Alteration in plasma antioxidant capacities in chronic renal failure and hemodialysis patients: a possible explanation for the increased cardiovascular risk in these patients

Clermont, Gaëlle

doi:10.1016/s0008-6363(00)00117-6

Cited by 109 publications

(90 citation statements)

References 32 publications

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“…Elevated NO levels in CRF patients, which significantly decreased after dialysis, and evidence for production of oxygen free radicals during HD have been reported. 25,26,27 The present study showed increased levels of FFAs, TG, TC and decreased HDL-C and Ph-lipids in predialysis samples as a consequence of carnitine deficiency with no significant changes after dialysis. After L-carnitine supplementation the FFAs, TC and HDL-C returned to control levels while TG and Ph-lipids continued to be significantly different from controls.…”

Section: Discussionsupporting

confidence: 51%

Dyslipidemia, Oxidative Stress and Cardiac Dysfunction in Children with Chronic Renal Failure: Effects of L-Carnitine Supplementation

2003

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Background: Secondary carnitine deficiency may develop in chronic renal failure (CRF) patients undergoing longterm hemodialysis (HD), with a resulting higher incidence of cardiovascular diseases, dyslipidemia and oxidative stress. We studied the efficacy of 12 months of L-carnitine supplementation on the amelioration of dyslipidemia, oxidative stress and cardiac dysfunction in 24 CRF children undergoing long-term HD compared with 24 age-and sex-matched controls. Methods: Plasma samples were analyzed spectrophotometerically before and after dialysis sessions and after 2-month supplementation with oral L-carnitine (50 mg/kg/day) for free carnitine (FC), the lipid profile, and oxidative stress markers. Echocardiography the day following dialysis measured cardiac diameters, wall thicknesses, left ventricular mass index (Ml), end diastole and systole volume indices and functions. Results: The pre-dialysis FC concentration was substantially lower than controls and decreased significantly at the end of the dialysis session. Pre-and post-dialysis plasma levels of free fatty acids (FFAs), trigyleride (TG), total cholesterol (TC) and oxidative stress markers significantly increased while high-density lipoprotein cholesterol (HDL-C) and phospholipids significantly decreased compared to controls. Echocardiography detected a significant increase in cardiac diameters and thickness, and systolic and diastolic cardiac dysfunction. After L-carnitine supplementation, plasma levels of FC increased to normal levels. FFAs, TC and HDL-C returned to control levels while TG, phospholipids, and the oxidative stress markers decreased but remained significantly higher than controls. There was a significant decrease in cardiac diameters and an increase in left ventricular diastolic function (E/A ratio), but no correlation between FC levels and echocardiographic parameters. Pre-dialysis, post-dialysis and after treatment, plasma FC level showed a significant positive correlation with HDL-C and phospholipids and a significant negative correlation with each of oxidative stress markers, FFAs, TG and TC. On the other hand, FFAs showed a significant positive correlation with TG, TC, DC, NO and a significant negative correlation with HDL-C and phospholipids. Conclusion: This study demonstrates that CRF children under regular HD suffer from a decrease in the level of plasma FC, dyslipidemia, oxidative stress, and an increase in cardiac diameters and thickness with impairment of cardiac functions. Oral L-carnitine supplementation at a dose of 50 mg/kg for 2 months can increase plasma FC level, improve dyslipidemia, decrease oxidative stress with reduction of cardiac diameters and increase in diastolic function.

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Section: Discussionsupporting

confidence: 51%

Dyslipidemia, Oxidative Stress and Cardiac Dysfunction in Children with Chronic Renal Failure: Effects of L-Carnitine Supplementation

2003

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“…Clermont et al 21 observaram uma depleção acentuada de antioxidantes após sessão de hemodiálise. Os autores encontraram também uma diminuição nos níveis de vitamina C e tióis, e um aumento nos níveis do radical ascorbil em relação ao nível de vitamina C. A atividade antioxidante do plasma e os níveis de ácido úrico eram significativamente mais altos nos…”

Section: Discussionunclassified

“…A acentuação nos níveis do radical ascorbil após a diálise demonstra aumento na concentração de espécies ativas de oxigênio. 21 Erdogan et al, 22 em uma avaliação da capacidade antioxidante total no plasma humano, mostraram que esta era formada pela presença de: urato (35 -65%), ascorbato (0 -24%), vitamina E (5 -10%) e proteínas (10 -50%). Neste trabalho, observou-se diminuição paralela em ambos, ácido úrico e estado antioxidante do plasma após sessão de HD, bem como maior TRAP nos pacientes quando comparados aos controles.…”

