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Marzougui H, Turki M, Ben Dhia I, Maaloul R, Chaker H, Makhlouf R, Agrebi I, Kammoun K, Jamoussi K, Ayadi F, Ben Hmida M, Hammouda O. Melatonin intake before intradialytic exercise reverses oxidative stress and improves antioxidant status in hemodialysis patients. Int J Artif Organs 2023; 46:264-273. [PMID: 37051719 DOI: 10.1177/03913988231165324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
PURPOSE The present study aimed to investigate for the first time the effects of melatonin (MEL) intake on oxidative stress and cellular damage during intradialytic exercise (IEX). METHODS Thirteen hemodialysis (HD) patients volunteered to participate in the current randomized crossover trial. Participants performed four HD sessions in four different conditions: (Exercise (EX)-MEL), (EX-Placebo (PLA)), (Control (C)-MEL), and (C-PLA). 3 mg of MEL or PLA were taken 60 min before starting exercise, or at the equivalent time in the C conditions. Blood samples were taken before HD (T0), immediately after the end of IEX (T1), 60 min after IEX (T2), or at the corresponding times in the C conditions to measure free radicals damage, antioxidant biomarkers, as well as biomarkers of muscle and liver damage. RESULTS Malondialdehyde and Advanced Oxidation Protein Products decreased in (C-MEL) (p < 0.05, d = 2.19; p < 0.01, d = 0.99, respectively) at T2 compared to T0. Catalase and total thiol levels increased in (C-MEL) (p < 0.01, d = 1.51; p < 0.01, d = 1.56, respectively) and in (EX-MEL) (p = 0.01, d = 1.28; p < 0.01, d = 1.52, respectively) at T1 compared to T0. Total bilirubin levels increased in (EX-MEL) and (C-MEL) at T2 compared to T0 (p < 0.001, d = 2.77; p < 0.001, d = 1.36, respectively), but only at T2 compared to T1 in (EX-MEL) (p < 0.001, d = 1.67). In all conditions, uric acid levels decreased at T1 compared to T0 and at T2 compared to T1, while biomarkers of muscle and liver damage remained unchanged. CONCLUSION This pilot study is the first to show that MEL ingestion, alone or combined with IEX, could improve oxidant-antioxidant balance during HD.
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Affiliation(s)
- Houssem Marzougui
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Mouna Turki
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Biochemistry Department, CHU Habib Bourguiba, University of Sfax, Sfax, Tunisia
| | - Imen Ben Dhia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Laboratory: Evaluation and Management of Musculoskeletal System Pathologies, LR20ES09, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Rami Maaloul
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Hanen Chaker
- Nephrology Department, CHU Hedi Chaker, University of Sfax, Sfax, Tunisia
- Research Laboratory of Renal Pathology, LR19ES11, Faculty of Medicine, University of Sfax, Sfax,Tunisia
| | - Rihab Makhlouf
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Biochemistry Department, CHU Habib Bourguiba, University of Sfax, Sfax, Tunisia
| | - Ikram Agrebi
- Nephrology Department, CHU Hedi Chaker, University of Sfax, Sfax, Tunisia
- Research Laboratory of Renal Pathology, LR19ES11, Faculty of Medicine, University of Sfax, Sfax,Tunisia
| | - Khawla Kammoun
- Nephrology Department, CHU Hedi Chaker, University of Sfax, Sfax, Tunisia
- Research Laboratory of Renal Pathology, LR19ES11, Faculty of Medicine, University of Sfax, Sfax,Tunisia
| | - Kamel Jamoussi
- Biochemistry Department, CHU Hedi Chaker, University of Sfax, Sfax, Tunisia
| | - Fatma Ayadi
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Biochemistry Department, CHU Habib Bourguiba, University of Sfax, Sfax, Tunisia
| | - Mohamed Ben Hmida
- Nephrology Department, CHU Hedi Chaker, University of Sfax, Sfax, Tunisia
- Research Laboratory of Renal Pathology, LR19ES11, Faculty of Medicine, University of Sfax, Sfax,Tunisia
| | - Omar Hammouda
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France
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Baltusnikiene A, Staneviciene I, Jansen E. Beneficial and adverse effects of vitamin E on the kidney. Front Physiol 2023; 14:1145216. [PMID: 37007997 PMCID: PMC10050743 DOI: 10.3389/fphys.2023.1145216] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/01/2023] [Indexed: 03/17/2023] Open
Abstract
This article reviews the beneficial and adverse effects of high-dose vitamin E supplementation on the vitamin E status and renal function in human and rodent studies. The high doses of vitamin E, which can cause renal effects, were compared to upper limits of toxicity (UL) as established by various authorities worldwide. In recent mice studies with higher doses of vitamin E, several biomarkers of tissue toxicity and inflammation were found to be significantly elevated. In these biomarker studies, the severity of inflammation and the increased levels of the biomarkers are discussed together with the need to re-evaluate ULs, given the toxic effects of vitamin E on the kidney and emphasizing oxidative stress and inflammation. The controversy in the literature about vitamin E effects on the kidney is mainly caused by the dose-effects relations that do not give a clear view, neither in human nor animals studies. In addition, more recent studies on rodents with new biomarkers of oxidative stress and inflammation give new insights into possible mechanisms. In this review, the controversy is shown and an advice given on the vitamin E supplementation for renal health.
