1
|
Sarandol E, Erdinc S, Senol E, Ersoy A, Surmen-Gur E. Effects of vitamin C supplementation on oxidative stress and serum paraoxonase/arylesterase activities in patients on long-term hemodialysis. Nefrologia 2023; 43:351-359. [PMID: 36494280 DOI: 10.1016/j.nefroe.2022.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 11/10/2021] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Oxidative stress increases oxidizability of apolipoprotein-B containing lipoproteins and decreases paraoxonase (PON) activity in hemodialysis (HD) patients and plays an important part in the development of atherosclerotic cardiovascular diseases. In HD patients, plasma ascorbic acid (AA) levels are decreased either due to the loss by hemodialysis membranes or due to malnutrition and contribute to the imbalance of antioxidant defense mechanisms. We hypothesized that long-term ascorbic acid (AA) supplementation recovers oxidizability of lipoproteins in HD patients by reinforcing PON activity. METHODS Twenty-nine adult patients were treated with 100mg and 500mg AA at the end of each HD session thrice a week for two consecutive 16 weeks-periods, respectively. Blood samples were obtained before the first HD session and prior to the first HD sessions following the 100mg AA-supplemented and the 500mg AA-supplemented periods. RESULTS PON activities were significantly increased after 100mg (p<0.05) and 500mg AA (p<0.001) supplementation periods compared to the basal level. Apo-B lipoprotein oxidizability (Δ-MDA) was significantly decreased after 500mg AA supplementation compared to both basal (p<0.05) and 100mg AA supplementation periods (p<0.05). Plasma AA concentrations were negatively correlated with Δ-MDA levels (R=-0.327; p<0.01). CONCLUSION Our results suggest that long-term parenteral 500mg AA supplementation improves PON activity alleviating apo B-containing lipoproteins oxidizability in HD patients.
Collapse
Affiliation(s)
- Emre Sarandol
- Bursa Uludag University, Medical Faculty, Department of Medical Biochemistry, 16059 Bursa, Turkey
| | - Selda Erdinc
- Bursa Uludag University, Medical Faculty, Department of Medical Biochemistry, 16059 Bursa, Turkey
| | - Emel Senol
- Bursa Uludag University, Medical Faculty, Department of Nefrology, 16059 Bursa, Turkey
| | - Alparslan Ersoy
- Bursa Uludag University, Medical Faculty, Department of Nefrology, 16059 Bursa, Turkey
| | - Esma Surmen-Gur
- Bursa Uludag University, Medical Faculty, Department of Medical Biochemistry, 16059 Bursa, Turkey.
| |
Collapse
|
2
|
MERT H, DURGAÇ M, ÖZCAN N, MİS L, MERT N. Hemodializ Hastalarında Sistatin C Düzeyleri, Oksidan-Antioksidan ve İnflamasyon Durumu. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.30934/kusbed.1056643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: Cystatin C is considered an important marker for the detection of renal dysfunction. It was aimed to determine cystatin C levels, status of oxidant-antioxidant and inflammation in hemodialysis (HD) patients.
Methods: The study groups consisted of 20 HD patients and 20 healthy controls. Blood samples were obtained from the control group and from the HD group before hemodialysis. Serum cystatin C, total antioxidant capacity (TAC), total oxidative state (TOS), tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6) interleukin 18 (IL-18) levels were detected by Enzyme Linked Immunosorbent Assay (ELISA), C-reactive protein (CRP) and some biochemical parameters were analyzed by autoanalyser.
Results: Cystatin C, TOS, TNF-α, IL-6, IL-18 and CRP levels of the HD group were significantly higher than the control group.
Conclusion: As a result; oxidative stress and inflammation were increased in patients with chronic renal failure undergoing hemodialysis. New strategies and new studies are needed to reduce the increase in oxidative stress and inflammation in HD patients.
Collapse
|
3
|
Sarandol E, Erdinc S, Senol E, Ersoy A, Surmen-Gur E. Effects of vitamin C supplementation on oxidative stress and serum paraoxonase/arylesterase activities in patients on long-term hemodialysis. Nefrologia 2022. [DOI: 10.1016/j.nefro.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
4
|
Demirci-Çekiç S, Özkan G, Avan AN, Uzunboy S, Çapanoğlu E, Apak R. Biomarkers of Oxidative Stress and Antioxidant Defense. J Pharm Biomed Anal 2021; 209:114477. [PMID: 34920302 DOI: 10.1016/j.jpba.2021.114477] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/27/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022]
Abstract
A number of reactive oxygen and nitrogen species are produced during normal metabolism in human body. These species can be both radical and non-radical and have varying degrees of reactivity. Although they have some important functions in the human body, such as contributing to signal transmission and the immune system, their presence must be balanced by the antioxidant defense system. The human body has an excellent intrinsic enzymatic antioxidant system in addition to different non-enzymatic antioxidants having small molecular masses. An extrinsic source of antioxidants are foodstuffs such as fruits, vegetables, herbs and spices, mostly rich in polyphenols. When the delicate biochemical balance between oxidants and antioxidants is disturbed in favor of oxidants, "oxidative stress" conditions emerge, under which reactive species can cause oxidative damage to biomacromolecules such as proteins, carbohydrates, lipids and DNA. This oxidative damage is often associated with cancer, aging, and neurodegenerative disorders. Because reactive species are extremely short-lived, it is almost impossible to measure their concentrations directly. Although there are certain methods such as ESR / EPR that serve this purpose, they have some disadvantages and are quite costly systems. Therefore, products generated from oxidative damage of proteins, lipids and DNA are often used to quantify the extent of oxidative damage rather than direct measurement of reactive species. These oxidative damage products are usually known as biomarkers. Determination of the concentrations of these biomarkers and changes in the concentration of protective antioxidants can provide useful information for avoiding certain diseases and keep healthy conditions.
Collapse
Affiliation(s)
- Sema Demirci-Çekiç
- Department of Chemistry, Faculty of Engineering, Istanbul University-Cerrahpasa, Avcilar, 34320 Istanbul, Turkey
| | - Gülay Özkan
- Department of Food Engineering, Faculty of Chemical and Metallurgical Engineering, Istanbul Technical Uviversity, Istanbul, Turkey
| | - Aslı Neslihan Avan
- Department of Chemistry, Faculty of Engineering, Istanbul University-Cerrahpasa, Avcilar, 34320 Istanbul, Turkey
| | - Seda Uzunboy
- Department of Chemistry, Faculty of Engineering, Istanbul University-Cerrahpasa, Avcilar, 34320 Istanbul, Turkey
| | - Esra Çapanoğlu
- Department of Food Engineering, Faculty of Chemical and Metallurgical Engineering, Istanbul Technical Uviversity, Istanbul, Turkey.
| | - Reşat Apak
- Department of Chemistry, Faculty of Engineering, Istanbul University-Cerrahpasa, Avcilar, 34320 Istanbul, Turkey; Turkish Academy of Sciences (TUBA), Vedat Dalokay St. No. 112, Cankaya, 06670 Ankara, Turkey.
| |
Collapse
|
5
|
Vitamin C overload may contribute to systemic oxalosis in children receiving dialysis. Pediatr Nephrol 2021; 36:435-441. [PMID: 32772326 DOI: 10.1007/s00467-020-04702-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 06/11/2020] [Accepted: 06/30/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Malnutrition and anorexia are common in children with chronic kidney disease (CKD) and gastrostomy tubes (GT) as well as nasogastric tubes (NGT) have been recommended to maximize nutritional support. The optimal requirement of vitamin C in children with CKD remains to be defined but oxalate is a breakdown product of vitamin C. Elevated vitamin C intake and bone oxalate were identified in two formula-fed dialyzed children with negative genetic testing for primary hyperoxaluria. METHODS We evaluated the impact of nutritional support on serum ascorbic acid and plasma oxalate levels in 13 dialyzed infants and young children. RESULTS All patients were fed by GT or NGT since the first months of life; overall patients were receiving between 145 and 847% of the age-specific DRI for vitamin C. Mean serum ascorbic acid and plasma oxalate levels were elevated (244.7 ± 139.7 μM/L and 44.3 ± 23.1 μM/L, respectively), and values did not differ according to the degree of residual kidney function. Ascorbic acid levels did not correlate with oxalate levels (r = 0.44, p = 0.13). CONCLUSIONS Excessive vitamin C intake may contribute to oxalate accumulation in dialyzed children.
