OXIDATIVE STRESS IN THE PATIENTS WITH CKD V STAGE AND ANEMIA WHO RECEIVE REPLACEMENT HEMODIALYSIS THARAPY

Abstract

The article presents research data of oxidative stress role in the pathogenesis of anemia in patients with CKD V stage, who receive hemodialysis replacement therapy. Background. Oxidative stress is a part of the pathogenesis of many complications in patients with CKD stage V on replacement therapy with hemodialysis. Anemia syndrome is the most frequent complication of this patient`s population. Aim. The aim of this study was to study indicators of oxidative stress in patients with CKD stage V and anemia on replacement therapy with hemodialysis. Materials and methods. We studied laboratory parameters in 42 hemodialysis patients with CKD V stage. Biochemical methods are used for investigation of lipid peroxidation processes: studied diene conjugates (DC), malondialdehyde (MDA), total lipids and catalase, lipid’s structure of erythrocytes membranes and their osmotic resistance. Results. We found that in dialysis patients anemic syndrome was associated with high activity of oxidative stress. Also increased destruction of red blood cells depends from high activity of oxidative stress. In the blood of the patients concentration of DC was 1,12±0,26 opt.den.units/ mg of lipids (p<0,01), and MDA level 0,35±0,05 opt.den.units/ mg of lipids (p<0,01). Levels of catalase, decreased to 0,029±0,0019 mm/l*sec (p<0,001). Also osmotic resistance of erythrocytes significantly decreased. MDA has inverse correlation relationship with hemoglobin in the blood, with a correlation coefficient r=-0,36. Investigation of erythrocyte membrane lipid structure of patients by TLC showed a significant decrease of phospholipids and monoglycerides of higher fatty acids, and the increase of cholesterol fractions. Conclusions. In patients with chronic kidney disease on dialysis replacement therapy anemic syndrome is associated with high activity of oxidative stress, as there is an inverse relationship between the level of hemoglobin and the content of MDA in blood. As a consequence of oxidative stress changes the lipid composition of erythrocyte membranes of the patient, because some fraction of lipids are substrates for oxidative processes. Impairment of lipid membranes of red blood cells of hemodialysis patients is one of the probably causes of anemia.

Keywords

• chronic kidney disease, dialysis, anemia, oxidative stress