scholarly journals Effect of α-Lipoic Acid on Oxidative Stress in End-Stage Renal Disease Patients Receiving Intravenous Iron

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Arif Showkat ◽  
William R. Bastnagel ◽  
Joanna Q. Hudson
Keyword(s):  
Oxidative Stress ◽  
Renal Disease ◽  
Lipoic Acid ◽  
End Stage Renal Disease ◽  
Transferrin Saturation ◽  
Lipid Hydroperoxide ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Oxidative stress is associated with increased risk of cardiovascular disease in end-stage renal disease (ESRD) patients. Intravenous (IV) iron has been shown to increase oxidative stress. The aim of the study was to evaluate changes in oxidative stress markers following administration of IV sodium ferric gluconate (SFG) to ESRD patients with and without administration of the antioxidant, α-lipoic acid. This is an open-label, crossover study. 125 mg of IV SFG was administered during control (C) and intervention (I) visits. During the I visit, 600 mg of α-lipoic acid was given orally prior to IV SFG. Blood samples were collected at defined time periods for F2-isoprostane (FIP), lipid hydroperoxide (LHP), malondialdehyde (MDA), and iron indices. We recruited ten African-American ESRD subjects: 50% male; mean age 45±9 years; mean hemoglobin 13±1 g/dL; ferritin 449±145 ng/mL; transferrin saturation 27±4%. There were no significant differences in iron indices between the two visits after IV SFG. MDA, FIP, and LHP increased significantly for both C and I visits with a greater increase in the I group. Administration of IV SFG results in an acute rise in oxidative stress in ESRD patients. In contrast to previous studies, administration of α-lipoic acid was associated with a greater increase in oxidative stress.

Could Antioxidant Supplementation Delay Progression of Cardiovascular Disease in End-Stage Renal Disease Patients?

2020 ◽  
Vol 19 (1) ◽  
pp. 41-54 ◽  
Author(s):  
Stefanos Roumeliotis ◽  
Athanasios Roumeliotis ◽  
Xenia Gorny ◽  
Peter R. Mertens
Keyword(s):  
Oxidative Stress ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Close Association ◽  
Omega 3 ◽  
Endstage Renal Disease ◽  
Increased Risk ◽  
Underlying Mechanisms ◽  
Stage Renal Disease ◽  
End Stage

In end-stage renal disease patients, the leading causes of mortality are of cardiovascular (CV) origin. The underlying mechanisms are complex, given that sudden heart failure is more common than acute myocardial infarction. A contributing role of oxidative stress is postulated, which is increased even at early stages of chronic kidney disease, is gradually augmented in parallel to progression to endstage renal disease and is further accelerated by renal replacement therapy. Oxidative stress ensues when there is an imbalance between reactive pro-oxidants and physiologically occurring electron donating antioxidant defence systems. During the last decade, a close association of oxidative stress with accelerated atherosclerosis and increased risk for CV and all-cause mortality has been established. Lipid peroxidation has been identified as a trigger for endothelial dysfunction, the first step towards atherogenesis. In order to counteract the deleterious effects of free radicals and thereby ameliorate, or delay, CV disease, exogenous administration of antioxidants has been proposed. Here, we attempt to summarize existing data from studies that test antioxidants for CV protection, such as vitamins E and C, statins, omega-3 fatty acids and N-acetylcysteine.

scholarly journals Anticoagulation in Patients with End-Stage Renal Disease and Atrial Fibrillation: Confusion, Concerns and Consequences

2020 ◽  
Vol 22 (3) ◽  
pp. 306-316
Author(s):  
Narender Goel ◽  
Deepika Jain ◽  
Danny B. Haddad ◽  
Divya Shanbhogue
Keyword(s):  
Atrial Fibrillation ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Decision Making ◽  
Controlled Trial ◽  
Oral Anticoagulants ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

End-stage renal disease (ESRD) patients have a higher prevalence of diabetes mellitus, hypertension, congestive heart failure and advanced age, along with an increased incidence of non-valvular atrial fibrillation (AF), thereby increasing the risk for cerebrovascular accidents. Systemic anticoagulation is therefore recommended in patients with ESRD with AF to reduce the risk and complications from thromboembolism. Paradoxically, these patients are at an increased risk of bleeding due to great degree of platelet dysfunction and impaired interaction between platelet and endothelium. Currently, CHA2DS2-VASc and Hypertension, Abnormal liver/kidney function, Stroke, Bleeding, Labile INR, Elderly, Drugs or alcohol (HAS-BLED) are the recommended models for stroke risk stratification and bleeding risk assessment in patients with AF. There is conflicting data regarding benefits and risks of medications such as antiplatelet agents, warfarin and direct oral anticoagulants in ESRD patients with AF. Moreover, there is no randomized controlled trial data to guide the clinical decision making. Hence, a multi-disciplinary approach with annual re-evaluation of treatment goals and risk-benefit assessment has been recommended. In this article, we review the current recommendations with risks and benefits of anticoagulation in patients with ESRD with AF.