Collapse
|
6
|
Meléndez-Flores JD, Estrada-Bellmann I. Linking chronic kidney disease and Parkinson's disease: a literature review. Metab Brain Dis 2021; 36:1-12. [PMID: 32990929 DOI: 10.1007/s11011-020-00623-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
Chronic kidney disease (CKD) has been typically implicated in cardiovascular risk, considering the function the kidney has related to blood pressure, vitamin D, red blood cell metabolism, and electrolyte and acid-base regulation. However, neurological consequences are also attributed to this disease. Among these, recent large epidemiological studies have demonstrated an increased risk for Parkinson's disease (PD) in patients with CKD. Multiple studies have evaluated individually the association of blood pressure, vitamin D, and red blood cell dysmetabolism with PD, however, no study has reviewed the potential mechanisms related to these components in context of CKD and PD. In this review, we explored the association of CKD and PD and linked the components of the former to propose potential pathways explaining a future increased risk for PD, where renin-angiotensin system, oxidative stress, and inflammation have a main role. Potential preventive and therapeutic interventions based on these associations are also explored. More preclinical studies are needed to confirm the potential link of CKD conditions and future PD risk, whereas more interventional studies targeting this association are warranted to confirm their potential benefit in PD.
Collapse
Affiliation(s)
- Jesús D Meléndez-Flores
- Neurology Division, Internal Medicine Department, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Madero y Gonzalitos S/N, 64700, Monterrey, NL, Mexico
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Ingrid Estrada-Bellmann
- Neurology Division, Internal Medicine Department, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Madero y Gonzalitos S/N, 64700, Monterrey, NL, Mexico.
- Movement Disorders Clinic, Neurology Division, Internal Medicine Department, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.
| |
Collapse
|
7
|
Qiu F, Chen L, Wang H, Huang M, Sun X, Kan J, Du J, Li Y. Protective effect of supplementation with Ginseng,
Lilii Bulbus
and Poria against
PM
2
.5
in air pollution‐induced cardiopulmonary damage among adults. Phytother Res 2020; 35:877-887. [DOI: 10.1002/ptr.6835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/06/2020] [Accepted: 07/18/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Feng Qiu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan People's Republic of China
| | - Liang Chen
- Nutrilite Health Institute, Amway (Lin et al.) R&D Center Shanghai China
| | - Hanjin Wang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan People's Republic of China
| | - Min Huang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan People's Republic of China
| | - Xiaojie Sun
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan People's Republic of China
| | - Juntao Kan
- Nutrilite Health Institute, Amway (Lin et al.) R&D Center Shanghai China
| | - Jun Du
- Nutrilite Health Institute, Amway (Lin et al.) R&D Center Shanghai China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan People's Republic of China
| |
Collapse
|
8
|
Plasma Vitamin C Concentrations Were Negatively Associated with Tingling, Prickling or Pins and Needles Sensation in Patients with Postherpetic Neuralgia. Nutrients 2020; 12:nu12082384. [PMID: 32784896 PMCID: PMC7468915 DOI: 10.3390/nu12082384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/13/2022] Open
Abstract
Vitamin C deficiency increases the risk of postherpetic neuralgia (PHN). In this cross-sectional study, the relationships among plasma vitamin C concentrations, pain and Leeds assessment of neuropathic symptoms and signs (LANSS) items were investigated during their first pain clinic visit of 120 PHN patients. The factors associated with vitamin C deficiency were determined. Independent predictors of vitamin C deficiency were presented as adjusted odds ratios (AOR) and 95% confidence intervals (CI). The patients had a high prevalence (52.5%) of vitamin C deficiency. Their plasma vitamin C concentrations were negatively associated with spontaneous pain and tingling, prickling or pins and needles sensation according to the LANSS questionnaire. Based on the receiver operator characteristic curve, the cutoffs for plasma vitamin C to predict moderate-to-severe and severe symptoms of sharp sensation were <7.05 and <5.68 mg/L, respectively. By comparison, the patients well-nourished with vitamin C had lower incidences of sharp sensations, sharp pain, and reddish skin. Multivariate analyses revealed that vitamin C deficiency was associated with the low intake of fruit/vegetables (AOR 2.66, 95% CI 1.09–6.48, p = 0.032), peptic ulcer disease (AOR 3.25, 95% CI 1.28–8.28, p = 0.014), and smoking (AOR 3.60, 95% CI 1.33–9.77, p = 0.010). Future studies are needed to substantiate these findings.
Collapse
|
9
|
Gum Arabic ( Acacia Senegal) Augmented Total Antioxidant Capacity and Reduced C-Reactive Protein among Haemodialysis Patients in Phase II Trial. Int J Nephrol 2020; 2020:7214673. [PMID: 32328307 PMCID: PMC7171621 DOI: 10.1155/2020/7214673] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/27/2020] [Accepted: 02/27/2020] [Indexed: 01/09/2023] Open
Abstract
Background Oxidative processes might increase in patients with end-stage renal disease (ESRD) according to the current literature. Oxidative stress (OS) is a risk factor of atherosclerosis and cardiovascular complications, which are major causes of mortality among ESRD patients. Haemodialysis (HD) is life-saving procedure, nevertheless it is an active chronic inflammatory status that could augment cardiovascular disease and increase mortality. Gum Arabic (GA) has been claimed to act as an antioxidant and anti-inflammatory agent in experimental studies and clinical trials. Therefore, we assumed GA supplementation among haemodialysis patients would reduce oxidative stress and consequently reduce the state of chronic inflammatory activation associated with haemodialysis. Methods Forty end-stage renal failure (ESRF) patients aged 18–80 years who were on regular haemodialysis in Arif Renal Center, Omdurman, Sudan, were recruited. All recruited patients met the inclusion criteria and signed informed consent prior to enrolment. The patients received 30 g/day of GA for 12 weeks. C-reactive protein (CRP) and complete blood count (CBC) were measured as baseline and monthly. Total antioxidant capacity (TAC) and oxidative stress marker malondialdehyde (MDA) levels were measured before and after GA intake. Ethical approval from the National Medicines and Poisons Board was obtained. Results Gum Arabic significantly augmented total antioxidant capacity level (P < 0.001) (95% CI, 0.408–0.625) and also attenuated oxidative marker MDA and C-reactive protein (P < 0.001). Conclusions GA has revealed potent antioxidative and anti-inflammatory properties in haemodialysis patients. Oral digestion of GA (30 g/day) decreased oxidative stress and inflammatory markers among haemodialysis patients. Trial registration. ClinicalTrials.gov Identifier: NCT03214692, registered 11 July 2017 (prospective registration).
Collapse
|
10
|
Spaia S, Magoula I, Tsapas G, Vayonas G. Effect of Pyrazinamide and Probenecid on Peritoneal Urate Transport Kinetics during Continuous Ambulatory Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080002000109] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective We administered pyrazinamide (PZA) and probenecid (PB) — two well-known modulators of urate transport via the proximal tubules — to evaluate their impact on urate transport through the peritoneal membrane and to clarify mechanisms affecting peritoneal transport. Setting A continuous ambulatory peritoneal dialysis (CAPD) unit in 2nd Hospital of IKA (Social Services Institute), Greece. Patients In 20 stable CAPD patients, on the study day, a 4-hour, 2-L, 1.36% glucose exchange was performed (control exchange). Pyrazinamide 3 g was given orally and another identical exchange was performed (study exchange). The same protocol was repeated with 2 g PB. Kt/V, peritoneal clearances of urea, creatinine, and urate for each exchange, and mass transfer area coefficients (MTAC) for the three solutes and their dialysate-to-plasma concentration (D/P) ratios were used to estimate peritoneal transport. Results Administration of PZA resulted in decreased clearances and MTAC values for the three solutes. The D/P ratio decreased significantly only for urate, indicating a more intense influence of PZA on urate. After PB administration, clearances of urea, creatinine, and urate were increased. MTAC and D/P ratio increased significantly only for urate ( p < 0.05), demonstrating an action similar to that exerted on renal tubules. Conclusions These findings provide evidence that unrestricted diffusion is not the only transport mechanism in the case of urate, and demonstrate the existence of an active mechanism in peritoneal urate transport with a reabsorptive and, probably, a secretive component that resembles that of renal tubule urate transport. Attention should be given in the case of CAPD patients undergoing antituberculous (PZA) treatment: it might have a negative impact on urea, creatinine, and urate peritoneal transport rates.
Collapse
Affiliation(s)
| | - Ifigenia Magoula
- 2nd Medical Clinic, Aristotelian University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - George Tsapas
- 2nd Medical Clinic, Aristotelian University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | | |
Collapse
|
11
|
Gaggini M, Sabatino L, Vassalle C. Conventional and innovative methods to assess oxidative stress biomarkers in the clinical cardiovascular setting. Biotechniques 2020; 68:223-231. [PMID: 32066251 DOI: 10.2144/btn-2019-0138] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Oxidative stress has a pivotal and widely described role in the onset and progression of atherosclerotic plaque and cardiovascular disease. Many oxidative stress-related biomarkers can be measured in biological samples; however, there are still many aspects that limit the adoption of oxidative stress assessment in clinical laboratory practice. Here, we report an overview of the different sources and main common oxidative stress biomarkers relevant for cardiovascular physiopathology, describing in detail a recently proposed lipidomic assay for ceramide assessment, as a promising future development in oxidative stress evaluation among the many available redox-related tests.
