scholarly journals Oxidative Stress in Non-Dialysis-Dependent Chronic Kidney Disease Patients

Author(s):  
Patricia Tomás-Simó ◽  
Luis D’Marco ◽  
María Romero-Parra ◽  
Mari Carmen Tormos-Muñoz ◽  
Guillermo Sáez ◽  
...  

Background: Cardiovascular complications are the leading cause of morbidity and mortality at any stage of chronic kidney disease (CKD). Moreover, the high rate of cardiovascular mortality observed in these patients is associated with an accelerated atherosclerosis process that likely starts at the early stages of CKD. Thus, traditional and non-traditional or uremic-related factors represent a link between CKD and cardiovascular risk. Among non-conventional risk factors, particular focus has been placed on anaemia, mineral and bone disorders, inflammation, malnutrition and oxidative stress and, in this regard, connections have been reported between oxidative stress and cardiovascular disease in dialysis patients. Methods: We evaluated the oxidation process in different molecular lines (proteins, lipids and genetic material) in 155 non-dialysis patients at different stages of CKD and 45 healthy controls. To assess oxidative stress status, we analyzed oxidized glutathione (GSSG), reduced glutathione (GSH) and the oxidized/reduced glutathione ratio (GSSG/GSH) and other oxidation indicators, including malondialdehyde (MDA) and 8-oxo-2’-deoxyguanosine (8-oxo-dG). Results: An active grade of oxidative stress was found from the early stages of CKD onwards, which affected all of the molecular lines studied. We observed a heightened oxidative state (indicated by a higher level of oxidized molecules together with decreased levels of antioxidant molecules) as kidney function declined. Furthermore, oxidative stress-related alterations were significantly greater in CKD patients than in the control group. Conclusions: CKD patients exhibit significantly higher oxidative stress than healthy individuals, and these alterations intensify as eGFR declines, showing significant differences between CKD stages. Thus, future research is warranted to provide clearer results in this area.

2018 ◽  
Vol 7 (8) ◽  
pp. 209 ◽  
Author(s):  
Mateusz Maciejczyk ◽  
Julita Szulimowska ◽  
Anna Skutnik ◽  
Katarzyna Taranta-Janusz ◽  
Anna Wasilewska ◽  
...  

There are still missing non-invasive biomarkers of chronic kidney disease (CKD) in children. Therefore, the aim of the study was to evaluate oxidative stress indicators in the non-stimulated (NWS) and stimulated saliva (SWS) of CKD children (n = 25) and healthy controls (n = 25). Salivary antioxidants (catalase (CAT), peroxidase (Px), superoxide dismutase (SOD), uric acid (UA), reduced glutathione (GSH), albumin), redox status (total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI)), and oxidative damage products (advanced glycation end products (AGE), advanced oxidation protein products (AOPP), malondialdehyde (MDA)) were evaluated. We have demonstrated the significantly higher activity of SWS GPx and SOD, as well as elevated concentrations of UA and albumin in NWS and SWS of CKD children vs. the control group. TAC, TOS and OSI were significantly higher only in SWS, while oxidative damage products (AGE, AOPP and MDA) were significantly higher in both NWS and SWS of CKD children. ROC analysis showed a considerably high diagnostic value of AOPP in both NWS and SWS of CKD children compared to controls (AUC = 0.92; 0.98). CKD is responsible for disturbances in salivary antioxidant systems and oxidative damage to proteins and lipids. Salivary AOPP can be a potential biomarker of CKD in children.


Author(s):  
M. Kolesnyk ◽  
L. Korol ◽  
L. Migal ◽  
O. Burdeyna ◽  
V. Novakivskyy