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Affiliation(s)
- Aldona Baltusnikiene
- Department of Biochemistry, Lithuanian University of Health Sciences, Kaunas, Lithuania
- *Correspondence: Aldona Baltusnikiene,
| | - Inga Staneviciene
- Department of Biochemistry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Eugène Jansen
- Retired from Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, Netherlands
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Sussman EJ, Singh B, Clegg D, Palmer BF, Kalantar-Zadeh K. Let Them Eat Healthy: Can Emerging Potassium Binders Help Overcome Dietary Potassium Restrictions in Chronic Kidney Disease? J Ren Nutr 2020; 30:475-483. [DOI: 10.1053/j.jrn.2020.01.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/12/2019] [Accepted: 01/12/2020] [Indexed: 12/29/2022] Open
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Podkowińska A, Formanowicz D. Chronic Kidney Disease as Oxidative Stress- and Inflammatory-Mediated Cardiovascular Disease. Antioxidants (Basel) 2020; 9:E752. [PMID: 32823917 DOI: 10.3390/antiox9080752] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022] Open
Abstract
Generating reactive oxygen species (ROS) is necessary for both physiology and pathology. An imbalance between endogenous oxidants and antioxidants causes oxidative stress, contributing to vascular dysfunction. The ROS-induced activation of transcription factors and proinflammatory genes increases inflammation. This phenomenon is of crucial importance in patients with chronic kidney disease (CKD), because atherosclerosis is one of the critical factors of their cardiovascular disease (CVD) and increased mortality. The effect of ROS disrupts the excretory function of each section of the nephron. It prevents the maintenance of intra-systemic homeostasis and leads to the accumulation of metabolic products. Renal regulatory mechanisms, such as tubular glomerular feedback, myogenic reflex in the supplying arteriole, and the renin–angiotensin–aldosterone system, are also affected. It makes it impossible for the kidney to compensate for water–electrolyte and acid–base disturbances, which progress further in the mechanism of positive feedback, leading to a further intensification of oxidative stress. As a result, the progression of CKD is observed, with a spectrum of complications such as malnutrition, calcium phosphate abnormalities, atherosclerosis, and anemia. This review aimed to show the role of oxidative stress and inflammation in renal impairment, with a particular emphasis on its influence on the most common disturbances that accompany CKD.
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Kaur S, Panghal A, Garg M, Mann S, Khatkar SK, Sharma P, Chhikara N. Functional and nutraceutical properties of pumpkin – a review. ACTA ACUST UNITED AC 2019. [DOI: 10.1108/nfs-05-2019-0143] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to review the nutritional and food value of pumpkin Cucurbita, along with different health benefits. Cucurbita (pumpkin) is an herbaceous vine, member of Cucurbitaceae family. It is an edible, heat-sensitive plant, which has an abundant amount of active compounds such as carotenoids, alkaloids, flavonoids, polyphenols, tannins, tocopherols, phytosterols and cucurbitacin, accounted for numerous health benefits, namely, antidiabetic, antioxidant, anticarcinogenic, hypotensive, hyper protective activities.
