LIPID-PEROXIDATION AND ANTIOXIDANT ACTIVITY IN CHRONIC-HEMODIALYSIS PATIENTS TREATED WITH RECOMBINANT-HUMAN-ERYTHROPOIETIN

In anaemia of chronic renal failure, the most important factor in the shortened erythrocyte survival may be lipid peroxidation of the cell m embrane. Defective antioxidant activity may increase this damage. Alth ough recombinant human erythropoietin (r-HuEPO) can effectively correc t anaemia in chronic haemodialysis patients, its actions on lipid pero xidation and antioxidant activity are not clear. These actions were in vestigated in 13 patients undergoing chronic haemodialysis. Antioxidan t activity, including red blood cell superoxide dismutase and total gl utathione peroxidase levels and the lipid peroxidation product malondi aldehyde, were measured before and 3 months after initiation of r-HuEP O treatment, using heparinized venous whole blood for cell and plasma determinations. Age-matched healthy volunteers were controls. Signific antly higher levels of superoxide dismutase and total glutathione pero xidase were found in the patients than in the controls p < 0.01). Plas ma malondialdehyde levels were not affected by r-HuEPO. The results ar e explained by erythropoiesis and cellular haemoglobin synthesis due t o r-HuEPO, followed by increase of circulating young red cells. The me mbranes of these young cells contain more antioxidant enzymes than the others. Despite r-HuEPO treatment, plasma malondialdehyde levels in h aemodialysis patients may be higher than normal because of the uraemic milieu and the chronic haemodialysis.