The object was to study the effect of oxidative factors and methods of renal replacement therapy (RRT) on indices of oxidative stress (OS) and resistance cells in blood in patients with chronic kidney disease stage V(CKD VD) and anemic syndrome. Material and methods. The study involved 47 patients with CKD VD: 14patients were treated by hemodiafiltration (HDF), 14 patients by hemodialysis (HD) and 19 patients by peritoneal dialysis (PD). The severity ofanemia was assessed according to the KDIGO (2012) criteria. The control group consisted of30 healthy people of the same age and sex. Along with the standard diagnostic methods, we defined the content of malonic dialdehyde in serum (MDAs) and in erythrocytes (MDAe), the content of ceruloplasmin (CPs), transferrin (TRs) and SH - groups in the blood serum, the index of the OS (IOS), catalase activity in serum (CTs), glucose - 6 - phosphate dehydrogenase (G - 6 - PDHe) and total peroxidase activity (TPA) in erythrocyte, osmotic (OR) and peroxide resistance (PR) of red blood cells and erythrocyte membrane permeability (EMP). Statistical analysis was performed using the programs Microsoft Excel 5,0 and MedStat. Results. It has been stated that in the CKD VD patients agains the rates in control group the MDAs content increased by 3.3 times and MDAe - 1.2 times, TRs content reduced by 34%, SH - groups - by 31%, TPAe - by 41% and G - 6 - FDGe - by 58%, marcers of OR by 30%, PR - by 60%; 4.6 times increased CTs activity and OSI; 2 times grew peroxide hemolysis (PH) and 1.3 times - EMP. The analysis (depending on the RRT modality) showed that the patients treated by HDF had typical MDAs increase by 3.9 times on a background of CPs by 24%o, TRs - 33%, SH - groups - 25%, TPAe - 51%, G6 - PDHe - 42%; the increase in serum OSI - 5.4 times and 2.6 times in erythrocytes, PR - by 3.6 times and CTs activity by 3,5 times; HD group were characterized by the highest value of MDAe, OSI, PH and CTs, along with more expressed decrease of indices TRs, SH - groups, TPA and G - 6 - FDHe activity compared with rates in patients with HDF. The patients treated with PD had the lowest content of MDAs and the highest values on the background ofTPAe, the significant increase of CPs by 1.7 times and lowest TRs and G - 6 - PDHe. The patients with PD showed twice lower OS activity by OSI. Conclusion.Thus, in patients with CKD VD, who had HD, HDF or PD an anemic syndrome was associated with high OS activity and the increased degree of hemolysis. These changes are stipulated by RRT methods: for patients receiving HDF were typical the lowest rates of hemolysis and the highest degree of protection for erythrocytes, and for patients treated with HD - the highest OS.


2010 ◽  
Vol 1 (3) ◽  
pp. 146
Author(s):  
MOCHAMMAD THAHA ◽  
Widodo Widodo ◽  
Moh. Yogiantoro ◽  
WENNY PUTRI NILAMSARI ◽  
MOCHAMAD YUSUF ◽  
...  

Background: Uremic patients are in a pro-oxidant state and show an increased level of asymmetric dimethylarginine (ADMA), which is due to increased PRMT1 activity and reduced dimethylarginine dimethylaminohydrolase (DDAH) as degradation enzymes. Reactive oxidant species may play an important role in increasing the action of PRMT1 and in inhibiting the action of DDAH. Albuminuria and ADMA are closely correlated with progression of cardiovascular disease in chronic kidney disease (CKD) patients as well as indicators for decreasing renal function. Although ACEIs and/or ARBs reduced albuminuria in CKD patients, the results are still conflicting. Several factors in these patients may play important roles in the mechanism of albuminuria such as oxidative stress. The antioxidant N-acetylcysteine may prove to have beneficial therapeutic effect, because it can reduce oxidative stress as shown by evidence in humans, and subsequently increase ADMA. The objective of the present study is to explore the contribution of the antioxidant N-acetylcysteine (NAC) to the decrease of ADMA and albuminuria in non-diabetic CKD patients. Material and Methods: Patients with non-DM CKD stage 1–4 with albuminuria were randomized to receive ACEI and/or ARB alone (control group) or with antioxidant NAC 600 mg orally twice a day (treatment group). Observations were performed for 3 months to measure ADMA and albuminuria before and after-treatment. 80 patients in total 40 in the control group and 40 in the treatment group were used. Results: After oral treatment with NAC, the plasma level of ADMA in the treatment group increased from 0.604 µmol/l to 0.689 µmol/l, whereas ADMA level in the control group exhibited a higher increase from 0.561 µmol/l to 0.743 µmol/l. The increases in these groups were significantly different (p < 0.02). Moreover, the level of albuminuria was reduced from 148.12 µg/mg • cr to 132.7 µg/mg • cr in the treatment group, and from 75.25 µg/mg • cr to 71.85 µg/mg • cr in the control group. The difference was significant (p < 0.001). Conclusion: The anti-oxidant N-acetylcysteine can be used as adjuvant therapy to inhibit the progression of CKD in patients by decreasing the ADMA level and albuminuria.


2018 ◽  
Vol 21 (6) ◽  
pp. 465-474 ◽  
Author(s):  
Emanuela Valle ◽  
Liviana Prola ◽  
Diana Vergnano ◽  
Roberta Borghi ◽  
Fiammetta Monacelli ◽  
...  