Collapse
|
12
|
Ige AO, Ongele FA, Adele BO, Emediong IE, Odetola AO, Adewoye EO. Pathophysiology of iron overload-induced renal injury and dysfunction: Roles of renal oxidative stress and systemic inflammatory mediators. ACTA ACUST UNITED AC 2019; 26:175-180. [PMID: 30910397 DOI: 10.1016/j.pathophys.2019.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 11/16/2022]
Abstract
Iron-overload has been recognized as a risk factor for organ dysfunction and damage resulting in diseases such as liver and heart disease, diabetes mellitus, and neurodegenerative diseases. This study investigated renal function and some systemic inflammatory indices in iron-overloaded male Wistar rats. Thirty animals were equally distributed into 3groups and treated daily i.p. with either normal saline (0.2 ml; control), iron (as ferrous sulphate) (15 mg/kg) or iron (30 mg/kg) for 21days respectively. Post-treatment, blood samples were obtained from each animal by cardiac puncture after light anaesthesia into plain sample bottles. Iron, ferritin, transferrin, creatinine, urea, albumin, total protein, interleukin-6 (IL-6), prostaglandins-E2 and tumor necrosis factor-α (TNF-α) were analysed in serum. Kidney homogenates were obtained per group and analysed for superoxide dismutase (SOD), total antioxidant capacity (TAC), reduced glutathione (GSH), lipid peroxidation (MDA) and nitric oxide (NO). Kidney histology was evaluated per group using both Haematoxylin and Eosin and periodic acid Schiff stains. Iron-overload caused a graded increase (p < 0.05) in serum iron, ferritin, transferrin, creatinine, urea, IL-6, TNF-α, TAC, MDA and NO levels as well as a reduction in albumin levels, renal SOD and GSH in groups 2 (iron 15 mg/kg) and 3 (iron 30 mg/kg) respectively compared to control. Histological evaluation of the kidney showed structural and tubular aberrations consistent with renal damage via inflammatory processes in iron overloaded rats. Our present study suggests that iron-overloading causes renal dysfunction by triggering the evolution of several inflammatory mediators which lead to a cascade of systemic and renal inflammatory processes that alter renal structure and function.
Collapse
Affiliation(s)
- A O Ige
- Applied and Environmental Physiology Unit, Department of Physiology, University of Ibadan, Nigeria.
| | - F A Ongele
- Applied and Environmental Physiology Unit, Department of Physiology, University of Ibadan, Nigeria
| | - B O Adele
- Applied and Environmental Physiology Unit, Department of Physiology, University of Ibadan, Nigeria
| | - I E Emediong
- Applied and Environmental Physiology Unit, Department of Physiology, University of Ibadan, Nigeria
| | - A O Odetola
- Applied and Environmental Physiology Unit, Department of Physiology, University of Ibadan, Nigeria
| | - E O Adewoye
- Applied and Environmental Physiology Unit, Department of Physiology, University of Ibadan, Nigeria
| |
Collapse
|
13
|
Yang N, Jia X, Wang D, Wei C, He Y, Chen L, Zhao Y. Silibinin as a natural antioxidant for modifying polysulfone membranes to suppress hemodialysis-induced oxidative stress. J Memb Sci 2019. [DOI: 10.1016/j.memsci.2018.12.056] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
14
|
Panchal S, Schneider C, Malhotra K. Scurvy in a hemodialysis patient. Rare or ignored? Hemodial Int 2018; 22:S83-S87. [PMID: 30411462 DOI: 10.1111/hdi.12705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chronic kidney disease and dialysis brings with it a plethora of complications, including malnutrition. Strict dietary restrictions in hemodialysis (HD) patients further complicate the picture as it increases the risk of deficiency of micronutrients, specifically water-soluble vitamins. Today, there is a lack of concrete guidelines concerning recommendations on vitamin supplementation in HD patients. This lack of data is partly due to our incomplete understanding of handling of vitamins in a uremic state. There is a dire need for more data on the impact of dialysis and uremic state on water-soluble vitamins to facilitate appropriate preventative supplementation. We present a case of scurvy in a HD patient that will contribute toward the understanding of vitamin status in HD. We hope it will aid in screening HD patients for vitamin C deficiency and individualizing supplementation of vitamin C.
Collapse
Affiliation(s)
- Sarju Panchal
- University of Missouri-School of Medicine, Class of 2019, One Hospital Drive, Columbia, Missouri 65212, USA
| | - Christine Schneider
- Division of Nephrology, Department of Medicine, University of Missouri, CE425, 1 Hospital Drive, Columbia, Missouri 65212, USA
| | - Kunal Malhotra
- Division of Nephrology, Department of Medicine, University of Missouri, CE425, 1 Hospital Drive, Columbia, Missouri 65212, USA
| |
Collapse
|
15
|
Harshman LA, Lee-Son K, Jetton JG. Vitamin and trace element deficiencies in the pediatric dialysis patient. Pediatr Nephrol 2018; 33:1133-1143. [PMID: 28752387 PMCID: PMC5787050 DOI: 10.1007/s00467-017-3751-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 02/06/2023]
Abstract
Pediatric dialysis patients are at risk of nutritional illness secondary to deficiencies in water-soluble vitamins and trace elements. Unlike 25-OH vitamin D, most other vitamins and trace elements are not routinely monitored in the blood and, consequently, the detection of any deficiency may not occur until significant complications develop. Causes of vitamin and trace element deficiency in patients on maintenance dialysis patient are multifactorial, ranging from diminished nutritional intake to altered metabolism as well as dialysate-driven losses of water-soluble vitamins and select trace elements. In this review we summarize the nutritional sources of key water-soluble vitamins and trace elements with a focus on the biological roles and clinical manifestations of their respective deficiency to augment awareness of potential nutritional illness in pediatric patients receiving maintenance dialysis. The limited pediatric data on the topic of clearance of water-soluble vitamins and trace elements by individual dialysis modality are reviewed, including a brief discussion on clearance of water-soluble vitamins and trace elements with continuous renal replacement therapy.
Collapse
Affiliation(s)
- Lyndsay A Harshman
- Stead Family Department of Pediatrics, Division of Nephrology, Dialysis & Transplantation, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA.
- Stead Family Department of Pediatrics, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 4037 Boyd Tower, Iowa City, IA, 52242-1053, USA.
| | - Kathy Lee-Son
- Stead Family Department of Pediatrics, Division of Nephrology, Dialysis & Transplantation, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Jennifer G Jetton
- Stead Family Department of Pediatrics, Division of Nephrology, Dialysis & Transplantation, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| |
Collapse
|
16
|
|
17
|
Eiselt J, Racek J, Opatrnyjr K. The Effect of Hemodialysis and Acetate-Free Biofiltration on Anemia. Int J Artif Organs 2018. [DOI: 10.1177/039139880002300306] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors monitored, for a period of 12 months, anemia-, nutrition-, and free radical-related parameters and the rHuEPO dose required to maintain target hemoglobin (Hb) in 20 patients with chronic renal failure. Ten patients each were randomized for treatment by either acetate-free biofiltration (AFB) or low-flux hemodialysis (HD). At baseline, Hb levels were 102±2 (AFB) vs. 98±2 g/L (HD) (not significant difference, NS), the rHuEPO dose was 4050±976 vs. 5100±1538 IU/week (NS). Compared with baseline and with HD, lower rHuEPO doses were required during AFB at months 8, 9, 10 and 11, and 12 when they were 2100±510 (AFB) vs. 6000±1153 (HD), p=0.008. Prealbumin, transferrin and cholinesterase levels rose in the AFB group. Kt/V, albumin, transferrin saturation, aluminium, bicarbonate in serum, superoxide dismutase and glutathione peroxidase in erythrocytes, and malondialdehyde and antioxidant capacity in plasma did not differ between the AFB and HD groups. In terms of anemia control, AFB using an AN69 membrane was found to be more advantageous than low-flux HD, AFB improves some nutritional parameters. The compared methods do not differ in their effect on lipid peroxidation and the antioxidant system. (Int J Artif Organs 2000; 23: 173–80)
Collapse
Affiliation(s)
| | - J. Racek
- Institute of Clinical Biochemistry and Laboratory Diagnosis, Charles University and University Hospital, Plzeň - Czech Republic
| | | |
Collapse
|
18
|
Eiselt J, Racek J, Opatrný K. Oxidative Stress: The Effect of Erythropoietin and the Dialysis Membrane. Int J Artif Organs 2018. [DOI: 10.1177/039139880002300106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - J. Racek
- Institute of Clinical Biochemistry and Laboratory-based Diagnosis, Charles University and University Hospital, Plzeň-Czech Republic
| | | |
Collapse
|
19
|
Oxidative Stress in Kidney Diseases: The Cause or the Consequence? Arch Immunol Ther Exp (Warsz) 2017; 66:211-220. [PMID: 29214330 PMCID: PMC5956016 DOI: 10.1007/s00005-017-0496-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/11/2017] [Indexed: 12/20/2022]
Abstract
Exaggerated oxidative stress (OS) is usually considered as a disturbance in regular function of an organism. The excessive levels of OS mediators may lead to major damage within the organism’s cells and tissues. Therefore, the OS-associated biomarkers may be considered as new diagnostic tools of various diseases. In nephrology, researchers are looking for alternative methods replacing the renal biopsy in patients with suspicion of chronic kidney disease (CKD). Currently, CKD is a frequent health problem in world population, which can lead to progressive loss of kidney function and eventually to end-stage renal disease. The course of CKD depends on the primary disease. It is assumed that one of the factors influencing the course of CKD might be OS. In the current work, we review whether monitoring the OS-associated biomarkers in nephrology patients can support the decision-making process regarding diagnosis, prognostication and treatment initiation.