Section: Tabelaunclassified

“…Esse maior TRAP tem sido atribuído a um aumento no nível de urato desses pacientes, e os resultados deste trabalho estão em consonância com achados da literatura. 21 A depleção da capacidade antioxidante é atribuí-da em grande parte à eliminação do ácido úrico pela diálise. Em adição, é frequente a perda de antioxidantes causada pela remoção de antioxidantes solúveis em água durante sessão de hemodiálise devido ao seu baixo peso molecular.…”

Section: Tabelaunclassified

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Efeito de uma sessão de hemodiálise sobre o estresse oxidativo sistêmico de pacientes renais crônicos terminais

Bianchi¹,

Barp²,

Thomé³

et al. 2009

J. Bras. Nefrol.

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Objective: To assess the effect of a hemodialysis (HD) session on systemic oxidative stress of chronic renal patients. Methods and Results: The study comprised 17 patients (10 women and 7 men with mean age of 39.9 ± 13.5 years) undergoing hemodialytic treatment at the Unit of Nephrology of Hospital de Clínicas de Porto Alegre, and a control group formed by 18 healthy individuals (4 women and 14 men with mean age of 34.8 ± 10.1 years). Renal patients had blood samples withdrawn before and after HD session. Means were analyzed by Student t test (p < 0.05). In red blood cells, the activity of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) was assessed. In plasma, the non-enzymatic antioxidant system was assessed by measuring the total reactive antioxidant potential (TRAP). No significant differences were observed between the values of SOD and CAT before and after HD. Comparison with the control group showed a significant reduction in the activity of those enzymes. After HD session, a significant reduction in TRAP was observed. Oxidative damage to membrane lipids was assessed through chemiluminescence (CL), and the damage to proteins through carbonyl assay. No significant difference was observed in the values of CL and carbonyls after HD. However, when compared with the control group, a significant difference was observed, indicating a greater damage to membrane lipids and proteins in renal patients. Conclusions: Chronic renal patients on HD treatment show a reduction in the activity of antioxidant enzymes SOD and CAT, in addition to an increase in oxidative damage, when compared with healthy individuals. One HD session does not change those levels.

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“…17,31,32 In addition, HD membrane materials may activate neutrophils 33 and platelets. 34 The abrupt change of hemodynamic and metabolic balance caused by dialysis may also add to the development of OS.…”

Section: Discussionmentioning

confidence: 99%

Oxidative Stress Modulation Immediately After Hemodialysis

Alamdari

Honarmand

Sarrafnejad

et al. 2009

Dialysis & Transplantation

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AIMThe aim of this study was to estimate oxidative stress (OS) before and after dialysis in hemodialysis (HD) patients and correlate this stress with routine biochemical parameters.METHODSera of patients (n = 21), under regular HD, were collected 5 minutes before and after an HD session. Oxidative stress was estimated using the pro‐oxidant‐antioxidant assay (PAB), along with routine biochemical parameters in the same sera.RESULTSA significant increase of OS value was observed in HD patients 5 minutes after dialysis. Before HD, a significant correlation was established between the PAB values and fasting blood sugar, calcium, and C‐reactive protein (CRP); and an inverse correlation between the PAB values and uric acid, serum creatinine, albumin, and albumin/globulin ratio. This correlation was not obvious after HD. PAB value, after dialysis, correlated significantly only with serum iron and inversely with alanine transaminase.CONCLUSIONThis study found that the already‐increased OS in HD patients is further increased immediately after dialysis. However, factors influencing post‐dialysis OS may be different from pre‐dialysis factors.

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Alteration in plasma antioxidant capacities in chronic renal failure and hemodialysis patients: a possible explanation for the increased cardiovascular risk in these patients

Abstract: Our study demonstrates that profound disturbances in the extracellular redox system occur during the course of chronic renal failure and hemodialysis, and may provide an explanation for the cardiovascular complications in these patients.

Cited by 109 publications

References 32 publications

Dyslipidemia, Oxidative Stress and Cardiac Dysfunction in Children with Chronic Renal Failure: Effects of L-Carnitine Supplementation

Dyslipidemia, Oxidative Stress and Cardiac Dysfunction in Children with Chronic Renal Failure: Effects of L-Carnitine Supplementation

Efeito de uma sessão de hemodiálise sobre o estresse oxidativo sistêmico de pacientes renais crônicos terminais

Oxidative Stress Modulation Immediately After Hemodialysis

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