Hippokratia 2004; 8(4):170-172
D Yonova, , Trendafilov, V Papazov, I Stanchen, R Zidarov, S Antonov
Clinic of Nephrology, Medican University Hospital "Alexandrovska", Sofia, Bulgaria
Background: Two general types of extrarenal depuration are used in patients with terminal uremia - peritoneal dialysis (CAPD) and hemodialysis (HD). All uremic patients are exposed to oxidative stress, due to uremia "per se" and some artificial materials are suspected as well, but not surely proved.
Material and methods: The study compares some plasma markers of oxidative stress in 22 patients on CAPD (1st group) ( 12 males and 10 females) and 22 HD patients (2nd group), (12 males and 10 females) more than 24 months on dialysis: MDA and oxidized LDL (ELISA) and, of antioxidant activity: enzymatic - glutathione peroxidase (GPx) (enzymatic assay): and non-enzymatic factors: vitamin E and vitamin C (HPLC). All patients -non-diabetic and without peritonitis - were tested for above mentioned biochemical markers (before HD for the 2nd group).
Results: The existence of oxidative stress was proved to be in both groups. CAPD patients had lower levels of markers of oxidative stress (NS) and significantly higher antioxidant activity for vitamin E and GPx (p < 0.01 and p < 0.01 respectively) compared to patients in HD group. The measured values for 1st / 2nd group were: MDA 6.01±0.33 ??mol / l versus 6.21±0.23 ??mol / l (p: NS); oxidized LDL 350 ±230 mU / ml versus 366±252 mU / ml (p: NS); GPx 18.8± 5.8 ??moll / Hb versus 14.8±4.7 ??mol / Hb (p < 0.01) and vitamin E 24.7±4.4 ??mol / 1 versus 20.8±5.3 ??mol / l (p < 0.01); vitamin C 52.12±26.2 ??mol / l versus 50.2±25.6 ??mol / 1 (p: NS).
Conclusion The findings suggest that uremia is playing the main role in oxidative damages even in dialysis faze of chronic renal failure, but CAPD seems to be slightly more bio -compatible than conventional HD, probably because of the greater number of artificial materials used in the latter. In conclusion dialysis patients more or less need some kind of antioxidant treatment in both dialysis procedures - CAPD or HD despite CAPD has some advantages.
Keywords: haemodialysis, peritoneal dialysis, oxidative stress