scholarly journals Apoprotein(A) Isoforms Risk Factors for Atherogenesis in Esrd Patients on Haemodialysis

2014 ◽  
Vol 68 (1) ◽  
pp. 16-20
Author(s):  
Danica Labudovic ◽  
Katerina Tosheska-Trajkovska ◽  
Sonja Alabakovska
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Renal Disease ◽  
Vascular Disease ◽  
End Stage Renal Disease ◽  
Relative Risks ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Introduction. End-stage renal disease (ESRD) patients undergoing hemodialysis are at an increased risk of arteriosclerotic vascular disease (ASVD). The increased risk is commonly attributed to the traditional risk factors related to ESRD. However, interest for more recent risk factors for ASVD, such as the level of lipoprotein(a) and its specific apoprotein(a) has been promoted. The aim of this paper is to determine whether apo(a) phenotype is a risk factor for arteriosclerotic vascular disease in ESRD patients who are on hemodialysis. Methods. Apo(a) phenotypisation was performed by using the Western Blot Technique of blood samples from 96 end-stage renal disease patients who were undergoing hemodialysis, and from 100 healthy individuals. Results. Frequency distribution of the basic apo(a) isoforms calculated by means of the χ2-test has shown that there was no significant statistical difference in distribution among patients on hemodialysis, and healthy carriers (χ2-0.36, p<0.548-for carriers of single apo(a) isoforms, (χ2-0.10, p<0.7545-for carriers of double apo(a) isoforms). The calculated relative risks have demonstrated that apo(a) phenotype was not a risk factor for ASVD in HD patients. Conclusion. Based on the results obtained, it can be concluded that the apo(a) phenotype is not a risk factor for arteriosclerotic vascular disease in patients undergoing hemodialysis.

scholarly journals Associations of Common Variants in HFE and TMPRSS6 Genes with Hepcidin-25 and Iron Status Parameters in Patients with End-Stage Renal Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Violeta Dopsaj ◽  
Aleksandra Topić ◽  
Miljan Savković ◽  
Neda Milinković ◽  
Ivana Novaković ◽  
...  
Keyword(s):  
Renal Disease ◽  
Diagnostic Accuracy ◽  
End Stage Renal Disease ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Control Group ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background. Influence of TMPRSS6 A736V and HFE (C282Y and H63D) polymorphisms on serum hepcidin-25 levels and iron status parameters in end-stage renal disease (ESRD) patients stratified according to gender has not been previously investigated. In addition, we aimed to evaluate the diagnostic accuracy of the parameters to separate iron-deficiency anemia (IDA) from anemia of chronic disease. Materials and Methods. Iron status parameters and genetic analysis were performed in 126 ESRD patients and in 31 IDA patients as the control group. Results. ESRD patients had significantly higher ferritin and hepcidin-25 (<0.001) relative to IDA patients. Cut-off values with the best diagnostic accuracy were found for hepcidin ≥9.32 ng/mL, ferritin ≥48.2 μg/L, transferrin saturation ≥16.8%, and MCV ≥81 fL. Interaction between gender and HFE haplotypes for the hepcidin-25 and ferritin levels in ESRD patients (p=0.005, partial eta squared=0.09; p=0.027, partial eta squared=0.06, respectively) was found. Serum transferrin was influenced by the combined effect of gender and TMPRSS6 A736V polymorphism in ESRD patients (p=0.002, partial eta squared=0.07). Conclusion. Our findings could contribute to the further investigation of mechanisms involved in the pathophysiology and important gender-related involvement of the TMPRSS6 and HFE polymorphisms on anemia in ESRD patients.

