62+/-0.5 to 2.36+/-0.4 micromol/L). The mean values of erythrocyte enzymes were in or under the lower margin of normal range and were not influenced by vitamin E in CAPD patients. The results of our study showed that orally administered vitamin E is a very important antioxidant agent for CAPD patients.

[Oral administration of iron with vitamin C in haemodialyzed patients]. / Perorálne pouzitie zeleza s vitamínom C u hemodialyzovaných chorých.

One tablet of Sorbifer Durules contains 100 mg Fe2+ and 60 mg vitamin C. The authors examined in a short-term study 24 haemodialyzed patients with chronic renal failure of different etiology. The investigation was divided into three parts. During the first 4 weeks the patients did not receive Fe2+ nor vitamin C. During the subsequent four weeks the patients had Sorbifer Durules, one tablet/24 hours. This period was followed by another four weeks when the patients went again without Fe2+ and vitamin C treatment. At regular intervals, i.e. on days 0, 28, 56 and 84 the authors assessed the packed cell volume, blood haemoglobin and serum iron level, the total iron binding capacity, transferrin saturation, ferritin, and vitamin C in serum as well as the plasma oxalic acid level. Four weeks treatment using Sorbifer Durules led to a significant rise of the packed cell volume and haemoglobin in blood, iron and vitamin C in serum. This treatment did not affect the oxalic acid plasma level. Oral treatment with Sorbifer Durules, one tablet/24 hours, was adequate for maintaining the serum iron concentration in haemodialyzed patients during treatment with recombinant human erythropoietin. This treatment prevented at the same time the development of vitamin C deficiency in serum and a further rise of plasma oxalic acid in these patients.

Prostaglandins during haemodialysis treatment.

The prostaglandins 6-keto Pgf1 alpha,PG F2 alpha and thromboxane B2 before and during haemodialysis were studied by means of radioisotope method. A significant increase of 6-keto PGF1 alpha and decrease of PGF2 alpha was found. The concentration of thromboxane B2 was markedly, but not significantly decreased. This constellation inhibiting the thrombocytes aggregation and promoting vasodilation seems to be favourable as far as biocompatibility is concerned. Dialysis treatment caused no significant changes in prostaglandins concentration.