Nephrology Dialysis Transplantation, Vol 12, Issue 7 1399-1405, Copyright © 1997 by Oxford University Press
D Bonnefont-Rousselot, MC Jaudon, B Issad, P Cacoub, F Congy, C Jardel, J Delattre and C Jacobs
BACKGROUND: An oxidative stress has been reported in patients with chronic
renal failure (CRF) treated by haemodialysis. To our knowledge, only scant
information is available concerning CRF patients treated by continuous
ambulatory peritoneal dialysis (CAPD) with regard to their redox and
nutritional status. METHODS: The oxidative stress and the biological
nutritional status were evaluated in 20 elderly CRF patients treated by
CAPD, compared with a control group of 30 elderly non-CRF patients. Plasma
peroxidation products were assayed as thiobarbituric acid-reactive
substances (TBARS), and two enzymatic antioxidant systems were determined:
erythrocyte superoxide dismutase (SOD), glutathione peroxidase activity in
plasma (P-GSH-Px) and in erythrocytes (E-GSH- Px). Selenium, vitamin E,
beta-carotene and vitamin A were evaluated as plasma non-enzymatic
antioxidants. Nutritional status and iron status were assessed by
determining serum albumin, prealbumin, iron, ferritin and transferrin
concentrations. RESULTS: Plasma TBARS concentration was high in both groups
(CAPD: 1.37 +/- 0.06 mumol/l versus non-CRF: 1.41 +/- 0.06 mumol/l; P =
NS), compared with usual values (0.60 to 1.20 mumol/l), on account of the
patients' ages. SOD and E-GSH-Px activities were normal in both groups. A
significant lowering in P-GSH-Px activity was observed only in CAPD
patients (211 +/- 14 U/l, usual values: 480 to 650 U/l). Plasma selenium
concentration, decreased in both groups, was significantly lower in CAPD
than in non-CRF patients (P < 0.01). Plasma vitamin E, beta-carotene and
vitamin A concentrations were significantly enhanced only in CAPD patients
(P < 0.0001, P < 0.005 and P < 0.0001, respectively. Biological
nutritional markers were similar in both groups and within usual values.
CONCLUSIONS: This study demonstrated the existence of an oxidative stress
in CAPD-treated elderly CRF patients, evidenced by a decrease in plasma
selenium levels and in P-GSH-Px activity. However, plasma TBARS were not
higher in CAPD patients than in age-matched non-CRF control subjects,
probably on account on the patients' ages.
ORIGINAL ARTICLES
Antioxidant status of elderly chronic renal patients treated by continuous ambulatory peritoneal dialysis
Laboratoire de Biochimie, Groupe Hospitalier Pitie-Salpetriere, Paris, France.
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