Nephrology Dialysis Transplantation, Vol 13, Issue 10 2594-2600, Copyright © 1998 by Oxford University Press
P Stenvinkel, I Holmberg, O Heimburger and U Diczfalusy
Background. The incidence of premature cardiovascular
disease is high in patients with chronic renal failure (CRF).
Free-radical-induced tissue damage is thought to play a major role in the
pathogenesis of atherosclerosis and several reports indicate increased
oxidative stress in patients with CRF. However, the cause of such stress in
CRF is not exactly known. Plasmalogens, a group of phospholipids with a
vinyl ether bond in the sn-1 position, are supposed to be sensitive markers
of oxidative stress. Methods. The fasting relative
plasmalogen levels of erythrocyte membranes (DMA 16/C16:0 and DMA
18/C18:0), as well as of vitamin E and serum lipids, were determined in a
cohort of 105 patients (mean age 51±2 years) with advanced CRF
(creatinine clearance 9±1 ml/min) before starting dialysis
treatment. Twenty-nine healthy controls (47±2 years) were also
investigated. Results. Significantly lower relative
plasmalogen levels (DMA 16/C16:0 and DMA 18/C18:0) were found in
erythrocytes of predialysis patients than in controls. When the patients
were divided on the basis of subjective global assessment of nutritional
status (SGA), the malnourished patients (SGA 2-4) had significantly
(P<0.05) lower relative plasmalogen levels than
the well-nourished predialysis patients (SGA 1). In the prospective part of
the study, we found that a 12-month dialysis treatment in 38 patients was
associated with significant increases in both erythrocyte DMA 16/C16:0
(P<0.001) and DMA18/C18:0
(P<0.05) ratios. Conclusion.
The present results suggest that predialysis patients are
exposed to an augmented oxidative stress which is partially reversed by 12
months of dialysis treatment. The present study also demonstrates lower
relative plasmalogen levels in erythrocyte membranes in malnourished than
in well-nourished predialysis patients. One could speculate that an
increased oxidative stress may be a factor contributing to the high
prevalence of cardiovascular disease documented in malnourished CRF
patients. Keywords: oxidative stress; phospholipid
plasmalogens; malnutrition; chronic renal failure; dialysis treatment
ORIGINAL ARTICLES
A study of plasmalogen as an index of oxidative stress in patients with chronic renal failure. Evidence of increased oxidative stress in malnourished patients
Departments of Renal Medicine and Clinical Chemistry, K56, Huddinge University Hospital, S-141 86 Huddinge, Sweden; Corresponding author
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