Objectives Cats are commonly affected by chronic kidney disease (CKD). Many reactive carbonyl intermediates and end products originating from the oxidative stress pathways are recognised as uraemic toxins and may play a role in CKD progression. The aim of the present study is to confirm whether carbonyl end-product formation is higher in cats affected by CKD and to assess whether an angiotensin-converting enzyme inhibitor (ACEi) might affect these hallmarks. Methods Twenty-two cats were divided into three groups: a control group (CG), cats with CKD and cats with CKD treated with an ACEi. Serum levels of pentosidine, carboxymethyllysine, advanced oxidation protein products, malondialdehyde, methylglyoxal and hexanoyl-lysine were measured. In addition, biochemical parameters and systolic blood pressure were evaluated. After checking for normality, comparisons between groups were performed followed by multiple comparison tests. P values ⩽0.05 were considered significant. Correlations between concentrations of the considered biomarkers and of the other metabolic parameters were investigated. Results Advanced oxidation protein products, malondialdehyde and hexanoyl-lysine concentrations were significantly higher in CKD and ACEi-treated groups compared with the CG ( P <0.05). Carboxymethyllysine increased in the ACEi-treated group when compared with the CG, whereas intermediate values of these biomarkers were found in the CKD group ( P <0.05). The ACEi-treated group showed the highest values of carboxymethyllysine, advanced oxidation protein products and hexanoyl-lysine. By contrast, the CKD group had the highest concentration of malondialdehyde. No statistically significant difference was found in the levels of pentosidine or methylglyoxal. End products correlated with creatinine and urea and with each other. Conclusions and relevance Significantly high concentrations of both intermediate and end products of carbonyl/oxidative stress were detected in CKD cats. This is the first study to have concurrently taken into account several uraemic toxins and biochemical parameters in cats affected by CKD.


2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S154-S154
Author(s):  
A S Boraik ◽  
M Abdelmonem ◽  
M Shedid ◽  
H M Abd Elaal ◽  
A Elhusseny ◽  
...  

Abstract Introduction/Objective Chronic kidney disease (CKD) is affecting about 14% of the general population. CKD is associated with a decrease in calcium level in the body. In the early stages of (CKD), dialysis may not be needed. The late stages of CKD will require dialysis or a kidney transplant to save a life. Secondary hyperparathyroidism is a crucial disorder in CKD patients. It explains why the illness causes a significant change in bone and mineral metabolism. This study aims to study renal hyperparathyroidism (rHPT) in dialysis patients with late-stage of chronic kidney disease (CKD). Methods/Case Report A total of 55 subjects were enrolled in this study for late-stage dialysis patients from Egypt. Serum creatinine and PTH levels were measured. Among the 55 subjects; 41 subjects (74.5%) were males, 14 subjects (25.5%) were females with a mean age of 52.7 and 34.3 years for males and females, respectively. Subjects were divided into two groups; Study group I consists of 33 dialysis patients; three patients were females (9%) while 30 patients were males (91%), and control group II consists of 22 healthy individuals, 11 subjects were females (50%), and 11 subjects were males (50%). Results (if a Case Study enter NA) In our study, in comparison between two groups as regards blood investigations. The means of creatinine and PTH in the study group I were 8.93 mg/dl and 316.8, while in the control group II were 0.9, and 38.4 respectively. Comparing the two groups shows that mean of Creatinine and PTH in the study group was statistically significantly higher than the control group (p-value less than 0.001). Conclusion In patients with CKD, accurate measurement of (PTH) is critical for treatment decision-making to reduce the risk of bone and cardiovascular diseases. We recommend that patients with diabetes and high blood pressure be aware that they must take their medications consistently to avoid kidney problems.


Author(s):  
Andressa Keiko Matsumoto ◽  
Michael Maes ◽  
Ana Paula Michelin ◽  
Abel Esteves Soares ◽  
Laura de Oliveira Semeão ◽  
...  