scholarly journals The risk factors associated with COVID-19-Related death among patients with end‐stage renal disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hadith Rastad ◽  
Hanieh-Sadat Ejtahed ◽  
Gita Shafiee ◽  
Anis Safari ◽  
Ehsan Shahrestanaki ◽  
...  
Keyword(s):  
Renal Disease ◽  
Hospital Mortality ◽  
Medical History ◽  
End Stage Renal Disease ◽  
Demographic Factors ◽  
Increased Risk ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background The extent to which patients with End-stage renal disease (ESRD) are at a higher risk of COVID-19-related death is still unclear. Therefore, the aim of this study was to identify the ESRD patients at increased risk of COVID-19 -related death and its associated factors. Methods This retrospective cohort study was conducted on 74 patients with ESRD and 446 patients without ESRD hospitalized for COVID-19 in Alborz province, Iran, from Feb 20 2020 to Apr 26 2020. Data on demographic factors, medical history, Covid-19- related symptoms, and blood tests were obtained from the medical records of patients with confirmed COVID-19. We fitted univariable and multivariable Cox regression models to assess the association of underlying condition ESRD with the COVID-19 in-hospital mortality. Results were presented as crude and adjusted Hazard Ratios (HRs) and 95% confidence intervals (CIs). In the ESRD subgroup, demographic factors, medical history, symptoms, and blood parameters on the admission of survivors were compared with non-survivors to identify factors that might predict a high risk of mortality. Results COVID-19 patients with ESRD had in-hospital mortality of 37.8% compared to 11.9% for those without ESRD (P value < 0.001). After adjusting for confounding factors, age, sex, and comorbidities, ESRD patients were more likely to experience in-hospital mortality compared to non-ESRD patients (Adjusted HR (95% CI): 2.59 (1.55–4.32)). The Log-rank test revealed that there was a significant difference between the ESRD and non-ESRD groups in terms of the survival distribution (χ2 (1) = 21.18, P-value < 0.001). In the ESRD subgroup, compared to survivors, non-survivors were older, and more likely to present with lack of consciousness or O2 saturation less than 93%; they also had lower lymphocyte but higher neutrophil counts and AST concentration at the presentation (all p –values < 0.05). Conclusions Our findings suggested that the presence of ESRD would be regarded as an important risk factor for mortality in COVID-19 patients, especially in those who are older than age 65 years and presented with a lack of consciousness or O2 saturation less than 93%.

scholarly journals Association of Nrf2, SOD2 and GPX1 Polymorphisms with Biomarkers of Oxidative Distress and Survival in End-Stage Renal Disease Patients

Toxins ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 431 ◽  
Author(s):  
Djurdja Jerotic ◽  
Marija Matic ◽  
Sonja Suvakov ◽  
Katarina Vucicevic ◽  
Tatjana Damjanovic ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Overall Survival ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Glutathione S Transferase ◽  
Event Modeling ◽  
Oxidative Phenotype ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The oxidative stress response via Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) interlinks inflammation- and metabolism-related pathways in chronic kidney disease. We assessed the association between polymorphisms in Nrf2, superoxide dismutase (SOD2), glutathione peroxidase (GPX1), and the risk of end-stage renal disease (ESRD). The modifying effect of these polymorphisms on both oxidative phenotype and ESRD prognosis, both independently and/or in combination with the glutathione S-transferase M1 (GSTM1) deletion polymorphism, was further analyzed. Polymorphisms in Nrf2 (rs6721961), SOD2 (rs4880), GPX1 (rs1050450), and GSTM1 were determined by PCR in 256 ESRD patients undergoing hemodialysis and 374 controls. Byproducts of oxidative stress were analyzed spectrophotometically or by ELISA. Time-to-event modeling was performed to evaluate overall survival and cardiovascular survival. The SOD2 Val/Val genotype increased ESRD risk (OR = 2.01, p = 0.002), which was even higher in combination with the GPX1 Leu/Leu genotype (OR = 3.27, p = 0.019). Polymorphism in SOD2 also showed an effect on oxidative phenotypes. Overall survival in ESRD patients was dependent on a combination of the Nrf2 (C/C) and GPX1 (Leu/Leu) genotypes in addition to a patients’ age and GSTM1 polymorphism. Similarly, the GPX1 (Leu/Leu) genotype contributed to longer cardiovascular survival. Conclusions: Our results show that SOD2, GPX1, and Nrf2 polymorphisms are associated with ESRD development and can predict survival.

scholarly journals Plasma oxalic acid as a trigger for oxidative processes in end-stage renal disease patients