Collapse
|
20
|
Affiliation(s)
- I F Benzie
- a Department of Health Sciences , The Hong Kong Polytechnic University , Kowloon , Hong Kong
| | - J J Strain
- b Human Nutrition Research Group , University of Ulster at Coleraine , Northern Ireland
| |
Collapse
|
21
|
Georgatzakou HT, Antonelou MH, Papassideri IS, Kriebardis AG. Red blood cell abnormalities and the pathogenesis of anemia in end-stage renal disease. Proteomics Clin Appl 2016; 10:778-90. [PMID: 26948278 DOI: 10.1002/prca.201500127] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/14/2016] [Accepted: 02/29/2016] [Indexed: 12/20/2022]
Abstract
Anemia is the most common hematologic complication in end-stage renal disease (ESRD). It is ascribed to decreased erythropoietin production, shortened red blood cell (RBC) lifespan, and inflammation. Uremic toxins severely affect RBC lifespan; however, the implicated molecular pathways are poorly understood. Moreover, current management of anemia in ESRD is controversial due to the "anemia paradox" phenomenon, which underlines the need for a more individualized approach to therapy. RBCs imprint the adverse effects of uremic, inflammatory, and oxidative stresses in a context of structural and functional deterioration that is associated with RBC removal signaling and morbidity risk. RBCs circulate in hostile plasma by raising elegant homeostatic defenses. Variability in primary defect, co-morbidity, and therapeutic approaches add complexity to the pathophysiological background of the anemic ESRD patient. Several blood components have been suggested as biomarkers of anemia-related morbidity and mortality risk in ESRD. However, a holistic view of blood cell and plasma modifications through integrated omics approaches and high-throughput studies might assist the development of new diagnostic tests and therapies that will target the underlying pathophysiologic processes of ESRD anemia.
Collapse
Affiliation(s)
- Hara T Georgatzakou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Marianna H Antonelou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Issidora S Papassideri
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Anastasios G Kriebardis
- Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological and Educational Institute of Athens, Greece
| |
Collapse
|
22
|
Apak R, Özyürek M, Güçlü K, Çapanoğlu E. Antioxidant Activity/Capacity Measurement. 3. Reactive Oxygen and Nitrogen Species (ROS/RNS) Scavenging Assays, Oxidative Stress Biomarkers, and Chromatographic/Chemometric Assays. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2016; 64:1046-1070. [PMID: 26689748 DOI: 10.1021/acs.jafc.5b04744] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
There are many studies in which the antioxidant potential of different foods have been analyzed. However, there are still conflicting results and lack of information as a result of unstandardized assay techniques and differences between the principles of the methods applied. The measurement of antioxidant activity, especially in the case of mixtures, multifunctional or complex multiphase systems, cannot be evaluated satisfactorily using a simple antioxidant test due to the many variables influencing the results. In the literature, there are many antioxidant assays that are used to measure the total antioxidant activity/capacity of food materials. In this review, reactive oxygen and nitrogen species (ROS/RNS) scavenging assays are evaluated with respect to their mechanism, advantages, disadvantages, and potential use in food systems. On the other hand, in vivo antioxidant activity (AOA) assays including oxidative stress biomarkers and cellular-based assays are covered within the scope of this review. Finally, chromatographic and chemometric assays are reviewed, focusing on their benefits especially with respect to their time saving, cost-effective, and sensitive nature.
Collapse
Affiliation(s)
- Reşat Apak
- Department of Chemistry, Faculty of Engineering, Istanbul University , Avcilar, 34320 Istanbul, Turkey
| | - Mustafa Özyürek
- Department of Chemistry, Faculty of Engineering, Istanbul University , Avcilar, 34320 Istanbul, Turkey
| | - Kubilay Güçlü
- Department of Chemistry, Faculty of Engineering, Istanbul University , Avcilar, 34320 Istanbul, Turkey
| | - Esra Çapanoğlu
- Department of Food Engineering, Faculty of Chemical and Metallurgical Engineering, Istanbul Technical University , Maslak, 34469 Istanbul, Turkey
| |
Collapse
|
23
|
Application of FTIR-ATR Spectroscopy to Determine the Extent of Lipid Peroxidation in Plasma during Haemodialysis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:245607. [PMID: 25961007 PMCID: PMC4417580 DOI: 10.1155/2015/245607] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/29/2015] [Indexed: 11/21/2022]
Abstract
During a haemodialysis (HD), because of the contact of blood with the surface of the dialyser, the immune system becomes activated and reactive oxygen species (ROS) are released into plasma. Particularly exposed to the ROS are lipids and proteins contained in plasma, which undergo peroxidation. The main breakdown product of oxidized lipids is the malondialdehyde (MDA). A common method for measuring the concentration of MDA is a thiobarbituric acid reactive substances (TBARS) method. Despite the formation of MDA in plasma during HD, its concentration decreases because it is removed from the blood in the dialyser. Therefore, this research proposes the Fourier Transform Infrared Attenuated Total Reflectance (FTIR-ATR) spectroscopy, which enables determination of primary peroxidation products. We examined the influence of the amount of hydrogen peroxide added to lipid suspension that was earlier extracted from plasma specimen on lipid peroxidation with use of TBARS and FTIR-ATR methods. Linear correlation between these methods was shown. The proposed method was effective during the evaluation of changes in the extent of lipid peroxidation in plasma during a haemodialysis in sheep. A measurement using the FTIR-ATR showed an increase in plasma lipid peroxidation after 15 and 240 minutes of treatment, while the TBARS concentration was respectively lower.
Collapse
|
24
|
Evaluation of assays for measurement of serum (anti)oxidants in hemodialysis patients. BIOMED RESEARCH INTERNATIONAL 2014; 2014:843157. [PMID: 24982909 PMCID: PMC4055181 DOI: 10.1155/2014/843157] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 04/24/2014] [Accepted: 05/05/2014] [Indexed: 01/17/2023]
Abstract
Background. Various biomarkers and assays have been used for assessment of (anti)oxidant status in hemodialysis patients, including those intended for measurement of serum total (anti)oxidants, most often as a part of panel biomarkers. Methods. Serum (anti)oxidant status was measured in 32 chronically hemodialyzed patients and in 47 healthy persons, using two oxidations and three antioxidant assays. Results. The patients before the hemodialysis session have had higher values of total oxidants in comparison to the healthy persons, with a further increase during the hemodialysis. These findings were confirmed with both oxidation assays, but they differ in the percentage of increase and the statistical significance. All three antioxidant assays showed significantly higher values of the total serum antioxidants in the patients before the hemodialysis session in comparison to the healthy persons, and their significant decrease during the hemodialysis. However, the assays differ in the percentage of decrease, its statistical significance, and the correlations with uric acid. Conclusion. The variability of results of total (anti)oxidants which are obtained using different assays should be taken into account when interpreting data from clinical studies of oxidative stress, especially in complex pathologies such as chronic hemodialysis.