Design/methodology/approach
Major well-known bibliometric information sources such as Web of Science, Scopus, Mendeley and Google Scholar were searched with keywords such as nutrition value of Cucurbita, Cucurbita utilization, bioactive compounds of pumpkin, health benefits, processing, food formulations and current scenarios were chosen to obtain a large range of papers to be analyzed. A final inventory of 105 scientific sources was made after sorting and classifying them according to different criteria based on topic, academic field, country of origin and year of publication.
Findings
The comprehensive review of different literature, data sources and research papers seeks to find and discuss various nutritional benefits of pumpkin. It contains all necessary macro- and micro-nutrients, amino acids, vitamins, antioxidants and bioactive compounds with a relatively low amount of antinutrients. The recent upsurge in consumer interest for health-promoting products has opened up new vistas for plant products containing bioactive compounds in different food formulations.
Originality/value
This paper contains information regarding the chemical composition, nutritive value, phytochemical studies, pharmacological properties, bio-accessibility, food and industrial applications of pumpkin. Worldwide, pumpkin is used as food additive in various food products such as candy, weaning mix, corn grits, kheer, jam, crackers, bread, etc. Effect of different processing methods such as high temperature, pH, blanching, oven drying, freeze-drying to retain or minimize its losses in case of color, texture, flavor, and the carotenoids are of concern. The review paper highlights the nutritional, therapeutic, potential and processing attributes.
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Ninić A, Sopić M, Munjas J, Spasojević-Kalimanovska V, Kotur-Stevuljević J, Bogavac-Stanojević N, Ivanišević J, Simić-Ogrizović S, Kravljača M, Jelić-Ivanović Z. Association Between Superoxide Dismutase Isoenzyme Gene Expression and Total Antioxidant Status in Patients with an End-Stage Renal Disease. Balkan Med J 2018; 35:431-436. [PMID: 30063213 PMCID: PMC6251379 DOI: 10.4274/balkanmedj.2018.0170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Chronic renal failure, particularly end-stage renal disease, is a serious health problem associated with a high mortality rate. Uremic syndrome leads to increased oxidative stress, inflammation, and dyslipidemia. Aims: To examine superoxide dismutase isoenzyme gene expression in peripheral blood mononuclear cells of patients on hemodialysis and to determine the associations between superoxide dismutase isoenzyme gene expression, oxidative stress, and non-enzymatic antioxidative protection. Study Design: Case control study. Methods: This study included 33 patients on hemodialysis (age, 55.33±15.31 years old) and 33 apparently healthy controls (age, 45.37±8.92 years old). Superoxide dismutase isoenzyme messenger ribonucleic acid levels were determined by real-time polymerase chain reaction. General biochemical parameters, high sensitivity C-reactive protein, total antioxidant status, thiobarbituric acid-reactive substances, and the superoxide anion radical were also determined. Results: Normalized Cu/Zn superoxide dismutase and Mn superoxide dismutase messenger ribonucleic acid levels were significantly higher in patients than controls (p<0.001 and p=0.011). A significant negative correlation was detected between normalized Cu/Zn superoxide dismutase messenger ribonucleic acid levels and total protein, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total antioxidant status. Normalized Mn superoxide dismutase messenger ribonucleic acid levels were negatively correlated with total protein and total antioxidant status. A multiple regression analysis revealed independent associations between total antioxidant status and normalized Cu/Zn superoxide dismutase (p=0.038) and between total antioxidant status and normalized Mn superoxide dismutase messenger ribonucleic acid levels (p=0.038 and p=0.018, respectively). Conclusion: The superoxide dismutase isoenzyme gene is expressed at a higher rate in patients with end-stage renal failure, probably due to increased oxidative stress and attenuated antioxidative defense. The plasma total antioxidant status is an independent predictor of normalized superoxide dismutase isoenzyme messenger ribonucleic acid levels.
