Effect of Different Dialyzer Membranes and Dialysate Base on Lipid Peroxidation & Antioxidant Levels in Hemodialysis Patients | ||||
Journal of High Institute of Public Health | ||||
Article 1, Volume 29, Issue 1, January 1999, Page 1-20 | ||||
Document Type: Original Article | ||||
DOI: 10.21608/jhiph.1999.428355 | ||||
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Authors | ||||
ABDEL-KADER M M1; NAGUIB M1; EHSAN M. H2 | ||||
1Departments of Internal Medicine, Faculty of Medicine, Alexandra University, Egypt | ||||
2Medical Biochemistry, Faculty of Medicine, Alexandra University, Egypt | ||||
Abstract | ||||
Previous reports have indicated the existence of an oxidizing stress from hemodialysis [HD] and a disturbance in the enzyme systems which detoxify free radicals in chronic renal failure [CRF] patients. Furthermore, the use of bioincompatible dialysis membranes was believed to increase radical production. This work aimed to assess the alterations in lipid peroxidation and antioxidant levels in CRF and in hemodialysis patients. Also, the influence of using conventional cuprophane dialyzers as compared to polysulfone dialyzers, together with the effect of using acetate versus bicarbonate as the base compound in the dialysate fluid. The study was conducted on 40 subjects divided into 4 groups: GI [ 10 patients with CRF on conservative treatment], GIl [10 patients on HD with cuprophane membrane], GIII [10 patients on HD with polysulfone membrane], and GIV [10 control subjects]. Gll & GIll were subjected to acetate and bicarbonate HD consecutively for periods of one month for each mode of HD. Blood samples were collected at the end of this period before| predialysis] and 4 hours after starting a HD session [postdialysis]. Malondialdehyde [MDA] was significantly increased in GI, GIl and GIll compared to GIV, and its predialysis level was significantly higher in Gl. than Glil, then, the level decreased significantly after 4 hours of HD. Erythrocyte superoxide dismutase [SOD], Catalase [CAT] and Glutathione peroxidase [GPx] were significantly reduced in each of GI, GIl, and GIll compared to controls. Erythrocyte SOD & CAT did not differ significantly between GIl & GIll. Serum tocopherol was significantly reduced in GI, GIl and GIll compared to controls,with significantly higher predialysis levels in GIll than GIl. Plasma ascorbate was significantly diminished in Gl, GIl, and GIll than controls, with nonsignificant difference between GIl & GIlI. Serum selenium [Se] was significantly reduced in GI,GIl, and GIll compared to controls, and was not significantly different between GIl and GIll . Regarding bicarbonate vs. acetate HD, a significant rise of erythrocyte GPx was observed after a HD session in GIll with bicarbonate HD and not with acetate, and was not detected in GIl. Predialysis plasma ascorbate was significantly decreased in GIl on bicarbonate HD compared to acetate HD, otherwise no significant differences in the studied parameters were detected when acetate or bicarbonate HD were performed. It can be concluded that polysulfone, which is a biocompatible membrane, induces less stimulation of lipid peroxidation and has some advantage over cuprophane, with less reduction of antioxidant levels, especially erythrocyte GPx and plasma vitamin E. On the other hand, bicarbonate HD had only little advantage over acetate HD regarding the effect of HD on lipid peroxidation and the levels of studied antioxidants. Abbreviations: melondi HD: hemodialysis. CRF: chronic renal failure, MDA: malondialdehyde, SOD: superoxide clen dismutase, CAT: catalase, GPx: Glutathione peroxidase, Se: Selenium. | ||||
Keywords | ||||
Different Dialyzer Membranes; Dialysate Base; Lipid Peroxidation; Antioxidant Levels; Hemodialysis Patients | ||||
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