OXIDATIVE STRESS IN HEMODIALYSIS

Patients with chronic renal failure, including those receiving regular long-term haemodialysis, have a high incidence of premature cardiovas cular disease. Oxidative stress, which occurs when there is excessive free-radical production or low antioxidant levels, has recently been i mplicated as a causative factor in atherogenesis. The aim of this stud y was to determine if chronic renal failure and haemodialysis were ass ociated with increased oxidative stress. Serum malondialdehyde was mea sured as a marker of lipid peroxidation in 15 patients with conservati vely managed chronic renal failure (CRF), 15 patients with CRF undergo ing regular haemodialysis and 15 healthy controls. Selenium, glutathio ne peroxidase and antioxidant vitamins were also measured. Malondialde hyde was elevated in dialysis patients in comparison to CRF and contro l groups (dialysis 1.16 +/- 0.08 mu mol/l, CRF 0.94 +/- 0.07, controls 0.66 +/- 0.10). Antioxidants, including vitamin C, selenium and gluta thione peroxidase, were decreased in dialysis patients and to a lesser extent in the CRF group (vitamin C-dialysis 16.43 +/- 3.76 mu mol/l, CRF 34.5 +/- 8.6, controls 56.11 +/- 7.41; selenium-dialysis 0.77 +/- 0.07 mu mol/l, CRF 0.69 +/- 0.06, controls 1.09 +/- 0.06: glutathione peroxidase-dialysis 101 +/- 5 U/l, CRF 160 +/- 11, controls 290 +/- 10 ). These findings indicate oxidative stress in patients with CRF which is further exacerbated by haemodialysis, as evidenced by increased li pid peroxidation and low antioxidant levels. This stress may play a ro le in the development of atherosclerosis in these groups.