Collapse
|
25
|
Blood modifications associated with end stage renal disease duration, progression and cardiovascular mortality: a 3-year follow-up pilot study. J Proteomics 2014; 101:88-101. [DOI: 10.1016/j.jprot.2014.02.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 01/24/2014] [Accepted: 02/04/2014] [Indexed: 12/12/2022]
|
26
|
Mahlicli FY, Altinkaya SA. Immobilization of alpha lipoic acid onto polysulfone membranes to suppress hemodialysis induced oxidative stress. J Memb Sci 2014. [DOI: 10.1016/j.memsci.2013.07.061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
27
|
Zhang K, Li Y, Cheng X, Liu L, Bai W, Guo W, Wu L, Zuo L. Cross-over study of influence of oral vitamin C supplementation on inflammatory status in maintenance hemodialysis patients. BMC Nephrol 2013; 14:252. [PMID: 24228847 PMCID: PMC3840610 DOI: 10.1186/1471-2369-14-252] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 11/05/2013] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Both vitamin C deficiency and inflammation are prevalent in maintenance hemodialysis (MHD) patients. In this study, we aimed to elucidate the effect of oral vitamin C supplementation on inflammatory status in MHD patients with low vitamin C level and high hypersensitive C-reactive protein (hs-CRP) level. METHODS A total of 128 patients were recruited in our present study. Patients were divided into two groups. In group 1 (n = 67), patients were orally administered with 200 mg/day vitamin C in the first 3 months, and then the vitamin C supplementation was withdrawn in the next 3 months. In group 2 (n = 61), patients were not given vitamin C in the first 3 months, and then they were orally administered with 200 mg/day in the next 3 months. Levels of hs-CRP, prealbumin, albumin and hemoglobin as well as the EPO resistance index (ERI) were determined at the baseline and every 3 months throughout the study. Plasma vitamin C level was determined by high-performance liquid chromatography with UV detection. RESULTS Among the 128 patients, 28 of them dropped out of the study before completion. Consequently, a total of 100 patients (group 1: n = 48; group 2: n = 52) were included in the final analysis. At the baseline, the plasma vitamin C level of all patients was less than 4 μg/mL. However, this proportion was decreased to 20% after the vitamin C supplementation for 3 months. Compared with patients without the vitamin C supplementation, a decreased level of hs-CRP and an increased level of prealbumin were induced by the vitamin C supplementation for 3 months in both groups. However, levels of these biomarkers returned to their original state after the supplementation was withdrawn. Same beneficial effects on plasma albumin, hemoglobin and ERI response to vitamin C supplementation were observed in the two groups without statistical significance. CONCLUSIONS The inflammatory status in MHD patients with plasma vitamin C deficiency and high levels of inflammatory markers could be partially improved by long-term oral administration of small doses of vitamin C. TRIAL REGISTRATION The clinical trial number: NCT01356433.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Li Zuo
- Department of Medicine, Renal Division, Peking University First Hospital, Beijing, P, R, China.
| |
Collapse
|
28
|
Clase CM, Ki V, Holden RM. Water-soluble vitamins in people with low glomerular filtration rate or on dialysis: a review. Semin Dial 2013; 26:546-67. [PMID: 23859229 PMCID: PMC4285924 DOI: 10.1111/sdi.12099] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
People with low glomerular filtration rate and people on dialysis are spontaneously at risk for vitamin deficiency because of the potential for problems with decreased appetite and decreased sense of smell and taste, leading to decreased intake, and because decreased energy or decreased cognitive ability results in difficulties in shopping and cooking. Imposed dietary restrictions because of their renal dysfunction and because of comorbidities such as hypertension and diabetes exacerbate this problem. Finally, particularly for water-soluble vitamins, loss may occur into the dialysate. We did not identify any randomized trials of administering daily doses close to the recommended daily allowances of these vitamins. In people who are eating at all, deficiencies of B5 and B7 seem unlikely. It is unclear whether supplements of B2 and B3 are necessary. Because of dialyzability and documented evidence of insufficiency in dialysis patients, B1 supplementation is likely to be helpful. B6, B9, and B12 are implicated in the hyperhomocysteinemia observed in patients on dialysis. These vitamins have been studied in combinations, in high doses, with the hope of reducing cardiovascular outcomes. No reductions in patient-important outcomes were seen in adequately powered randomized trials. Because of their involvement in the homocysteine pathway, however, supplementation with lower doses, close to the recommended daily allowances, may be helpful. Vitamin C deficiency is common in patients on dialysis who are not taking supplements: low-dose supplements are warranted. Vitamins for dialysis patients contain most or all of the B vitamins and low-dose vitamin C. We are not aware of any medical reasons to choose one over another.
Collapse
Affiliation(s)
- Catherine M Clase
- Department of Medicine, McMaster UniversityHamilton, ON, Canada
- Department of Clinical Epidemiology, McMaster UniversityHamilton, ON, Canada
| | - Vincent Ki
- Department of Medicine, McMaster UniversityHamilton, ON, Canada
| | - Rachel M Holden
- Department of Medicine, Queen's UniversityKingston, ON, Canada
| |
Collapse
|
29
|
Mellwig KP, Pulawski E, Horstkotte D, van Buuren F. Lipid apheresis: oxidative stress, rheology, and vasodilatation. Clin Res Cardiol Suppl 2013; 7:45-9. [PMID: 22528131 PMCID: PMC3374116 DOI: 10.1007/s11789-012-0043-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In the treatment of homozygous and therapy-resistant hypercholesterolemia, lipid apheresis enables not only low density lipoprotein (LDL) cholesterol to be lowered by approximately 60%, but also oxidative stress factors to be influenced and adhesion molecules reduced. This was investigated in a group of 12 patients using the heparin-induced extracorporeal LDL precipitation (H.E.L.P.) procedure.A significant lowering of LDL cholesterol and fibrinogen leads to an improvement in rheology and endothelial function, detectable and measurable within approximately 20 h by assessing minimum coronary resistance using positron emission tomography (PET) performed in 35 patients. This effect is detectable even after the first lipid apheresis session (H.E.L.P. procedure), documented in 12 patients.Lipid apheresis appears to be the most effective procedure in the treatment of elevated lipoprotein(a) [Lp(a)]. A chosen group of nine patients with selective elevated Lp(a) illustrated both the influence on endothelial dysfunction, in the shape of sharply increased minimum coronary resistance, and the reduction through lipid apheresis, indicating that Lp(a) seems to exert a similar effect on the vascular wall and vascular function as LDL cholesterol.
Collapse
Affiliation(s)
- K-P Mellwig
- Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany.
| | | | | | | |
Collapse
|
30
|
Early oxidative change in low density lipoproteins during progressive chronic renal failure. Indian J Clin Biochem 2012; 14:176-83. [PMID: 23105216 DOI: 10.1007/bf02867916] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Modified low density lipoproteins (LDL), including their oxidized forms, have been widely implicated in the etiology of atherosclerosis and concomitant cardiovascular disease (CVD) in chronic renal failure (CRF). The nature of events that lead to oxidative changes in LDL proteins are not clearly understood. Thus, patients suffering from CRF were grouped into mild, moderate and severe categories based on their blood urea and serum creatinine levels. Progression of CRF was accompanied not only with gradual increase in serum malondialdehyde (MDA) but also parallel increase in conjugated diene and MDA levels in LDL fractions separated from serum. Serum superoxide dismutase (SOD) activity was concurrently found to decrease, along with a decrease in high-density lipoprotein (HDL) cholesterol, during the progression of CRF. Gradual increase in the appearance of LDL oxidation products seems to accompany progressive manifestation of CRF. The results presented suggest that determination of serum MDA and SOD levels may enhance the diagnostic significance of the study of lipid profile in determining the risk for cardio vascular disease in CRF.
Collapse
|
31
|
Zhang K, Dong J, Cheng X, Bai W, Guo W, Wu L, Zuo L. Association between vitamin C deficiency and dialysis modalities. Nephrology (Carlton) 2012; 17:452-7. [PMID: 22404236 DOI: 10.1111/j.1440-1797.2012.01595.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIM We designed a cross-sectional study to investigate plasma vitamin C level in patients who underwent maintenance haemodialysis (MHD) and continuous ambulatory peritoneal dialysis (CAPD) to explore whether there is a difference in vitamin C deficiency between MHD patients and CAPD patients. METHODS This investigation included 382 dialysis patients without vitamin C supplement before the study. Demographic characteristics, laboratory tests, ascorbic acid and total plasma vitamin C level were measured. A linear regression model was built to explore the association between vitamin C deficiency and dialysis modalities after adjusting for age, dialysis vintage, gender, Charlson index, modality of dialysis and hsCRP. RESULTS The range of plasma vitamin C level was from 0.48 µg/mL to 31.16 µg/mL. 35.9% (n = 137) patients had severe vitamin C deficiency (<2 µg/mL). Plasma vitamin C level was inversely associated with age and dialysis vintage. After age and dialysis vintage were adjusted, vitamin C deficiency was associated with MHD. R square for model fitting was relatively low, which implied that there were other vitamin C influencing factors not included in the model. CONCLUSIONS Vitamin C deficiency is common in dialysis patients, especially in patients treated with MHD.
Collapse
Affiliation(s)
- Kunying Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
| | | | | | | | | | | | | |
Collapse
|
32
|
Raimann JG, Levin NW, Craig RG, Sirover W, Kotanko P, Handelman G. Is vitamin C intake too low in dialysis patients? Semin Dial 2012; 26:1-5. [PMID: 23106569 DOI: 10.1111/sdi.12030] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Vitamin C has several well-established roles in physiology including synthesis of collagen, carnitine and epinephrine, absorption of dietary iron, and mobilization of storage iron for erythropoeisis. Loss of several of these functions explains the pathology of scurvy, where defective collagen synthesis and anemia are major symptoms. Vitamin C deficiency is very common in dialysis patients and may arise from dialytic vitamin C clearance, restricted intake of vitamin C-rich foods, and increased vitamin C catabolism in vivo from inflammation. In the dialysis population, greater vitamin C intake may be needed for optimal health. Relationships between intake, body distribution, inflammation, and dialytic losses are complex and need further study. Concern about vitamin C metabolism leading to accumulation of tissue oxalate has led to the recommendation that vitamin C intake equals, but not exceeds, the intake recommended for the general population. Vitamin C deficiency in dialysis patients may have clinical consequences; a study in Renal Research Institute clinics found an association with periodontal disease. Data also support a role for vitamin C in prevention of dialysis-related anemia. New research questions are proposed in this editorial, with a discussion of strategies to determine the optimal provision of vitamin C for CKD patients.