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Affiliation(s)
- Ana Ninić
- Department for Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia
| | - Miron Sopić
- Department for Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia
| | - Jelena Munjas
- Department for Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia
| | | | - Jelena Kotur-Stevuljević
- Department for Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia
| | | | - Jasmina Ivanišević
- Department for Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia
| | - Sanja Simić-Ogrizović
- Clinic of Nephrology, Clinical Centre of Serbia, Belgrade, Serbia,University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Milica Kravljača
- Clinic of Nephrology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Zorana Jelić-Ivanović
- Department for Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia
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Lippi I, Perondi F, Meucci V, Mannarini C, Intorre L, Guidi G. Plasma alpha-tochopherol determined by HPLC in dogs at different stages of chronic kidney disease: a retrospective study. Vet Res Commun 2017; 41:195-9. [PMID: 28488081 DOI: 10.1007/s11259-017-9690-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/01/2017] [Indexed: 01/02/2023]
Abstract
The aim of the present study was to investigate retrospectively the plasma concentration of alpha-tocopherol in dogs with naturally acquired chronic kidney disease (CKD), at different stages of severity. Forty dogs (CKD group) with different stages of CKD (IRIS 1 n=12, IRIS 2 n=8, IRIS 3 n=11, IRIS 4 n=9) and 20 clinically healthy dogs were considered. Plasma alpha-tocopherol was assessed in both groups through high performance liquid chromatography (HPLC). Dogs of CKD group showed significantly lower (p=0.0002) levels of plasma alpha-tocopherol compared with clinically healthy dogs. A significant difference (p<0.04) in the number of patients with plasma alpha-tocopherol > or ≤ 21.5 ppm was found in CKD patients at different stages of severity. No significant correlation between plasma levels of alpha-tocopherol and plasma creatinine was found. In the present study, dogs affected by spontaneous CKD showed significantly lower plasma concentrations of alpha-tocopherol compared with clinically healthy dogs. Plasma alpha-tocopherol deficiency seems to be more severe in IRIS stage 1 and 4, compared with IRIS stage 2 and 3. The finding of marked alpha-tocopherol deficiency in patients in IRIS stage 1 should encourage further studies on the early use of prescription renal diet and antioxidant in this group of patients.
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Abstract
The aims of this study were to determine the effects of acetylsalicylic acid (ASA) on inflammation and oxidative stress markers in hemodialysis (HD) patients and to examine the associations between these markers and the sociodemographic and clinical characteristics of participants. The study included 36 subjects who used 300 mg of ASA for 60 days. Inflammation and oxidative stress were assessed based on levels of biochemical markers. ASA usage promoted a decrease in high-sensitivity C-reactive protein (p = 0.01). The level of hydrogen peroxide increased after 30 days of use of ASA and subsequently decreased (p = 0.01). Reduced glutathione reduced at the end of the study (p < 0.01); the malondialdehyde level did not change and the levels of vitamins A and E were inverse to drug use (p = 0.01). ASA usage promoted reduced levels of inflammation, increased production of markers of oxidative stress, and reduced antioxidant defense.
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Affiliation(s)
- Fabíola Pansani Maniglia
- Division of Nephrology, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - José Abrão Cardeal da Costa
- Division of Nephrology, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, SP, Brazil
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Dejanov P, Dejanova B. Appropriate Biomarkers For Oxidative Stress In Patients With End Stage Renal Disease. Serbian Journal of Experimental and Clinical Research 2015. [DOI: 10.1515/sjecr-2015-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractThe appropriate biomarkers for oxidative stress (OS) in patients with end stage renal disease (ESRD) are important in renal pathology. Patients (56) with ESRD were investigated (35 men and 21 women). Patients, with mean age of 45±17 years, defined education, specific HD duration and calculated body mass index (BMI), were exposed to a polysulphone type HD membrane for approximately 4 hours per HD session, 3 times per week. The control group was composed of 31 healthy volunteers. The total antioxidative capacity (TAC) and the antioxidative (AO) enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx), were assessed. Analyses included Randox Crumlin GB; lipid peroxidation (LP) using its end product, malonyldialdehyde (MDA) (fluorimetric); and a LDL-ox immunoassay (Biomedica gruppe, Vienna, Austria). The TAS was higher in ESRD patients before HD (1.63±0.1 mmol/L) compared to the control group (1.23±0.03 mmol/L).
