Oxidative stress in end-stage renal disease: an emerging threat to patient outcome

Locatelli, Francesco; Canaud, Bernard; Eckardt, Kai‐Uwe; Stenvinkel, Peter; Wanner, Christoph; Zoccali, Carmine

doi:10.1093/ndt/gfg074

Cited by 649 publications

(572 citation statements)

References 41 publications

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“…In the present study, we observed that HD significantly increased total peroxide concentration in both groups, whether they received iv.Fe or not. Peroxide generation in our ESRD patients therefore seemed not to be correlated to iv.Fe administration; the observed increase is more likely to result from other sources of oxidative stress related to HD (22).…”

Section: Discussionmentioning

confidence: 88%

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Non–Transferrin-Bound Iron in the Serum of Hemodialysis Patients Who Receive Ferric Saccharate

Scheiber-Mojdehkar

Lutzky²,

Schaufler³

et al. 2004

Journal of the American Society of Nephrology

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Abstract. Intravenous iron (iv.Fe) is used to optimize response to recombinant human erythropoietin (r-HuEPO) in ESRD, but no consensus exists with respect to the best regimen to avoid transferrin "oversaturation," oxidative stress, and the occurrence of non-transferrin-bound iron (NTBI). Iv.Fe was stopped for 1 wk in 35 hemodialysis (HD) patients who were routinely receiving iv.Fe and r-HuEPO. The iv.Fe group received 100 mg of ferric saccharate (Venofer) at the end of the first HD session, whereas the time-control group was treated under the same conditions but received no iv.Fe. Serum samples were taken before the first HD session, immediately and 60 min after iv.Fe administration, and before the next HD session. Sera were analyzed for NTBI and peroxides; transferrin saturation was analyzed by urea-PAGE and Western blot. In an in vitro model system with HepG2 cells, the effects of ESRD serum on the labile iron pool (LIP) were assayed using the fluorescence calcein assay. NTBI significantly increased after iv.Fe-administration and returned to baseline values before the next HDsession. There was a shift from apo-to monoferric transferrin, but no "oversaturation" of transferrin after iv.Fe-treatment. Peroxides increased in both groups after HD. Hemodialysis decreased bioavailable iron for the LIP in HepG2-cells, whereas serum of iv.Fe-treated HD patients highly increased the LIP in these cells. A total of 100 mg of iv.Fe led to NTBI generation but not to an oversaturation of transferrin. Peroxide concentrations significantly increased during HD but were not correlated to iv.Fe administration and seemed to result from other sources of oxidative stress related to HD. NTBI can enter liver cells and increase the potentially harmful LIP.

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Section: Discussionmentioning

confidence: 88%

“…There is wide agreement that patients who undergo regular HD treatment experience increased oxidative stress (22). NTBI in the circulation could in principle participate in redox reactions that give rise to reactive oxygen species.…”

mentioning

confidence: 99%

Non–Transferrin-Bound Iron in the Serum of Hemodialysis Patients Who Receive Ferric Saccharate

Scheiber-Mojdehkar

Lutzky²,

Schaufler³

et al. 2004

Journal of the American Society of Nephrology

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“…A variety of heterogeneous ischemic conditions, including endothelial and extracellular hypoxia, acidosis, free radical injury, and sodium and calcium pump disruptions, have been associated with rapid modifications of the cobalt binding properties (47)(48)(49). Therefore, IMA should not be regarded as a specific cardiac marker, especially in patients suffering from diseases associated with enhanced oxidative stress, such as uremia (50), where the balance between prooxidant and antioxidant capacities is conventionally shifted toward an increased oxidative stress (51,52). Moreover, HD is often associated with adverse ischemic effects, such as arteriovenous (AV) access-related ischemia and hypoperfusion (53), which results from dialysis-induced alterations in oxygen delivery and myocardial oxygen consumption.…”

Section: Discussionmentioning

confidence: 99%

Effect of hemodialysis on traditional and innovative cardiac markers

Montagnana

Lippi

Tessitore

et al. 2008

Clinical Laboratory Analysis

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The diagnostic approach to acute coronary syndrome (ACS) is challenging in patients with impaired renal function since most serum biomarkers are commonly increased in this clinical setting. Cardiac troponin T (cTnT), creatine kinase isoenzyme MB (CK MB), myoglobin, and ischemia modified albumin (IMA), were assayed in 45 patients prehemodialysis (pre-HD) and posthemodialysis (post-HD), and results were adjusted for hemoconcentration. The pre-HD values of serum IMA and cTnT were above the respective diagnostic thresholds (IMAo85 K units/L; cTnT o0.03 ng/mL) in six (13%) and 27 (60%) patients undergoing chronic HD, respectively. A significant (105.0 vs. 79.0 K units/L, Po0.0001) and variable (138%; 95% confidence interval [CI], 12-65%) increase of serum IMA was observed post-HD, whereas the other biomarkers significantly decreased (cTnT: 0.029 vs. 0.044 ng/mL, P 5 0.016; CK-MB:2.33 vs.2.50 mg/L, Po 0.0001; myoglobin: 128.1 vs. 148.7 mg/L, Po0.0001). Biomarkers of myocardial injury, especially cTnT and IMA, might be used in HD patients, provided that an appropriate diagnostic interpretation is guarantee, according to individual baseine value, metabolism, and time of sampling. Moreover, IMA might be reliably applied to stratify the long-term risk of these patients, but not for diagnosing an ACS during or immediately post-HD.

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“…In CRF, not only the usual cardiovascular risk factor but also those unique to uremia increases oxidative stress [1][2][3][4][5][6][7]. In the presence of oxidative stress, free oxygen radicals attacks the functional molecules, such as proteins, lipids and DNA, either denaturing them or altering their structure.…”

Section: Introductionmentioning

confidence: 99%

The Assessment of Oxidative Stress on Patients with Chronic Renal Failure at Different Stages and on Dialysis Patients Receiving Different Hypertensive Treatment

2013

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Oxidative stress in end-stage renal disease: an emerging threat to patient outcome

Cited by 649 publications

References 41 publications

Non–Transferrin-Bound Iron in the Serum of Hemodialysis Patients Who Receive Ferric Saccharate

Non–Transferrin-Bound Iron in the Serum of Hemodialysis Patients Who Receive Ferric Saccharate

Effect of hemodialysis on traditional and innovative cardiac markers

The Assessment of Oxidative Stress on Patients with Chronic Renal Failure at Different Stages and on Dialysis Patients Receiving Different Hypertensive Treatment

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