Collapse
|
33
|
Patel M, Ramavataram DVSS. Non transferrin bound iron: nature, manifestations and analytical approaches for estimation. Indian J Clin Biochem 2012; 27:322-32. [PMID: 24082455 DOI: 10.1007/s12291-012-0250-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 08/12/2012] [Indexed: 12/20/2022]
Abstract
Iron is an essential trace element and plays a number of vital roles in biological system. It also leads the chains of pathological actions if present in excess and/or present in free form. Major portion of iron in circulation is associated with transferrin, a classical iron transporter, which prevent the existence of free iron. The fraction of iron which is free of transferrin is known as "non transferrin bound iron". Along with the incidence in iron over loaded patient non transferrin bound iron has been indicated in patients without iron overload. It has been suggested as cause as well as consequence in a number of pathological conditions. The major organs influenced by iron toxicity are heart, pancreas, kidney, organs involved in hematopoiesis etc. The most commonly suggested way for iron mediated pathogenesis is through increased oxidative stress and their secondary effects. Generation of free oxygen radicals by iron has been well documented in Fenton chemistry and Haber-Weiss reaction. Non transferrin bound iron has obvious chance to generate the free reactive radicals as it is not been shielded by the protective carrier protein apo transferrin. The nature of non transferrin bound iron is not clear at present time but it is definitely a group of heterogenous iron forms free from transferrin and ferritin. A variety of analytical approaches like colorimetry, chromatography, fluorimetry etc. have been experimented in different research laboratories for estimation of non transferrin bound iron. However the universally accepted gold standard method which can be operated in pathological laboratories is still to be developed.
Collapse
Affiliation(s)
- Meghna Patel
- Institute of Medical Technology, 173-B New Industrial Estate, Road No. 6G, Udyognagar, Udhana, Surat, Gujarat India
| | | |
Collapse
|
34
|
The influence of vitamin E supplementation on erythropoietin responsiveness in chronic hemodialysis patients with low levels of erythrocyte superoxide dismutase. Int Urol Nephrol 2012; 45:495-501. [DOI: 10.1007/s11255-012-0175-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 03/08/2012] [Indexed: 10/28/2022]
|
35
|
Oxidative Stress Markers in Hemodialysis and Peritoneal Dialysis Patients, Including Coenzyme Q10 and Ischemia-Modified Albumin. Int J Artif Organs 2012; 35:226-32. [DOI: 10.5301/ijao.5000078] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2011] [Indexed: 11/20/2022]
Abstract
Objectives Oxidative stress results from an imbalance between the production of free radicals and antioxidant activity. There is wide agreement that patients undergoing regular dialysis treatment experience increased oxidative stress. The aim of this study was to investigate serum total antioxidant status (TAS), total oxidant status (TOS), ischemia-modified albumin (IMA), and coenzyme Q10 (CoQ10) levels in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients, compared with controls. Methods This study was performed on 41 (21 men, 20 women) CAPD patients, 38 (20 men,18 women) HD patients, and 43 (23 men, 20 women) healthy control subjects. CoQ10 levels were standardized using blood lipids. Results Serum TAS levels and CoQ10/total cholesterol values of the HD and CAPD patients were significantly lower, whereas serum IMA and TOS levels were significantly higher, than those of controls. Furthermore, CoQ10/LDL, CoQ10/triglycerides, and CoQ10/total cholesterol + triglycerides values of the CAPD patients were significantly lower than those of controls. No differences were found between serum IMA, TAS, TOS, CoQ10 levels, and adjusted CoQ10 values of the CAPD and HD patients. Conclusions Our results suggest that oxidative stress is increased in HD and CAPD patients compared with controls, as proven by decreased TAS and adjusted CoQ10 levels and increased TOS and IMA levels. Therefore, an antioxidant supplementation to these patients may be suggested.
Collapse
|
36
|
Sex-related differences in association of oxidative stress status with coronary artery disease. Fertil Steril 2012; 97:414-9. [DOI: 10.1016/j.fertnstert.2011.11.045] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 11/23/2011] [Accepted: 11/29/2011] [Indexed: 12/20/2022]
|
37
|
Monti DA, Mitchell E, Bazzan AJ, Littman S, Zabrecky G, Yeo CJ, Pillai MV, Newberg AB, Deshmukh S, Levine M. Phase I evaluation of intravenous ascorbic acid in combination with gemcitabine and erlotinib in patients with metastatic pancreatic cancer. PLoS One 2012; 7:e29794. [PMID: 22272248 PMCID: PMC3260161 DOI: 10.1371/journal.pone.0029794] [Citation(s) in RCA: 175] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 12/03/2011] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Preclinical data support further investigation of ascorbic acid in pancreatic cancer. There are currently insufficient safety data in human subjects, particularly when ascorbic acid is combined with chemotherapy. METHODS AND FINDINGS 14 subjects with metastatic stage IV pancreatic cancer were recruited to receive an eight week cycle of intravenous ascorbic acid (three infusions per week), using a dose escalation design, along with standard treatment of gemcitabine and erlotinib. Of 14 recruited subjects enrolled, nine completed the study (three in each dosage tier). There were fifteen non-serious adverse events and eight serious adverse events, all likely related to progression of disease or treatment with gemcitabine or erlotinib. Applying RECIST 1.0 criteria, seven of the nine subjects had stable disease while the other two had progressive disease. CONCLUSIONS These initial safety data do not reveal increased toxicity with the addition of ascorbic acid to gemcitabine and erlotinib in pancreatic cancer patients. This, combined with the observed response to treatment, suggests the need for a phase II study of longer duration. TRIAL REGISTRATION Clinicaltrials.gov NCT00954525.
Collapse
Affiliation(s)
- Daniel A. Monti
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Edith Mitchell
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Anthony J. Bazzan
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Susan Littman
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - George Zabrecky
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Charles J. Yeo
- Department of Surgery and the Jefferson Pancreas, Biliary, and Related Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Madhaven V. Pillai
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Andrew B. Newberg
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Sandeep Deshmukh
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Mark Levine
- Molecular and Clinical Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| |
Collapse
|
38
|
Martí del Moral L, Agil A, Navarro-Alarcón M, López-Ga de la Serrana H, Palomares-Bayo M, Oliveras-López MJ. Altered serum selenium and uric acid levels and dyslipidemia in hemodialysis patients could be associated with enhanced cardiovascular risk. Biol Trace Elem Res 2011; 144:496-503. [PMID: 21789541 DOI: 10.1007/s12011-011-9152-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 07/13/2011] [Indexed: 10/18/2022]
Abstract
In the present study, the first objective was to follow up serum selenium (Se) concentrations in 117 hemodialysis patients (HPs) during a 2-year longitudinal study, relating concentrations to biochemical indexes (n = 6; namely lipoprotein profile, uric acid, and total protein levels). It was also evaluated whether the disease is associated with an enhanced cardiovascular risk. A healthy control group (n = 50) was also studied. Mean serum Se levels were significantly lower in HPs than in the controls (p = 0.002); mean levels significantly increased from the first to third blood sampling (p < 0.001). HPs showed a marked dyslipidemia, with a significant reduction in total cholesterol, low-density lipoprotein, and high-density lipoprotein cholesterol levels and a significant increase in triglyceride levels (p < 0.001). HPs showed a marked hyperuricemia (p < 0.001). Serum selenium levels in HPs were correlated negatively with uric acid levels (inflammation biomarker; p < 0.01). In HPs, serum Se levels are reduced due to their disease (chronic renal failure). Serum Se levels rose until the third blood sampling. The marked dyslipidemia and hyperuricemia found in HPs and the negative correlation between the serum Se and uric acid levels in these patients could imply an enhanced cardiovascular risk.
