Does Dialysis Modality Influence the Oxidative Stress of Uremic Patients?
Does Dialysis Modality Influence the Oxidative Stress of Uremic Patients?
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DOI：
10.1159/000331560
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发表时间：
2012-01-01
影响因子：
2.8
通讯作者：
Mircescu, Gabriel
中科院分区：
文献类型：
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作者：
Capusa, Cristina;Stoian, Irina;Mircescu, Gabriel
背景/目标：由于腹膜在腹膜透析过程中具有更好的相容性和更好的残余肾功能，我们质疑慢性肾脏病（CKD）的氧化负荷是否受透析方式的影响。研究方法：入组了49例稳定的CKD患者，其中17例接受持续非卧床腹膜透析（CAPD），16例接受血液透析（HD），16例未透析，13例健康受试者。采用分光光度法测定血浆硫代巴比妥酸反应物质（TBARS; nmol/g蛋白）、血清总抗氧化活性（TAA）、血浆总游离巯基（Pt-SH; μ mol/g蛋白）、白蛋白和尿酸。计算血清残余抗氧化活性（RAA）。结果：HD组（78.3 ± 20.3）的TBARS高于非透析组（53.1 ± 27.9，p = 0.007）和CAPD组（58.3 ± 19.8，p = 0.008）。CKD患者的Pt-SH降低，但透析组之间的值相当。HD和CAPD患者的TAA和RAA增加相似，高于其他两组。结论：CKD患者和COPD患者均存在氧化应激反应，肾功能下降.与CAPD相比，慢性HD期间的脂质过氧化似乎更增强，但研究的透析方法之间的血浆抗氧化状态没有差异。因此，透析方式似乎会影响脂质过氧化，而不会改变CKD患者的细胞外抗氧化防御。版权所有（C）2012 S. Karger AG，巴塞尔
Background/Aims: Since peritoneal membrane is more compatible and residual renal function better preserved during peritoneal dialysis, we questioned whether the oxidative burden in chronic kidney disease (CKD) is influenced by dialysis modality. Methods: 49 stable CKD patients, 17 on continuous ambulatory peritoneal dialysis (CAPD), 16 on hemodialysis (HD), and 16 non-dialyzed, and 13 healthy subjects were enrolled. Plasma thiobarbituric acid-reactive substances (TBARS; nmol/g protein), serum total antioxidant activity (TAA), total plasma-free thiols (Pt-SH; mu mol/g protein), albumin and uric acid were measured by spectrophotometry. Serum residual antioxidant activity (RAA) was calculated. Results: TBARS were higher in HD (78.3 +/- 20.3) versus both non-dialyzed (53.1 +/- 27.9, p = 0.007) and CAPD groups (58.3 +/- 19.8, p = 0.008). Pt-SH was reduced in CKD patients, but showed comparable values between dialysis groups. TAA and RAA were similarly increased in HD and CAPD patients than in the other two groups. Conclusion: Oxidative stress occurs in all CKD patients and worsens as renal function declines. Lipid peroxidation seems more augmented during chronic HD as compared to CAPD, but the plasma antioxidant status did not differ between the investigated dialysis methods. Therefore, dialysis modality appears to influence lipid peroxidation without changing the extracellular antioxidant defense of CKD patients. Copyright (C) 2012 S. Karger AG, Basel