Oxidative stress during hemodialysis: Effect of heparin

Background. Patients on chronic hemodialysis (IID) are exposed to oxidative stress. An I-ID session is used in this study as an in vivo model fur stud ying the influence of heparin on oxidative stress caused partially by activ ated peripheral blood polymorphonuclear leukocytes (PMNLs) during a I-ID se ssion. Methods. Each patient underwent HD once with and once without heparin. Oxid ative stress was determined by evaluating both the rate of superoxide relea se from phorbol 12-myristate: 13-acetate (PMA)-stimulated PMNLs and plasma levels of oxidized glutathione (GSSG), both measured before and after the d ialysis session. Results. In vitro, heparin reduced the rate of superoxide release from sepa rated PMA-stimulated PMNLs. In vivo, the rate of superoxide release from PM NLs was always increased after the dialysis session, regardless of the pres ence of heparin. However, in the presence of heparin, this increase was sig nificantly smaller. The augmentation in the rate of superoxide release afte r the dialysis session without heparin was accompanied by a significant ele vation of GSSG, reflecting a preceding oxidation of plasma glutathione. Conclusions. The increase in both parameters. the rate of superoxide releas e, and the plasma GSSG concentration after HD treatment suggest that hepari n in vivo alleviates the oxidative stress induced by the dialysis process. Based on our results, heparin should be the anticoagulant of choice because of its suppressant action on IID-induced oxidative stress.