Preserved residual renal function is associated with lower oxidative stress in peritoneal dialysis patients

Ignace, Sophie; Fouque, Denis; Arkouche, Walid; Steghens, Jean‐Paul; Guebre-Egziabher, Fitsum

doi:10.1093/ndt/gfp077

Cited by 23 publications

(23 citation statements)

References 22 publications

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“…We found that TBARS correlated positively with DOD and negatively with hemoglobin level, while FRAP correlated positively with serum albumin levels. Similar to our study Ignace et al .,[14] and Sundl et al .,[15] also found a negative correlation of dialysis vintage with lipid peroxidation and AGEs levels in 23 and 37 PD patients, respectively. Kim et al .,[13] also found a direct correlation between total antioxidant capacity and serum albumin, which, however, is not consistent with majority of other studies.…”

Section: Discussionsupporting

confidence: 92%

Oxidative stress, endothelial function, carotid artery intimal thickness and their correlates among chronic peritoneal dialysis patients

Khaira¹,

Mahajan²,

Kumar³

et al. 2011

Indian J Nephrol

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We evaluated important nontraditional cardiovascular risk factors, endothelial function and oxidative stress (OS) among stable peritoneal dialysis (PD) patients. Their association with carotid intimal medial thickness (CIMT) was also assessed. Thirty-eight adult patients (13 diabetics, 20 males) on PD for >6 months and 15 age and sex-matched controls were studied. Duration of dialysis (DOD), residual urine output (UO), weekly Kt/V urea, detailed biochemical and lipid profile were noted. OS was measured by serum concentration of antioxidants; vitamin C and ferric reducing ability of plasma (FRAP) and pro-oxidant; thiobarbituric acid-reactive substances (TBARS). High-resolution ultrasonography was used to determine CIMT and flow-mediated dilatation of brachial artery [endothelium-dependent dilatation (EDD)] and dilatation subsequent to nitrate spray [endothelium-independent dilatation (EID)]. Mean age, DOD, UO and Kt/V of study population were 49.3 ± 11.6 years, 19.4 ± 11.8 months, 508.2 ± 422.9 ml/day and 1.73 ± 0.24, respectively. As compared to controls PD patients had higher CIMT (0.46 ± 0.05 vs 0.50 ± 0.07 mm, P = 0.003) and TBARS (1.5 ± 0.4 vs 5.1 ± 2.3 nM/ml, P < 0.001) but lower Vitamin C (1.7 ± 0.3 vs 0.6 ± 0.2 mg%, P < 0.001), FRAP (990.8 ± 78.1 vs 328.7 ± 183.5 μM/L, P < 0.001) and EDD (26.2 ± 5.4 vs 9.8 ± 4.6 %, P < 0.001). TBARS correlated positively with DOD and negatively with hemoglobin. Vitamin C and FRAP correlated positively with serum albumin. EDD correlated positively with UO, Kt/V and hemoglobin. CIMT correlated negatively with Kt/V and hemoglobin. Among themselves CIMT correlated negatively with EDD and vitamin C. EDD correlated positively with vitamin C, while FRAP correlated positively with vitamin C and negatively with TBARS. PD patients have higher OS, poorer endothelial function and higher structural atherosclerosis. These parameters are closely linked to each other, hemoglobin, DOD, residual UO, serum albumin and small solute clearances.

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Section: Discussionsupporting

confidence: 92%

Oxidative stress, endothelial function, carotid artery intimal thickness and their correlates among chronic peritoneal dialysis patients

Khaira¹,

Mahajan²,

Kumar³

et al. 2011

Indian J Nephrol

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“…However, in con- trast to previous observations (37,46), we found no relation between iPTH levels and ESA resistance. In addition, inflammation has been associated with ESA resistance (37) as well as with GFR and GFR decline (47,48). Apparent clinical effects of preserved RRF on ESA resistance may therefore partly be explained by less inflammation in patients with RRF.…”

Section: Discussionmentioning

confidence: 99%

Role of Residual Renal Function in Phosphate Control and Anemia Management in Chronic Hemodialysis Patients

