Nephrology Dialysis Transplantation, Vol 13, Issue 10 2583-2587, Copyright © 1998 by Oxford University Press
O Sommerburg, T Grune, H Hampl, E Riedel, P van Kuijk, J Ehrich and W Siems
Background. Patients with end-stage renal failure
undergoing haemodialysis (HD) are exposed to oxidative stress. Increased
levels of malondialdehyde (MDA) were demonstrated in plasma of uraemic
patients, indicating accelerated lipid peroxidation (LPO) as a consequence
of multiple pathogenetic factors. The aim of our investigation was to
examine the role of renal anaemia in oxidative stress in HD patients.
Methods. MDA and 4-hydroxynonenal (HNE) were measured
in three groups of patients undergoing HD: group I comprised eight patients
with a blood haemoglobin (Hb) <10 g/dl (mean Hb=8.1±1.3
g/dl), and group II were eight patients with a Hb <10 g/dl (mean
Hb=12.4±1.9 g/dl); none of these 16 patients had been treated
with human recombinant erythropoietin (rHuEpo). Group III comprised 27
patients with a mean Hb of 10.5±1.6 g/dl after long-term rHuEpo
treatment. Results. Mean plasma concentrations of both
MDA and HNE were significantly higher
(P<0.0001) in all 43 HD patients than in 20
healthy controls (MDA 2.85±0.25 vs
0.37± &mgr;M, HNE 0.32± vs
0.10±0.01 &mgr;M). Comprising the three groups, it was shown
that HD patients with a Hb <10 g/dl had significantly higher plasma
levels of LPO products (MDA 3.81±0.86 &mgr;M, HNE
0.45±0.07 &mgr;M) than HD patients with a Hb > 10
g/dl (MDA 2.77±0.58 &mgr;M, HNE 0.25±0.05
&mgr;M), and than HD patients treated with rHuEpo (MDA
2.50±0.12 &mgr;M, HNE 0.29±0.03 &mgr;M).
Furthermore, an inverse correlation between plasma concentration of LPO
products and haemoglobin levels was seen (r=0.62,
P<0.0001). Conclusion.
Radical generation in HD patients might be caused in part by
renal anemia itself. Treatment with rHuEpo may decrease radical generation
effectively in HD patients due to the increase in the number of red blood
cells and blood haemoglobin concentration. Keywords:
erythropoietin; haemodialysis; HNE; lipid peroxidation; MDA;
renal anaemia
ORIGINAL ARTICLES
Does long-term treatment of renal anaemia with recombinant erythropoietin influence oxidative stress in haemodialysed patients?
Paediatric Nephrology and Department of Physical Therapy and Rehabilitation, Charite Hospital, Schumannstrasse 20/21, 10098 Berlin, Germany; Department of Nephrology and Department of Chemistry, Free University of Berlin, Limonenstrasse 7, 10456 Berlin, Germany; Herzog Julius Hospital, Kurhausstrasse 13-17, 38655 Bad Harzburg, Germany; University of Texas Medical Branch, Medical Research Building 7-150, Galveston, TX 77555-1067, USA; Corresponding author address: Children's Hospital, University of Heidelberg Medical School, Im Neuenheimer Feld 150, D-69120 Heidelberg, Germany
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