Collapse
Affiliation(s)
- Loreto Martí del Moral
- Department of Nutrition and Food Chemistry, Faculty of Pharmacy, University of Granada, 18071, Granada, Spain
| | | | | | | | | | | |
Collapse
|
39
|
Effect of pomiferin administration on kidney ischaemia-reperfusion injury in rats. Interdiscip Toxicol 2011; 3:76-81. [PMID: 21217877 PMCID: PMC2984129 DOI: 10.2478/v10102-010-0015-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Revised: 06/09/2010] [Accepted: 06/21/2010] [Indexed: 11/21/2022] Open
Abstract
The aim of the study was to analyse protective effects of different doses of pomiferin in therapy of reperfusion injury. Rats were randomly divided into five groups (n=10). One group was intact. Three medicated groups and one placebo group were subjected to ischaemia and reperfusion of the left kidney. Pomiferin was administrated by single gastric gavage in 2 ml of 0.5% Avicel solution in doses of 5, 10 and 20 mg/kg. The placebo group was given only Avicel solution. On day 15, all the animals were exsanguinated and the reperfused kidneys were recovered. Selected biochemical markers were assessed in blood: antioxidative enzymes, total antioxidative capacity, malondialdehyde, creatinine, urea and uric acid. Creatinine, urea and total proteins were analysed in urine and 24-hour diuresis was recorded. The kidney tissue samples were used for histopathological examination. The results confirmed the expected protective effects of pomiferin. Pomiferin supported defensive reactions of the body against free radicals (increased levels of superoxide dismutase, total antioxidative capacity), decreased lipid peroxidation (decreased malondialdehyde) and contributed to the recovery of kidney functions (creatinine and urea in blood). The best biochemical and histopathological results were achieved after pomiferin administration in the dose of 5 mg/kg.
Collapse
|
40
|
López Vélez M, Martínez Martínez F. Study of serum antioxidant capacity and relation with CA 19-9 and PSA in patients with gastrointestinal tract and prostate tumors. Clin Biochem 2011; 44:1121-1127. [PMID: 21723270 DOI: 10.1016/j.clinbiochem.2011.06.082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 05/25/2011] [Accepted: 06/13/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVES We undertook the present study to investigate the possible relation between total antioxidant capacity (TAC) and tumor marker (TM) values in serum samples of patients with and without gastrointestinal tract and prostate tumors. DESIGN AND METHODS We measured the TAC using trolox equivalent antioxidant capacity (TEAC) and oxygen radical absorption capacity (ORAC) assays in 80 serum samples: 20 presented elevated values of CA 19-9; 20 had elevated PSA levels and two groups of 20 samples had values within reference ranges respectively. RESULTS Total antioxidant capacity - measured using the two different analytical methods - was higher in serum samples from patients with elevated CA 19-9 and PSA levels. This antioxidant status, measured by ORAC assay, correlated significantly with CA 19-9 (r: 0.502, P<0.05) and PSA (r:0.792, P<0.001) when the values of these tumor markers were pathological. CONCLUSIONS We concluded that increased serum TAC of the patients with altered levels of CA 19-9 and PSA may be due to the response of increased reactive oxygen species and can be considered as a sign of oxidative stress of these patients. We know that tumor markers are a useful tool for follow-up care of oncologic patients, whereas their role in the diagnosis of a malignancy is controversial. Therefore, the evaluation of serum antioxidant capacity in these pathological processes could contribute to improve diagnosis of these patients.
Collapse
Affiliation(s)
- M López Vélez
- Department of Physical Chemistry, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain.
| | - F Martínez Martínez
- Department of Physical Chemistry, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain.
| |
Collapse
|
41
|
Roozbeh J, Shahriyari B, Akmali M, Vessal G, Pakfetrat M, Raees Jalali GA, Afshariani R, Hasheminasab M, Ghahramani N. Comparative effects of silymarin and vitamin E supplementation on oxidative stress markers, and hemoglobin levels among patients on hemodialysis. Ren Fail 2011; 33:118-23. [PMID: 21332331 DOI: 10.3109/0886022x.2010.541579] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The incidence of accelerated atherosclerosis among patients on hemodialysis is very high and oxidative stress (OS) is a potentially major contributor to their morbidity and mortality. OBJECTIVE To evaluate the effects of Silymarin and/or vitamin E on OS markers and hemoglobin levels in patients on hemodialysis. METHODS Eighty patients on hemodialysis were randomized into four groups: Group 1 received silymarin 140 mg 3 times daily; Group 2 received vitamin E 400 IU/day; Group 3 received silymarin 140 mg 3 times daily and vitamin E 400 IU/day; and Group 4 was the control. Samples were obtained at baseline and on day 21 for measurement of malondialdehyde (MDA), red blood cell (RBC) glutathione peroxidase (GPX), and hemoglobin. RESULTS Combination of silymarin and vitamin E led to a reduction in the MDA levels (7.84 ± 1.84 vs. 9.20 ± 2.74 nmol/mL; p = 0.008). There was a significant increase in RBC GPX levels in all treatment groups compared with controls after 3 weeks. This was more pronounced in the group receiving combination compared with the group receiving vitamin E or the control group (5.78 ± 3.51, 4.22 ± 1.63, and 3.16 ± 1.89 IU/grHb, respectively; p < 0.001). There was also a significant increase in mean hemoglobin of all treatment groups compared with the control. CONCLUSIONS Oral supplementation with silymarin and vitamin E leads to reduction in MDA, increase in RBC GPX, and increase in hemoglobin levels in patients with end-stage renal disease. Studies with larger sample sizes and longer follow-up are required to investigate the effect of silymarin on cardiovascular outcomes and erythropoietin requirement.
Collapse
Affiliation(s)
- Jamshid Roozbeh
- Division of Nephrology, Department of Medicine, Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Erejuwa OO, Sulaiman SA, Wahab MSA, Sirajudeen KNS, Salleh MSM, Gurtu S. Differential responses to blood pressure and oxidative stress in streptozotocin-induced diabetic Wistar-Kyoto rats and spontaneously hypertensive rats: effects of antioxidant (honey) treatment. Int J Mol Sci 2011; 12:1888-907. [PMID: 21673929 PMCID: PMC3111640 DOI: 10.3390/ijms12031888] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Revised: 12/29/2010] [Accepted: 01/05/2011] [Indexed: 01/10/2023] Open
Abstract
Oxidative stress is implicated in the pathogenesis and/or complications of hypertension and/or diabetes mellitus. A combination of these disorders increases the risk of developing cardiovascular events. This study investigated the effects of streptozotocin (60 mg/kg; ip)-induced diabetes on blood pressure, oxidative stress and effects of honey on these parameters in the kidneys of streptozotocin-induced diabetic Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). Diabetic WKY and SHR were randomized into four groups and received distilled water (0.5 mL) and honey (1.0 g/kg) orally once daily for three weeks. Control SHR had reduced malondialdehyde (MDA) and increased systolic blood pressure (SBP), catalase (CAT) activity, and total antioxidant status (TAS). SBP, activities of glutathione peroxidase (GPx) and glutathione reductase (GR) were elevated while TAS was reduced in diabetic WKY. In contrast, SBP, TAS, activities of GPx and GR were reduced in diabetic SHR. Antioxidant (honey) treatment further reduced SBP in diabetic SHR but not in diabetic WKY. It also increased TAS, GSH, reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio, activities of GPx and GR in diabetic SHR. These data suggest that differences in types, severity, and complications of diseases as well as strains may influence responses to blood pressure and oxidative stress.
Collapse
Affiliation(s)
- Omotayo O. Erejuwa
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; E-Mails: (S.A.S.); (M.S.A.W.)
| | - Siti A. Sulaiman
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; E-Mails: (S.A.S.); (M.S.A.W.)
| | - Mohd Suhaimi Ab Wahab
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; E-Mails: (S.A.S.); (M.S.A.W.)
| | - Kuttulebbai N. S. Sirajudeen
- Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; E-Mail:
| | - Md Salzihan Md Salleh
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; E-Mail:
| | - Sunil Gurtu
- Monash University Sunway Campus, Jeffrey Cheah School of Medicine and Health Sciences, Jalan Lagoon Selatan, 46150, Bandar Sunway, Selangor, Malaysia; E-Mail:
| |
Collapse
|
43
|
Gosmanova EO, Le NA. Cardiovascular Complications in CKD Patients: Role of Oxidative Stress. Cardiol Res Pract 2011; 2011:156326. [PMID: 21253517 PMCID: PMC3022166 DOI: 10.4061/2011/156326] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Accepted: 12/08/2010] [Indexed: 11/20/2022] Open
Abstract
Starting with the early stages, patients with chronic kidney disease (CKD) experience higher burden of cardiovascular disease (CVD). Moreover, CVD complications are the major cause of mortality in CKD patients as compared with complications from chronic kidney failure. While traditional CVD risk factors, including diabetes, hypertension, hyperlipidemia, obesity, physical inactivity, may be more prevalent among CKD patients, these factors seem to underestimate the accelerated cardiovascular disease in the CKD population. Search for additional biomarkers that could explain the enhanced CVD risk in CKD patients has gained increasing importance. Although it is unlikely that any single nontraditional risk factor would fully account for the increased CVD risk in individuals with CKD, oxidative stress appears to play a central role in the development and progression of CVD and its complications. We will review the data that support the contribution of oxidative stress in the pathogenesis of CVD in patients with chronic kidney failure.