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Affiliation(s)
- Petar Dejanov
- 1Medical Faculty in Skopje, Skopje, Former Yugoslav Republic of Macedonia
| | - Beti Dejanova
- 1Medical Faculty in Skopje, Skopje, Former Yugoslav Republic of Macedonia
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Granata S, Dalla Gassa A, Tomei P, Lupo A, Zaza G. Mitochondria: a new therapeutic target in chronic kidney disease. Nutr Metab (Lond) 2015; 12:49. [PMID: 26612997 PMCID: PMC4660721 DOI: 10.1186/s12986-015-0044-z] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/18/2015] [Indexed: 12/24/2022] Open
Abstract
Cellular metabolic changes during chronic kidney disease (CKD) may induce higher production of oxygen radicals that play a significant role in the progression of renal damage and in the onset of important comorbidities. This condition seems to be in part related to dysfunctional mitochondria that cause an increased electron "leakage" from the respiratory chain during oxidative phosphorylation with a consequent generation of reactive oxygen species (ROS). ROS are highly active molecules that may oxidize proteins, lipids and nucleic acids with a consequent damage of cells and tissues. To mitigate this mitochondria-related functional impairment, a variety of agents (including endogenous and food derived antioxidants, natural plants extracts, mitochondria-targeted molecules) combined with conventional therapies could be employed. However, although the anti-oxidant properties of these substances are well known, their use in clinical practice has been only partially investigated. Additionally, for their correct utilization is extremely important to understand their effects, to identify the correct target of intervention and to minimize adverse effects. Therefore, in this manuscript, we reviewed the characteristics of the available mitochondria-targeted anti-oxidant compounds that could be employed routinely in our nephrology, internal medicine and renal transplant centers. Nevertheless, large clinical trials are needed to provide more definitive information about their use and to assess their overall efficacy or toxicity.
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Affiliation(s)
- Simona Granata
- Renal Unit, Department of Medicine, University-Hospital of Verona, Piazzale A. Stefani 1, 37126 Verona, VR Italy
| | - Alessandra Dalla Gassa
- Renal Unit, Department of Medicine, University-Hospital of Verona, Piazzale A. Stefani 1, 37126 Verona, VR Italy
| | - Paola Tomei
- Renal Unit, Department of Medicine, University-Hospital of Verona, Piazzale A. Stefani 1, 37126 Verona, VR Italy
| | - Antonio Lupo
- Renal Unit, Department of Medicine, University-Hospital of Verona, Piazzale A. Stefani 1, 37126 Verona, VR Italy
| | - Gianluigi Zaza
- Renal Unit, Department of Medicine, University-Hospital of Verona, Piazzale A. Stefani 1, 37126 Verona, VR Italy
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Zargari M, Sedighi O. Influence of Hemodialysis on Lipid Peroxidation, Enzymatic and Non-Enzymatic Antioxidant Capacity in Chronic Renal Failure Patients. Nephrourol Mon 2015; 7:e28526. [PMID: 26539417 PMCID: PMC4628136 DOI: 10.5812/numonthly.28526] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 04/16/2015] [Accepted: 04/24/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Free radical induced damages are thought to be involved in chronic kidney disease (CKD), especially in patients who are on hemodialysis (HD) for prolonged periods. Hemodialysis can influence multiple biochemical factors, several of which are useful, although the rest can be harmful and increase the severity of disease. OBJECTIVES The purpose of this study was to evaluate the effect of the HD membrane polysulfone on oxidative stress markers, by measuring the level of lipid peroxidation and total antioxidant activity (TAC), in the blood of HD patients. PATIENTS AND METHODS This study was carried out on 31 HD patients and 31 healthy persons, matched for age and sex, as control group. Blood samples were drawn before and after HD from arteriovenous fistulas, and once from the controls. Superoxide dismutase (SOD), catalase (CAT) and thiobarbituric acid-reactive substance (TBARS) in blood hemolyzate, Glutathione peroxidase (GpX) of whole blood and TAC of plasma were measured, respectively. Then, we investigated the association between TAC of plasma, measured by ferric reducing antioxidant power (FRAP), and lipid peroxidation level with its related parameters, in HD patients. RESULTS The SOD, GpX and CAT were decreased after HD (P < 0.05). Also, FRAP was shown to decrease after HD (P < 0.05). However, erythrocyte TBARS levels (μmol/gr of Hb) were increased after HD, in comparison with controls, and before HD (P < 0.05). There was a significant negative correlation between TBARS and antioxidant indices, such as SOD (r = -0.67, P = 0.001), GpX (r = -0.76, P = 0.001), CAT (r = -0.63, P = 0.001) and FRAP (r = -0.84, P = 0.001). The FRAP was significantly and directly correlated with uric acid (r = +0.62, P = 0.001), SOD (r = +0.72, P = 0.001), GpX (r = +0.87, P = 0.001) and CAT (r = +0.84, P = 0.001). CONCLUSIONS The results of our study proposed that there is a loss or inactivation of antioxidant factors, coupled with increased lipid peroxidation during the procedure of HD, possibly through the dialyzer membrane, with probable consequences on the severity of illness.
