Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Nov 17;11(11):2809.
doi: 10.3390/nu11112809.

Oxidative Status before and after Renal Replacement Therapy: Differences between Conventional High Flux Hemodialysis and on-Line Hemodiafiltration

José Alberto Navarro-García  1 , Elena Rodríguez-Sánchez  1 , Jennifer Aceves-Ripoll  1 , Judith Abarca-Zabalía  1 , Andrea Susmozas-Sánchez  1 , Laura González Lafuente  1 , Teresa Bada-Bosch  2 , Eduardo Hernández  2 , Evangelina Mérida-Herrero  2 , Manuel Praga  2 , Luis Miguel Ruilope  1   3   4 , Gema Ruiz-Hurtado  1   4
Affiliations
Comparative Study

Oxidative Status before and after Renal Replacement Therapy: Differences between Conventional High Flux Hemodialysis and on-Line Hemodiafiltration

José Alberto Navarro-García et al. Nutrients. .

Abstract

Hemodialysis patients experience high oxidative stress because of systemic inflammation and depletion of antioxidants. Little is known about the global oxidative status during dialysis or whether it is linked to the type of dialysis. We investigated the oxidative status before (pre-) and after (post-) one dialysis session in patients subjected to high-flux dialysis (HFD) or on-line hemodiafiltration (OL-HDF). We analyzed carbonyls, oxidized LDL (oxLDL), 8-hydroxy-2'-deoxyguanosine, and xanthine oxidase (XOD) activity as oxidative markers, and total antioxidant capacity (TAC), catalase, and superoxide dismutase activities as measures of antioxidant defense. Indices of oxidative damage (OxyScore) and antioxidant defense (AntioxyScore) were computed and combined into a global DialysisOxyScore. Both dialysis modalities cleared all markers (p < 0.01) except carbonyls, which were unchanged, and oxLDL, which increased post-dialysis (p < 0.01). OxyScore increased post-dialysis (p < 0.001), whereas AntioxyScore decreased (p < 0.001). XOD and catalase activities decreased post-dialysis after OL-HDF (p < 0.01), and catalase activity was higher after OL-HDF than after HFD (p < 0.05). TAC decreased in both dialysis modalities (p < 0.01), but remained higher in OL-HDF than in HFD post-dialysis (p < 0.05), resulting in a lower overall DialysisOxyScore (p < 0.05). Thus, patients on OL-HDF maintain higher levels of antioxidant defense, which might balance the elevated oxidative stress during dialysis, although further longitudinal studies are needed.

Keywords: dialysis; high-flux dialysis; on-line hemodiafiltration; oxidative stress.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Schematic flow-chart of patient selection and sample recruitment.
Figure 2
Figure 2
Markers of oxidative damage (A–D) and antioxidant defense (E–H) in dialysis patients pre- and post-dialysis. (A) Protein carbonyls, (B) oxidized LDL (oxLDL), (C) xanthine oxidase (XOD) activity, (D) 8-hydroxy-2′-deoxyguanosine (8-OHdG), (E) catalase activity, (F) superoxide (SOD) activity, (G) total antioxidant capacity (TAC) measured as AUC, and (H) TAC variation in luminescence inhibition after plasma addition (time = 1 s). Data is presented as mean ± SEM. ** p < 0.01 and *** p < 0.001 vs. pre-dialysis.
Figure 3
Figure 3
OxyScore, AntioxyScore, and DialysisOxyScore in pre- and post-dialysis stages. (A) OxyScore, (B) AntioxyScore, and (C) DialysisOxyScore in dialysis patients. Data is presented as median ± interquartile range. ** p < 0.01 and *** p < 0.001 vs. pre-dialysis.
Figure 4
Figure 4
Markers of oxidative damage (A–D) and antioxidant defense (E–H) in HFD and OL-HDF dialysis patients pre- and post-dialysis. (A) Protein carbonyls, (B) oxidized LDL (oxLDL), (C) xanthine oxidase (XOD) activity, (D) 8-hydroxy-2′-deoxyguanosine (8-OHdG), (E) catalase activity, (F) superoxide (SOD) activity, (G) total antioxidant capacity (TAC) measured as AUC, and (H) TAC variation in luminescence inhibition after plasma addition (time = 1 s). Data is presented as mean ± SEM. Blue bars represent data of pre-dialysis samples, clear blue for HFD, and dark blue for OL-HDF. Orange bars represent data of post-dialysis samples, clear orange for HDF, and dark orange for OL-HDF. * p < 0.05 ** p < 0.01 and *** p < 0.001 vs. pre-dialysis situation; # p < 0.05 and ## p < 0.01 vs. HFD.
Figure 5
Figure 5
OxyScore, AntioxyScore and DialysisOxyScore in HDF and OL-HDF pre- and post-dialysis. (A) OxyScore, (B) AntioxyScore, and (C) DialysisOxyScore in HFD and OL-HDF patients. Data is presented as median ± interquartile range. Blue bars represent data of pre-dialysis samples, clear blue for HFD, and dark blue for OL-HDF. Orange bars represent data of post-dialysis samples, clear orange for HDF, and dark orange for OL-HDF. ** p < 0.01 and *** p < 0.001 vs. pre-dialysis; # p < 0.05 and ## p < 0.01 vs. HFD.
See this image and copyright information in PMC

References

    1. Gorostidi M., Santamaria R., Alcazar R., Fernandez Fresnedo G., Galceran J.M., Goicoechea M., Oliveras A., Portoles J., Rubio E., Segura J., et al. Spanish Society of Nephrology Document on KDIGO Guidelines for the Assessment and Treatment of Chronic Kidney Disease. Nefrologia. 2014;34:302–316. doi: 10.3265/Nefrologia.pre2014.Feb.12464. - DOI - PubMed
    1. Ruilope L.M., Bakris G.L. Renal Function and Target Organ Damage in Hypertension. Eur. Heart J. 2011;32:1599–1604. doi: 10.1093/eurheartj/ehr003. - DOI - PubMed
    1. Qureshi A.R., Alvestrand A., Divino Filho J.C., Gutierrez A., Heimburger O., Lindholm B., Bergstrom J. Inflammation, Malnutrition, and Cardiac Disease as Predictors of Mortality in Hemodialysis Patients. J. Am. Soc. Nephrol. 2002;13:28–36. - PubMed
    1. Stenvinkel P., Alvestrand A. Inflammation in End-Stage Renal Disease: Sources, Consequences, and Therapy. Semin. Dial. 2002;15:329–337. doi: 10.1046/j.1525-139X.2002.00083.x. - DOI - PubMed
    1. Peters S.A., Bots M.L., Canaud B., Davenport A., Grooteman M.P., Kircelli F., Locatelli F., Maduell F., Morena M., Nube M.J., et al. Haemodiafiltration and Mortality in End-Stage Kidney Disease Patients: A Pooled Individual Participant Data Analysis from Four Randomized Controlled Trials. Nephrol. Dial. Transplant. 2016;31:978–984. doi: 10.1093/ndt/gfv349. - DOI - PubMed

Publication types