THE ROLE OF THE OXIDATIVE STATE OF GLUTATHIONE AND GLUTATHIONE-RELATED ENZYMES IN ANEMIA OF HEMODIALYSIS-PATIENTS

Objective: To investigate the oxidative state of glutathione and gluta thione peroxidase (GSH-Px), glutathione reductase (GSSG-R), and glucos e-6-phosphate dehydrogenase (G-6-PD) revels in patients with chronic r enal failure (CRF) and controls. Results: Erythrocyte GSH levels of pa tients were decreased, but GSSG was not significantly different from t hat of controls. Also, plasma GSH levels were not different, although GSSG was increased. GSSG/GSH ratios in erythrocyte and plasma were sig nificantly higher in CRF patients. Erythrocyte GSSG-R activity was hig h, but G-6-PD and GPX were low. Conclusions: The findings suggest that : 1. Low GSH is related to decreased G-6-PD activities. 2. The reducti on of peroxides with GPX are decreased by low GSH and low GPX activity . 3. GSSG may react with hemoglobin and causes protein aggregation in erythrocytes. These alterations cause hemolysis and could play a role in the pathogenesis of anemia in hemodialyzed patients.