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Affiliation(s)
- Mehryar Zargari
- Department of Biochemistry, Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari,IR Iran
- Corresponding author: Mehryar Zargari, Department of Biochemistry, Cellular and Molecular Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran. Tel: +98-1133543081, Fax: +98-1133543087, E-mail:
| | - Omid Sedighi
- Department of Nephrology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
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Tucker BM, Safadi S, Friedman AN. Is routine multivitamin supplementation necessary in US chronic adult hemodialysis patients? A systematic review. J Ren Nutr 2014; 25:257-64. [PMID: 25446839 DOI: 10.1053/j.jrn.2014.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 09/11/2014] [Accepted: 09/16/2014] [Indexed: 01/05/2023] Open
Abstract
Because of concern that United States (US) chronic hemodialysis patients are at high risk for the development of vitamin deficiencies, the great majority of such patients are routinely supplemented with a multivitamin. This policy is supported by major US dialysis providers and nonprofit organizations. Yet routine multivitamin supplementation expands hemodialysis patients' already large pill burden, probably accounts for many millions of dollars in annual costs, and in light of previous reports may even carry with it the possibility of increased risk of adverse outcomes. An analysis of the benefits of routine multivitamin supplementation in US patients is therefore in order. We performed a systematic review of the medical literature between 1970 and 2014 using the Ovid MEDLINE database to address this question. We conclude that there is insufficient evidence to support routine multivitamin use and recommend that the decision to supplement be made on an individual basis.
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Affiliation(s)
- Bryan M Tucker
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Sami Safadi
- Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Allon N Friedman
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Ruskovska T, Jansen EH, Antarorov R. Evaluation of assays for measurement of serum (anti)oxidants in hemodialysis patients. Biomed Res Int 2014; 2014:843157. [PMID: 24982909 DOI: 10.1155/2014/843157] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [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.
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Tbahriti HF, Kaddous A, Bouchenak M, Mekki K. Effect of different stages of chronic kidney disease and renal replacement therapies on oxidant-antioxidant balance in uremic patients. Biochem Res Int 2013; 2013:358985. [PMID: 24416590 DOI: 10.1155/2013/358985] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 11/11/2013] [Accepted: 11/14/2013] [Indexed: 01/12/2023] Open
Abstract
Oxidative stress seems to be involved in the path physiology of cardiovascular complications of chronic kidney disease (CKD). In this study, we determined the effect of different stages of CKD and substitutive therapies on oxidative stress. One hundred sixty-seven patients (age: 44 ± 06 years; male/female: 76/91) with CKD were divided into 6 groups according to the National Kidney Foundation classification. Prooxidant status was assessed by assaying thiobarbituric acid reactive substances, hydroperoxides, and protein carbonyls. Antioxidant defence was performed by analysis of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, vitamin E, Iron, and bilirubin. TBARS and LPO were higher in HD patients compared to other groups (P < 0.001), while protein carbonyls were more increased in PD patients. The antioxidant enzymes were declined already at severe stage of CKD and they were declined notably in HD patients (P < 0.001). Similar observation was found for vitamin E, Fe, and bilirubin where we observed a significant decrease in the majority of study groups, especially in HD patients (P < 0.001). The evolution of CKD was associated with elevated OS. HD accentuates lipid, while PD aggravates protein oxidation. However, the activity of antioxidant enzymes was altered by impaired renal function and by both dialysis treatments.