Penne

Weerd

Grooteman

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives There is increasing awareness that residual renal function (RRF) has beneficial effects in hemodialysis (HD) patients. The aim of this study was to investigate the role of RRF, expressed as GFR, in phosphate and anemia management in chronic HD patients.Design, setting, participants, & measurements Baseline data of 552 consecutive patients from the Convective Transport Study (CONTRAST) were analyzed. Patients with a urinary output Ն100 ml/24 h (n ϭ 295) were categorized in tertiles on the basis of degree of GFR and compared with anuric patients (i.e., urinary output Ͻ100 ml/24 h, n ϭ 274). Relations between GFR and serum phosphate and erythropoiesis-stimulating agent (ESA) index (weekly ESA dose per kg body weight divided by hematocrit) were analyzed with multivariable regression models.Results Phosphate levels were between 3.5 and 5.5 mg/dl in 68% of patients in the upper tertile (GFR Ͼ 4.13 ml/min per 1.73 m 2 ), as compared with 46% in anuric patients despite lower prescription of phosphate-binding agents. Mean hemoglobin levels were 11.9 Ϯ 1.2 g/dl with no differences between the GFR categories. The ESA index was 31% lower in patients in the upper tertile as compared with anuric patients. After adjustments for patient characteristics, patients in the upper tertile had significantly lower serum phosphate levels and ESA index as compared with anuric patients. ConclusionsThis study suggests a strong relation between RRF and improved phosphate and anemia control in HD patients. Efforts to preserve RRF in HD patients could improve outcomes and should be encouraged.

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“…Based on the higher permeability and compatibility of the peritoneal membrane, the avoidance of peaks and troughs in uremic toxins [7] and on the better-preserved residual renal function [8] , a lower oxidative burden could be assumed in PD patients. On the other hand, the unfavorable serum lipid profile and the chronic exposure of peritoneal cells to superphysiologic glucose level could increase glycosylation and lipid oxidation in PD patients [7] .…”

Section: Introductionmentioning

confidence: 99%

“…In accord with our results, these data point to a more favorable profile of PD regarding carbonyl and oxidative stress. Some reasons could be: (1) the greater bioincompatibility of HD procedure which stimulates the release of reactive oxygen species [1] , and (2) a better preserved native kidney function during PD [8] .…”

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confidence: 99%

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Does Dialysis Modality Influence the Oxidative Stress of Uremic Patients?

Căpuşă

Stoian

Rus

et al. 2012

Kidney Blood Press Res

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Background/Aims: Since peritoneal membrane is more compatible and residual renal function better preserved during peritoneal dialysis, we questioned whether the oxidative burden in chronic kidney disease (CKD) is influenced by dialysis modality. Methods: 49 stable CKD patients, 17 on continuous ambulatory peritoneal dialysis (CAPD), 16 on hemodialysis (HD), and 16 non-dialyzed, and 13 healthy subjects were enrolled. Plasma thiobarbituric acid-reactive substances (TBARS; nmol/g protein), serum total antioxidant activity (TAA), total plasma-free thiols (Pt-SH; µmol/g protein), albumin and uric acid were measured by spectrophotometry. Serum residual antioxidant activity (RAA) was calculated. Results: TBARS were higher in HD (78.3 ± 20.3) versus both non-dialyzed (53.1 ± 27.9, p = 0.007) and CAPD groups (58.3 ± 19.8, p = 0.008). Pt-SH was reduced in CKD patients, but showed comparable values between dialysis groups. TAA and RAA were similarly increased in HD and CAPD patients than in the other two groups. Conclusion: Oxidative stress occurs in all CKD patients and worsens as renal function declines. Lipid peroxidation seems more augmented during chronic HD as compared to CAPD, but the plasma antioxidant status did not differ between the investigated dialysis methods. Therefore, dialysis modality appears to influence lipid peroxidation without changing the extracellular antioxidant defense of CKD patients.

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Preserved residual renal function is associated with lower oxidative stress in peritoneal dialysis patients

Cited by 23 publications

References 22 publications

Oxidative stress, endothelial function, carotid artery intimal thickness and their correlates among chronic peritoneal dialysis patients

Oxidative stress, endothelial function, carotid artery intimal thickness and their correlates among chronic peritoneal dialysis patients

Role of Residual Renal Function in Phosphate Control and Anemia Management in Chronic Hemodialysis Patients

Does Dialysis Modality Influence the Oxidative Stress of Uremic Patients?

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