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Nephrol Dial Transplant (2001) 16: 574-579
© 2001 European Renal Association-European Dialysis and Transplant Association

Dehydroascorbic acid and oxidative stress in haemodialysis patients

Hidetsugu Nakayama,, Shinichiro Akiyama, Masahiro Inagaki1, Yoshiaki Gotoh and Katsuji Oguchi1

Department of Renal Medicine, Saiyu Soka Hospital, 1-21-37 Kitaya, Soka City, Saitama 340-0076 and 1 Department of Pharmacology, School of Medicine, Showa University, 1-5-8 Shinagawa-ku, Tokyo 142-8555, Japan

Background. The amount of dehydroascorbic acid contained within total ascorbic acid (oxidized as well as non-oxidized forms) in plasma, hereafter referred to as the dehydroascorbic acid fraction, may be a measure of oxidative stress during haemodialysis. In the present study, we determined this fraction in chronic haemodialysis patients.

Methods. Using high performance liquid chromatography, dehydroascorbic acid and total ascorbic acid levels were measured in 80 maintenance haemodialysis patients for a period of >2 years as well as in 49 controls, to examine a possible association of these compounds with clinical parameters and/or drugs taken by the patients.

Results. Dialysis patients who had an increased plasma urate level (P<0.05) and had been taking allopurinol (P<0.05) or NSAID (non-steroid anti-inflammatory drugs) (P<0.01), and dialysis patients who were younger (<=55 years), as compared with older dialysis patients (P<0.01), were found to have a lower dehydroascorbic acid fraction by multivariate analysis. Mean plasma dehydroascorbic acid levels and dehydroascorbic acid fractions were significantly lower in the younger haemodialysis patients (4.8±0.7 µmol/l and 28.4±3.9%) than in healthy younger controls (13.3±1.1 µmol/l and 41.1±1.8%) (P<0.0001 and P<0.01, respectively). Moreover, a correlation was found between plasma dehydroascorbic acid fraction and plasma lipid peroxide (r=0.66, P<0.01) in patients who had not been taking allopurinol and/or NSAID.

Conclusion. We found that dehydroascorbic acid fraction was related to patients' age, plasma urate level and to taking allopurinol or NSAID. Dehydroascorbic acid fraction may be another indirect index of oxidative stress.

Keywords: ascorbic acid; dehydroascorbic acid; haemodialysis

Present affiliation: H. Nakayama, Tsukuba Medical Center Hospital (Ibaraki Cancer Center Hospital) Division of Radiation Oncology, 1-3-1 Amakubo, Tsukuba City, Ibaraki 305-0005, Japan.

Correspondence and offprint requests to: H. Nakayama, Tsukuba Medical Center Hospital (Ibaraki Cancer Center Hospital), 1-3-1 Amakubo, Tsukuba City, Ibaraki 305-0005, Japan.


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