Abstract Introduction: The progressive decline in 25-hydroxyvitamin D [25(OH)D] in chronic kidney disease (CKD) limits the kidney ability of synthesizing the vitamin. Vitamin D deficiency as defined by KDIGO (25(OH)D <20 ng/mL) is prevalent in CKD patients and associated to oxidative stress (OS). We studied a possible association between vitamin D deficiency and OS in pre-dialysis patients. Methods: A cross-sectional study with 206 CKD patients was carried out. Laboratory tests for 25(OH)D, 1,25(OH)2D, inflammatory markers, and OS were added to routine tests including creatinine, albumin, calcium, phosphorus, alkaline phosphatase, iPTH, glucose, hemoglobin, uric acid, total cholesterol, LDL, HDL, and triglycerides. Results: Vitamin D deficiency was present in 55 CKD patients and normal vitamin D levels were seen in 149 patients. There was a significant association between vitamin D and estimated glomerular filtration rate (eGRF). Homocysteine levels were best predicted by eGRF, sex, and age; high sensitivity C-reactive protein (hsCRP) by staging and BMI; nitric oxide metabolites (NOx) were increased in late disease; leptin was influenced by BMI and higher in women than man; and adiponectin levels were higher in women. Conclusions: OS biomarkers were not correlated with vitamin D deficiency but increased NOx were seen in stages 4-5 CKD patients. Even though a relatively large number of CKD patients was included and a broad number of OS and inflammatory biomarkers were used in this studied we failed to find an association between vitamin D levels and eGRF. More studies are needed to evaluate the influence of vitamin D status in OS in pre-dialysis CKD patients.


Author(s):  
B. Buyukaydin ◽  
A.T. Isik ◽  
P. Soysal ◽  
M. Alay ◽  
R. Kazancioglu

Objective: Chronic kidney disease and malnutrition are serious and frequently encountered co-morbidities among older patients. We evaluated nutritional status of older pre-dialysis patients and the effect of malnutrition on length of stay (LOS) in hospital. Materials and Methods: 65 years and over 33 hospitalized pre-dialysis patients with glomerular filtration rate between 10-30ml/min/1.73m2 were included. There is no control group. For all patients, biochemical analysis was performed. The malnutrition risk was evaluated with Mini Nutritional Assessment Short-Form (MNA-SF) and Geriatric Nutritional Risk Index (GNRI) and LOS in hospital was recorded. Results: Mean GNRI was 98.4±12.9 and the mean MNA-SF was 8±3.15. For all patients, mean LOS was 10.58±9 days. According to MNA-SF, malnourished patients’ LOS was longer and a difference was observed between MNA-SF and GNRI in terms of LOS prediction (p=0.005, p=0.230). Conclusion: For older pre-dialysis patients, MNA-SF is probably a more sensitive index in terms of LOS in hospital prediction.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ling Li ◽  
Ya-Li Zhang ◽  
Xing-Yu Liu ◽  
Xiang Meng ◽  
Rong-Quan Zhao ◽  
...  

Periodontitis is a type of systemic immune inflammation that is caused by the complex infection of a variety of microorganisms in the subgingival plaque and the imbalance of the microbial ecological environment in the mouth. Periodontitis and chronic kidney disease (CKD) share many risk factors, such as obesity, smoking, and age. A growing body of data supports a strong correlation between periodontitis and kidney disease. Evidence supports the role of periodontal inflammation and elevated serum inflammatory mediators in renal atherosclerosis, renal deterioration, and end-stage renal disease (ESRD) development. Periodontitis is a risk factor for kidney disease. However, to our knowledge, there are few studies detailing the possible link between periodontitis and CKD. This review summarizes the possible mechanisms underlying periodontitis and CKD. More importantly, it highlights novel and potential pathogenic factors for CKD, including bacteria, pro-inflammatory mediators and oxidative stress. However, most research on the relationship between periodontitis and systemic disease has not determined causality, and these diseases are largely linked by bidirectional associations. Future research will focus on exploring these links to contribute to new treatments for CKD.


2009 ◽  
Vol 29 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Danuta Zwolińska ◽  
Wladyslaw Grzeszczak ◽  
Maria Szczepańska ◽  
Irena Makulska ◽  
Katarzyna Kiliś–Pstrusińska ◽  
...  

Objectives Enhanced oxidative stress has been observed in dialysis and predialysis adult patients with chronic kidney disease (CKD), which resulted in increased mortality and morbidity within this population. Not much attention in the literature has been paid to nonenzymatic antioxidant defense in children with CKD on peritoneal dialysis (PD). The aim of the present study was to describe the plasma, erythrocyte, and dialysate concentrations of oxidized (GSSG) and reduced glutathione (GSH) and vitamins A, E, and C in a pediatric PD population. Patients 10 children on PD and 27 age-matched healthy subjects were enrolled in the study. Results Erythrocyte and plasma GSH concentrations were lower in PD patients, erythrocyte concentration of GSSG remained unchanged, and plasma GSSG was significantly higher in children on PD. Children on PD exhibited decreased plasma concentrations of antioxidant vitamins compared to healthy subjects. Moreover, we documented loss of vitamins A, E, and C into ultrafiltrate. Conclusion Such low plasma levels of vitamins A, E, and C and simultaneously decreased activity of erythrocyte GSH may be responsible for the increased oxidative stress occurring in children with CKD on PD.


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