Evaluation of dynamic changes of nitric oxide and oxidative stress in hemodialysis patients

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Plasma concentrations of oxidized LDL and ADMA, both of which are markers of oxidative stress were measured. OxyLDL was significantly higher than healthy group and increased further by hemodialysis (HD). ADMA level was higher than healthy group before HD and gradually decreased in the time course of HD.Next, we evaluated the plasma levels of NO-related factors in pathophysiological model rats (hypertension and diabetes mellitus). In both groups, plasma BH_4 level decreased, plasma ADMA level increased, and myocardial DDAH (ADMA hydrolase) activity decreased. Superoxide production of control rats did not differ among heart, kidney and liver, while it decreased significantly in those organs of hypertensive rats.Systemic NO production rate in HD patients was estimated and the rate during HD was significantly higher than in the inter-HD period. There was a good linear correlation between L-arginine/ADMA and systemic NO production rate. Also the same between BH_4/BH_2 and systemic NO production rate. From a clinical viewpoint, variations of these parameters would affect significantly the NO production during HD, and thus control of these factors and other methods should be investigated further.