2021 ◽  
pp. 46-53
Author(s):  
L. Korol ◽  
N. Stepanova ◽  
V. Vasylchenko ◽  
L. Snisar ◽  
L. Lebid ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Oxalic Acid ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Malonic Dialdehyde ◽  
Sh Groups ◽  
Oxidative Processes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The present study aimed to evaluate the changes in oxidative stress markers according to the concentration of plasma oxalic acid (POx) in end-stage renal disease (ESRD) patients. Methods. We conducted a cross-sectional observational study involving 72 ESRD patients and 30 relatively healthy individuals who served as a control reference group for evaluation of POx concentration. Among ESRD patients there were 32 hemodialysis (HD) patients and 40 peritoneal dialysis (PD). POx concentration was measured spectrophotometrically using a commercially available kit (MAK315, Sigma, Spain). Malonic dialdehyde (MDA), ceruloplasmin (CP), transferrin (TR), sulfhydryl groups (SH-groups), antioxidant blood capacity (AOC) and total peroxidase activity of erythrocytes (TPA) were measured and the oxidative stress index (OSI) was calculated in all examined patients. Results. A significant increase in POx concentration was observed in ESRD patients compared with healthy volunteers (p < 0.0001). The concentrations of MDA in serum, OSI in erythrocytes and serum of the examined patients were gradually increased, while serum levels of CP, AOC, SH-groups and TPA in erythrocytes, on the contrary, were decreased in accordance with the increasing trend of POx concentrations. Correlation analysis demonstrated a statistically significant direct relationship between POx concentration and MDA (r = 0.57; p <0.0001) and OSI (r = 0.64; p <0.0001). The inverse correlation was determined between POx and antioxidant markers: CP (r = -0.35; p = 0.007), SH-groups in serum (r = -0.3; p = 0.04) and erythrocytes (r = -0.53 ; p <0.0001). Conclusions. The intensity of oxidative-antioxidant balance disorders in the blood of ESRD patients has been associated with the POx concentration: the higher the concentration of POx was the more active oxidative processes and the more pronounced lack of antioxidant protective factors occurred. Further studies are needed to determine the role of POx in the initiation of oxidative stress and chronic inflammation in ESRD patients.

scholarly journals Appropriate Biomarkers For Oxidative Stress In Patients With End Stage Renal Disease

2015 ◽  
Vol 16 (4) ◽  
pp. 287-290
Author(s):  
Petar Dejanov ◽  
Beti Dejanova
Keyword(s):  
Oxidative Stress ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Control Group ◽  
Women Patients ◽  
Total Antioxidative Capacity ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Biomarkers For Oxidative Stress

AbstractThe appropriate biomarkers for oxidative stress (OS) in patients with end stage renal disease (ESRD) are important in renal pathology. Patients (56) with ESRD were investigated (35 men and 21 women). Patients, with mean age of 45±17 years, defined education, specific HD duration and calculated body mass index (BMI), were exposed to a polysulphone type HD membrane for approximately 4 hours per HD session, 3 times per week. The control group was composed of 31 healthy volunteers. The total antioxidative capacity (TAC) and the antioxidative (AO) enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx), were assessed. Analyses included Randox Crumlin GB; lipid peroxidation (LP) using its end product, malonyldialdehyde (MDA) (fluorimetric); and a LDL-ox immunoassay (Biomedica gruppe, Vienna, Austria). The TAS was higher in ESRD patients before HD (1.63±0.1 mmol/L) compared to the control group (1.23±0.03 mmol/L).

scholarly journals Impact of kidney transplantation on the risk of retinal vein occlusion in end-stage renal disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jangwook Lee ◽  
Hye Rim Choe ◽  
Sang Hyun Park ◽  
Kyung Do Han ◽  
Dong Ki Kim ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Retinal Vein Occlusion ◽  
End Stage Renal Disease ◽  
Charlson Comorbidity Index Score ◽  
Vein Occlusion ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

AbstractIt has been known that retinal vein occlusion (RVO) is associated with chronic kidney disease, especially end-stage renal disease (ESRD). However, little is known about the effect of kidney transplantation (KT) on RVO incidence in ESRD patients. This study aimed to compare the incidence of RVO in KT recipients (n = 10,498), matched ESRD patients (n = 10,498), and healthy controls (HCs, n = 10,498), using a long-term population-based cohort. The incidence of RVO was 2.74, 5.68, and 1.02 per 1000 patient-years, for the KT group, the ESRD group, and the HCs group, respectively. Adjusted hazard ratios for RVO development compared to the HCs group, were 1.53 and 3.21, in the KT group and the ESRD group, respectively. In the KT group, multivariable regression analysis indicated that an age over 50, a Charlson Comorbidity Index score over 4, and a history of desensitization therapy were associated with an increased risk of RVO. In summary, KT recipients have a lower risk for development of RVO than ESRD patients treated with dialysis. However, the risk is still higher compared to healthy people who have normal kidney functions.

Sign in / Sign up

Export Citation Format

Share Document