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Montazerifar F, Karajibani M, Sanadgol H, Hashemi M. Effect of peritoneal dialysis on antioxidant defense system and oxidative stress. Int J Organ Transplant Med 2012. [DOI: 10.1016/j.hkjn.2012.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gbandjaba NY, Ghalim N, Hassar M, Berrougui H, Labrazi H, Taki H, Saile R, Khalil A. Paraoxonase activity in healthy, diabetic, and hemodialysis patients. Clin Biochem 2012; 45:470-4. [DOI: 10.1016/j.clinbiochem.2012.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 01/05/2012] [Accepted: 01/08/2012] [Indexed: 12/16/2022]
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Mangé A, Goux A, Badiou S, Patrier L, Canaud B, Maudelonde T, Cristol JP, Solassol J. HDL proteome in hemodialysis patients: a quantitative nanoflow liquid chromatography-tandem mass spectrometry approach. PLoS One 2012; 7:e34107. [PMID: 22470525 PMCID: PMC3309955 DOI: 10.1371/journal.pone.0034107] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 02/21/2012] [Indexed: 01/14/2023] Open
Abstract
Aside from a decrease in the high-density lipoprotein (HDL) cholesterol levels, qualitative abnormalities of HDL can contribute to an increase in cardiovascular (CV) risk in end-stage renal disease (ESRD) patients undergoing chronic hemodialysis (HD). Dysfunctional HDL leads to an alteration of reverse cholesterol transport and the antioxidant and anti-inflammatory properties of HDL. In this study, a quantitative proteomics approach, based on iTRAQ labeling and nanoflow liquid chromatography mass spectrometry analysis, was used to generate detailed data on HDL-associated proteins. The HDL composition was compared between seven chronic HD patients and a pool of seven healthy controls. To confirm the proteomics results, specific biochemical assays were then performed in triplicate in the 14 samples as well as 46 sex-matched independent chronic HD patients and healthy volunteers. Of the 122 proteins identified in the HDL fraction, 40 were differentially expressed between the healthy volunteers and the HD patients. These proteins are involved in many HDL functions, including lipid metabolism, the acute inflammatory response, complement activation, the regulation of lipoprotein oxidation, and metal cation homeostasis. Among the identified proteins, apolipoprotein C-II and apolipoprotein C-III were significantly increased in the HDL fraction of HD patients whereas serotransferrin was decreased. In this study, we identified new markers of potential relevance to the pathways linked to HDL dysfunction in HD. Proteomic analysis of the HDL fraction provides an efficient method to identify new and uncharacterized candidate biomarkers of CV risk in HD patients.
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Affiliation(s)
- Alain Mangé
- CHU Arnaud de Villeneuve, Dept of Cellular Biology, Montpellier, France
- University of Montpellier I, Montpellier, France
- Val d'Aurelle Cancer Institute, Dept of Clinical Oncoproteomic, Montpellier, France
| | - Aurélie Goux
- University of Montpellier I, Montpellier, France
- UMR 204 NUTRIPASS (University of Montpellier I/II), Montpellier, France
| | - Stéphanie Badiou
- University of Montpellier I, Montpellier, France
- CHU Lapeyronie, Dept of Biochemistry, Montpellier, France
- UMR 204 NUTRIPASS (University of Montpellier I/II), Montpellier, France
| | - Laure Patrier
- University of Montpellier I, Montpellier, France
- CHU Lapeyronie, Dept of Biochemistry, Montpellier, France
- UMR 204 NUTRIPASS (University of Montpellier I/II), Montpellier, France
| | - Bernard Canaud
- University of Montpellier I, Montpellier, France
- UMR 204 NUTRIPASS (University of Montpellier I/II), Montpellier, France
- CHU Lapeyronie, Dept of Nephrology, Montpellier, France
| | - Thierry Maudelonde
- CHU Arnaud de Villeneuve, Dept of Cellular Biology, Montpellier, France
- University of Montpellier I, Montpellier, France
- Val d'Aurelle Cancer Institute, Dept of Clinical Oncoproteomic, Montpellier, France
| | - Jean-Paul Cristol
- University of Montpellier I, Montpellier, France
- CHU Lapeyronie, Dept of Biochemistry, Montpellier, France
- UMR 204 NUTRIPASS (University of Montpellier I/II), Montpellier, France
| | - Jérôme Solassol
- CHU Arnaud de Villeneuve, Dept of Cellular Biology, Montpellier, France
- University of Montpellier I, Montpellier, France
- Val d'Aurelle Cancer Institute, Dept of Clinical Oncoproteomic, Montpellier, France
- * E-mail:
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Guo C, Wang C. Plasma aluminum is a risk factor for oxidative stress and inflammation status in hemodialysis patients. Clin Biochem 2011; 44:1309-14. [DOI: 10.1016/j.clinbiochem.2011.08.1132] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 08/11/2011] [Accepted: 08/14/2011] [Indexed: 12/22/2022]
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Roehrs M, Valentini J, Paniz C, Moro A, Charão M, Bulcão R, Freitas F, Brucker N, Duarte M, Leal M, Burg G, Grune T, Garcia SC. The relationships between exogenous and endogenous antioxidants with the lipid profile and oxidative damage in hemodialysis patients. BMC Nephrol 2011; 12:59. [PMID: 22029620 PMCID: PMC3213013 DOI: 10.1186/1471-2369-12-59] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 10/26/2011] [Indexed: 01/22/2023] Open
Abstract
Background We sought to investigate the relationships among the plasma levels of carotenoids, tocopherols, endogenous antioxidants, oxidative damage and lipid profiles and their possible effects on the cardiovascular risk associated with hemodialysis (HD) patients. Methods The study groups were divided into HD and healthy subjects. Plasma carotenoid, tocopherol and malondialdehyde (MDA) levels, as well as erythrocyte reduced glutathione (GSH), were measured by HPLC. Blood antioxidant enzymes, kidney function biomarkers and the lipid profiles were analyzed by spectrophotometric methods. Results Plasma lycopene levels and blood glutathione peroxidase (GPx) activity were significantly decreased in HD patients compared with healthy subjects. Total cholesterol, low-density lipoprotein cholesterol (LDL-c), creatinine, urea, MDA, GSH, superoxide dismutase (SOD) and catalase (CAT) were significantly increased in HD (p < 0.05). Lycopene levels were correlated with MDA (r = -0.50; p < 0.01), LDL-c (r = -0.38; p = 0.01) levels, the LDL-c/HDL-c index (r = -0.33; p = 0.03) and GPx activity (r = 0.30; p = 0.03). Regression models showed that lycopene levels were correlated with LDL-c (β estimated = -31.59; p = 0.04), while gender was correlated with the TC/HDL-c index and triglycerides. Age did not present a correlation with the parameters evaluated. GPx activity was negatively correlated with MDA levels and with the LDL-c/HDL-c and CT/HDL-c indexes. Conclusions Lycopene may represent an additional factor that contributes to reduced lipid peroxidation and atherogenesis in hemodialysis patients.
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Affiliation(s)
- Miguel Roehrs
- Laboratory of Toxicology (LATOX), Department of Clinical and Toxicology, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Cross J, Davenport A. Does online hemodiafiltration lead to reduction in trace elements and vitamins? Hemodial Int 2011; 15:509-14. [PMID: 22111819 DOI: 10.1111/j.1542-4758.2011.00580.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 06/01/2011] [Indexed: 12/16/2022]
Abstract
Hemodiafiltration (HDF) has been reported to improve nutritional intake, but as it increases convective losses, it could also increase micronutrient loss. We prospectively audited the effect of HDF on vitamin B12, zinc and selenium. Thirty-four patients dialyzing (T/Th/Sa) switched to HDF, and 44 dialyzing (M/W/F) remained on high-flux hemodialysis (HD) and were followed for 12 months. Dialysis adequacy, weight, hemoglobin, and serum albumin did not differ between the groups and did not change over 12 months' follow up. Similarly, vitamin B12 did not differ: HDF, 443 (325-682) ng/mL HD vs. 478 (327-690) ng/mL HDF; 6 months, 513 (351-664) ng/mL vs. 460 (379-647) ng/mL; or 12 months, 444 (317-617) ng/mL vs. 492 (323-644) ng/mL. And no patient had subnormal values. Folate levels, in those not taking supplements, were also stable (start, 6.2 ± 0.7 μg/L HD vs. 7.2 ± 1.0 μg/L HDF; 12 months, 6.5 ± 0.9 μg/L vs. 10.9 ± 2.4 μg/L). Serum zinc was subnormal in 50% prior to switching to HDF, 10.4 ± 0.4 μmol/L, but did not fall with HDF 10.2 ± 0.3 μmol/L; similarly, selenium was low in 49% prior to switching to HDF, 0.77 ± 0.06 μmol/L, but remained stable on HDF, 0.82 ± 0.06 μmol/L. Although HDF adds convective clearance to standard hemodialysis, it does not lead to a reduction in vitamin B12, folate, zinc, or selenium. However, half of this dialysis cohort had low levels of both zinc and selenium.
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Affiliation(s)
- Jennifer Cross
- UCL Center for Nephrology, Royal Free Hospital, University College, London, UK
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