Collapse
Affiliation(s)
- Elvira O Gosmanova
- Nephrology Division, Department of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | | |
Collapse
|
44
|
Al Youzbaki W, Thanoon I, Mustafa K, Al Hayali R. Comparison Between the Antioxidant Level of Uremic Patients Before and After Hemodialysis (Hd) and Vitamin E Therapy: Prospective cohort study. Qatar Med J 2010. [DOI: 10.5339/qmj.2010.2.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A prospective cohort study of 18 males aged 19–45 years with chronic renal failure attending the Ibn Sina Teaching Hospital, Mosul for Hemodialysis (HD) between March 2007 and March 2008 assessed the oxidative stress, antioxidant status, serum urea and serum creatinine before and after hemodialysis and following subsequent supplementation with oral Vitamin E. Blood samples collected before starting hemodialysis, after three weeks of twice-weekly dialysis, and then after three weeks of oral vitamin E (400 i.u/day) showed significant decreases of total antioxidant status (TAS) after HD but a significant increase of TAS after Vitamin E therapy; a non-significant increase of lipid peroxidation indicator (serum malondialdehyde; MDA) after HD alone but a significant decrease of MDA after Vitamin E therapy; a highly significant decrease of serum urea after HD and a highly significant increase of serum urea after Vitamin E therapy; a highly significant decrease of serum creatinine after HD and a highly significant increase of serum creatinine after Vitamin E therapy; a highly significant decrease of serum uric acid after HD and a highly significant increase of serum uric acid after Vitamin E therapy. There were non-significant correlations between TAS and MDA, uric acid, serum urea and serum creatinine after HD and after Vitamin E therapy. It is concluded that in patients with chronic renal failure oxidative stress is further exacerbated, as shown by decreased TAS and increased MDA although serum uric acid is not the sole contributor. Vitamin E supplementation in such patients after HD does not enhance renal function but it decreases the oxidative stress by decreasing MDA and enhancing antioxidant body status by increasing significantly TAS and serum uric acid.
Collapse
Affiliation(s)
| | | | - K.N. Mustafa
- **Department of Medicine, College of Medicine, University of Mosul, Mosul, Iraq
| | - R.Y. Al Hayali
- ***Nephrology Section, Ibn Sina University Hospital, Mosul, Iraq
| |
Collapse
|
45
|
Effect of non-genetic factors on paraoxonase 1 activity in patients undergoing hemodialysis. Clin Biochem 2010; 43:1375-80. [DOI: 10.1016/j.clinbiochem.2010.08.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 08/03/2010] [Accepted: 08/21/2010] [Indexed: 01/17/2023]
|
46
|
Schupp N, Heidland A, Stopper H. Genomic damage in endstage renal disease-contribution of uremic toxins. Toxins (Basel) 2010; 2:2340-58. [PMID: 22069557 PMCID: PMC3153169 DOI: 10.3390/toxins2102340] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 09/23/2010] [Accepted: 09/26/2010] [Indexed: 12/16/2022] Open
Abstract
Patients with end-stage renal disease (ESRD), whether on conservative, peritoneal or hemodialysis therapy, have elevated genomic damage in peripheral blood lymphocytes and an increased cancer incidence, especially of the kidney. The damage is possibly due to accumulation of uremic toxins like advanced glycation endproducts or homocysteine. However, other endogenous substances with genotoxic properties, which are increased in ESRD, could be involved, such as the blood pressure regulating hormones angiotensin II and aldosterone or the inflammatory cytokine TNF-α. This review provides an overview of genomic damage observed in ESRD patients, focuses on possible underlying causes and shows modulations of the damage by modern dialysis strategies and vitamin supplementation.
Collapse
Affiliation(s)
- Nicole Schupp
- Institute of Pharmacology and Toxicology, University of Würzburg, Versbacher Straße 9, 97078 Würzburg, Germany;
- Author to whom correspondence should be addressed; ; Tel.: +49-931-20148722; Fax: +49-931-20148446
| | - August Heidland
- Department of Internal Medicine, University of Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany;
| | - Helga Stopper
- Institute of Pharmacology and Toxicology, University of Würzburg, Versbacher Straße 9, 97078 Würzburg, Germany;
| |
Collapse
|
47
|
Development of a device for chemiluminescence determination of superoxide generated inside a dialysis hollow-fiber membrane. J Artif Organs 2010; 13:58-62. [PMID: 20169385 DOI: 10.1007/s10047-010-0481-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Accepted: 10/28/2009] [Indexed: 10/19/2022]
Abstract
Reactive oxygen species (ROS) generated during hemodialysis treatment cause dialysis complications because of the high reactivity of ROS. To prevent dialysis complications caused by oxidative stress, it is important to evaluate the generation and dismutation of ROS during hemodialysis treatment. In this study, our aim was to develop a device to determine superoxide (O(2)(-)) generated inside a dialysis hollow fiber, and also to examine whether this device could detect O(2)(-) separated from plasma using hollow fibers. Experimental apparatus was set up so that hypoxanthine (HX) solution flowed inside the hollow fibers and 2-methyl-6-p-methoxyphenylethynyl-imidazopyrazinone (MPEC) solution flowed outside the hollow fibers. Then, xanthine oxidase (XOD) solution was added to the HX solution to generate O(2)(-), and chemiluminescence resulting from the reaction of O(2)(-) with MPEC was measured with an optical fiber. Chemiluminescence intensity was measured at different HX concentrations, and the peak area of relative luminescence intensity yielded a first-order correlation with the HX concentration. Based on the relationship between HX and O(2)(-) concentrations determined by the cytochrome c reduction method, the relative luminescence intensity measured by this device was linearly dependent on the O(2)(-) concentration inside the hollow fibers. After modifications were made to the device, XOD solution injection into plasma including HX resulted in an increase in the relative luminescence intensity. We concluded that this novel device based on chemiluminescence is capable of determining aqueous O(2)(-) generated inside a hollow fiber and also of detecting O(2)(-) in plasma.
Collapse
|
48
|
Kao MPC, Ang DSC, Pall A, Struthers AD. Oxidative stress in renal dysfunction: mechanisms, clinical sequelae and therapeutic options. J Hum Hypertens 2010; 24:1-8. [PMID: 19727125 DOI: 10.1038/jhh.2009.70] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Oxidative stress has been increasingly linked to the high incidence of cardiovascular events in patients with chronic kidney disease (CKD), especially as traditional cardiovascular risk factors seem to not be able to account for the huge cardiovascular morbidity and mortality in this population group. Oxidative stress is increased in patients with renal impairment as a result of increased oxidant activity and reduced antioxidant capacity, and this is increased in a graded manner with increasing renal dysfunction. Inflammation, which is also present in CKD, further amplifies the oxidant generation process. The two clinical sequelae of oxidative stress are endothelial dysfunction and left ventricular hypertrophy, which have adverse cardiovascular consequences. With our new understanding of oxidative stress, it is now important to assess treatment options that reduce it in the hope that they reverse endothelial dysfunction and left ventricular hypertrophy and the clinical sequelae of these abnormalities.
Collapse
Affiliation(s)
- M P C Kao
- Division of Medical Sciences, Centre for Cardiovascular and Lung Biology, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
| | | | | | | |
Collapse
|
49
|
Golli-Bennour EE, Kouidhi B, Dey M, Younes R, Bouaziz C, Zaied C, Bacha H, Achour A. Cytotoxic effects exerted by polyarylsulfone dialyser membranes depend on different sterilization processes. Int Urol Nephrol 2009; 43:483-90. [DOI: 10.1007/s11255-009-9653-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 09/11/2009] [Indexed: 10/20/2022]
|
50
|
Cvetković T, Mitić B, Lazarević G, Vlahović P, Antić S, Stefanović V. Oxidative stress parameters as possible urine markers in patients with diabetic nephropathy. J Diabetes Complications 2009; 23:337-42. [PMID: 18358753 DOI: 10.1016/j.jdiacomp.2008.01.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Revised: 01/09/2008] [Accepted: 01/18/2008] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Reactive oxygen species play a crucial role in the pathogenesis of diabetic nephropathy (DN). The present study was performed to assess oxidative stress parameters-thiobarbituric acid reactive substances (TBARS), reactive carbonyl derivates (RCDs), and total sulfhydryl groups (TSHGs)-in serum and urine of patients with DN. METHODS All parameters were determined in patients with type 2 and type 1 diabetes mellitus and microalbuminuria (DMT2-MIA, DMT1-MIA, respectively) and patients with type 2 diabetes mellitus and macroalbuminuria (DMT2-MAA) compared to healthy controls. RESULTS Serum and urine TBARS levels were higher in all patients with DN and microalbiminuria compared to the control group. RCD levels significantly increased in serum of patients with DMT2 relative to the controls as well as in urine of patients with DMT2-MAA and DMT1-MIA. In all groups of patients, TSHGs decreased in serum but not in urine of patients with DMT2-MAA. CONCLUSION Urine TBARS, RCDs, and TSHGs could be proposed as possible markers for oxidative damage of kidney in DN.
Collapse
Affiliation(s)
- Tatjana Cvetković
- Clinic of Nephrology and Hemodialysis, Clinical Center, 18000 Nis, Serbia
| | | | | | | | | | | |
Collapse
|