Free Radicals in Peritoneal Dialysis: Agents of Damage?

Bręborowicz, Andrzej

doi:10.1177/089686089201200201

Cited by 21 publications

(5 citation statements)

References 74 publications

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“…In vitro studies showed that when cultured human mesothelial cells are exposed to dextrose or icodextrin dialysates for one hour, it produces ROS, increasing thus OS [ 6 ]. In line with these results, the limited “biocompatibility” of the peritoneal dialysis solution results in accumulation of ROS [ 7 ]. Huh et al suggested that accumulation of glucose degradation molecules in glucose-containing peritoneal solutions may trigger the onset and development of OS [ 8 ].…”

Section: Os Status In Pdmentioning

confidence: 88%

Oxidative Stress in Patients Undergoing Peritoneal Dialysis: A Current Review of the Literature

Liakopoulos

Roumeliotis

Gorny

et al. 2017

Oxidative Medicine and Cellular Longevity

100

121

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Peritoneal dialysis (PD) patients manifest excessive oxidative stress (OS) compared to the general population and predialysis chronic kidney disease patients, mainly due to the composition of the PD solution (high-glucose content, low pH, elevated osmolality, increased lactate concentration and glucose degradation products). However, PD could be considered a more biocompatible form of dialysis compared to hemodialysis (HD), since several studies showed that the latter results in an excess accumulation of oxidative products and loss of antioxidants. OS in PD is tightly linked with chronic inflammation, atherogenesis, peritoneal fibrosis, and loss of residual renal function. Although exogenous supplementation of antioxidants, such as vitamins E and C, N-acetylcysteine, and carotenoids, in some cases showed potential beneficial effects in PD patients, relevant recommendations have not been yet adopted in everyday clinical practice.

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Section: Os Status In Pdmentioning

confidence: 88%

Oxidative Stress in Patients Undergoing Peritoneal Dialysis: A Current Review of the Literature

Liakopoulos

Roumeliotis

Gorny

et al. 2017

Oxidative Medicine and Cellular Longevity

100

121

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“…Thus PB could be added to the list of drugs that affect urate transport through the peritoneal membrane. Since urate represents one of the main antioxidant substrates in humans (22-29), one could suggest that an augmented urate presence in the peritoneal cavity would be desirable in the case of peritonitis or situations with increased production of oxygen radicals (30) and, therefore, coadministration of a “uricosuric” drug could be studied in this setting.…”

Section: Discussionmentioning

confidence: 99%

Effect of Pyrazinamide and Probenecid on Peritoneal Urate Transport Kinetics during Continuous Ambulatory Peritoneal Dialysis

Spaia¹,

Magoula

Tsapas

et al. 2000

Perit Dial Int

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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.

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“…There are reports indicating that cadmium-induced toxicity results from the generation of free radicals [ 20 , 21 ]. Additionally, an increase of free radical formation may also be observed in patients with CPD [ 22 ]. Free radicals lead to lipid peroxidation, which might induce organ damage and structural change [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Association between blood cadmium levels and malnutrition in peritoneal dialysis

et al. 2014

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BackgroundMalnutrition is associated with an increased risk of cardiovascular death and may cause protein-energy wasting in individuals with chronic kidney disease. A previous study demonstrated that blood cadmium levels (BCLs) were associated with malnutrition in maintenance hemodialysis (MHD) patients. However, the correlation between cadmium exposure and malnutrition remains unclear in chronic peritoneal dialysis (CPD) patients. This study examined the possible adverse effects of environmental cadmium exposure in CPD patients.MethodsA total of 301 CPD patients were enrolled and divided into 3 study groups based on the following BCL tertiles: low (<0.19 μg/L), middle (0.19–0.39 μg/L), and high (>0.39 μg/L). Demographic, hematological, biochemical, and dialysis-related data were obtained for analysis. The analysis also included values of nutritional and inflammatory markers.ResultsThe BCLs of CPD patients were lower than those of MHD patients. At baseline, patients in the high BCL group were older and had a higher prevalence of diabetes mellitus but lower serum albumin, creatinine, and phosphate levels than the patients in the other 2 groups. After adjusting for potential variables, stepwise backward multiple linear regression analysis revealed that age and alanine aminotransferase levels were positively associated with logarithmic transformation of BCLs (log BCLs), while serum albumin levels were negatively associated with log BCLs in CPD patients. The log BCLs were a significant determinant (beta coefficient ± standard error = -0.185 ± 0.074; P = 0.013) of nutritional status and significantly associated with the presence of malnutrition (odds ratio = 2.64; 95% confidence interval: 1.07–6.48; P = 0.035) in CPD patients after adjustment for related variables.ConclusionsBCL is significantly associated with nutritional status and malnutrition in CPD patients. Therefore, it is important for CPD patients to avoid environmental exposure to cadmium such as through smoking and consumption of cadmium-rich foods.

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Free Radicals in Peritoneal Dialysis: Agents of Damage?

Cited by 21 publications

References 74 publications

Oxidative Stress in Patients Undergoing Peritoneal Dialysis: A Current Review of the Literature

Oxidative Stress in Patients Undergoing Peritoneal Dialysis: A Current Review of the Literature

Effect of Pyrazinamide and Probenecid on Peritoneal Urate Transport Kinetics during Continuous Ambulatory Peritoneal Dialysis

Association between blood cadmium levels and malnutrition in peritoneal dialysis

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