Plasma Protein Carbonylation in Haemodialysed Patients: Focus on Diabetes and Gender

Abstract

Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) experience oxidative/carbonyl stress, which is postulated to increase after the HD session. The influence of diabetes mellitus and sex on oxidation of plasma proteins in ESRD has not yet been clarified despite that diabetic nephropathy is the most common cause of ESRD in developed and developing countries and despite the increasingly emerging differences between males and females in epidemiology, pathophysiology, clinical manifestations, and outcomes for several diseases. Therefore, this study aimed to evaluate the possible effect of type 2 diabetes mellitus, gender, and dialysis filter on plasma level of protein carbonyls (PCO) in ESRD patients at the beginning and at the end of a single HD session. Results show that mean post-HD plasma PCO levels are significantly higher than mean pre-HD plasma PCO levels and that the type of dialysis filter and dialysis technique are unrelated to plasma PCO levels. The mean level of plasma PCO after a HD session increases slightly but significantly in nondiabetic ESRD patients compared to diabetic ones, whereas it increases more markedly in women than in men. These novel findings suggest that women with ESRD are more susceptible than men to oxidative/carbonyl stress induced by HD.

Serum levels of protein carbonyl, a marker of oxidative stress, are associated with overhydration, sarcopenia and mortality in hemodialysis patients

“…In our study, pre-HD protein carbonyl levels are not significantly different in diabetic and nondiabetic HD patients. These results are consistent with the previous reports [36,54]. Dursun and colleagues reported that both diabetes and HD increase oxidative stress, pre-HD protein carbonyl levels are not different in diabetic and non-diabetic patients [54].…”

“…The protein carbonyl level is accepted as a gold standard for measuring protein oxidation [20] and increases in parallel with CKD severity but decreases following renal transplantation and l-carnitine supplementation [3,34,35]. Uremia is associated with increased protein carbonyl stress and HD procedure can increase protein carbonyl level [36,37]. To our knowledge, our study is the first to demonstrate the close relationship of the protein carbonyl level with overhydration and sarcopenia.…”

“…Dursun and colleagues reported that both diabetes and HD increase oxidative stress, pre-HD protein carbonyl levels are not different in diabetic and non-diabetic patients [54]. Recent study measuring protein carbonyl levels before and after HD demonstrated that pre-and post-HD protein carbonyl levels were not different in nondiabetic and diabetic HD patients [36].…”

Oxidative Status before and after Renal Replacement Therapy: Differences between Conventional High Flux Hemodialysis and on-Line Hemodiafiltration

“…In the present study, no changes in carbonyls were observed post-dialysis, which agrees with previous reports examining protein carbonyls and advanced oxidation protein products [24,25]. However, protein carbonyls have been found to increase in other studies [22,26], which might be due to the different types of dialysis membrane used [14]. Also, XOD activity and 8-OHdG levels were significantly decreased post-dialysis in the present study, suggesting that both markers are efficiently filtered during the dialysis process.…”

Protein Carbonyl Content Is a Predictive Biomarker of Eccentric Left Ventricular Hypertrophy in Hemodialysis Patients

“…Emerging data suggest that chronic hemodialysis patients experience heightened oxidative and "carbonyl" stress, which have been proposed as the critical proof linking uremia to cardiovascular complications [42][43][44][45]. Some authors identified redox-dependent changes in cellular proteins and signaling pathways as one of the critical factors involved in left ventricular remodeling and hypertrophy [46][47][48][49].…”