Relationship between Change of Serum Lipid Peroxide Level During Hemodialysis and Endogenous Scrum Antioxidants

Choi, G B; Yoon, K I

Abstract

OBJECTIVES
Membrane bioincompatibility induce neutrophils to release of oxygen free radicals, resulting in cell membrane attack through peroxidation of polyunsaturated fatty acids. It was reported that serum antioxidant activity were significantly lower in CRF patients and the plasme lipid peroxide (LPO) level in the dialyzed patients was increased. So, we investigated whether or not the serum LPO level increases in chronic renal failure, and then investigated the relationship between the change of serum LPO level during hemodialysis and the endogenous serum antioxidants.
METHODS
The 20 healthy control with normsl renal function, 11 CRF patients and 34 ESRD patients maintained on hemodialysis were studied. We measured serum LPO by using thiobarbituric acid test reaction. Among endogenous antioxidants, serum ceruloplasmin, transferrin and vitamin C were measured. Serum LPO level were measured just before and after hemodialysis. Serum ceruloplasmin, transferrin, and vitamin C were measured just before initiation of hemodialysis.
RESULTS
Serum LPO levels obtained from CRF patients(12.6+/-8.3nM/mL) were significantly higher than from healthy control(4.3+/-0.9nM/mL) and than from HD patients(6.9+/-3.8nM/mL). But there were no significant difference between healthy control and HD patients. We found that significant amount of LPO were eliminated through dialyzer during hemodialysis. In 11 patients, serum LPO level increased significantly from a basal level of 5.0+/-2.0nM/rnL to a 6.1+/-2.4nM/mL after hemodialysis, but in 23 patients decreased significantly from a 7.9+/-4.lnM/ mL to a 5.9+/-2.4 nM/mL. Among 5 patients with low serum ceruloplasmin level(<25mg/dL), serum LPO level increased after hemodialysis in 4 patients. In contrast, among 29 patients with normal or high serum ceruloplasmin level(>25mg/dL), serum LPO level decreased after hemodialysis in 22 patients. So, the change of serum LPO level during hemodialysis was related to the serum ceruloplasmin level. But the change was not related to the serum transferrin or vitamin C level.
CONCLUSION
In CRF patients, the serum LPO level may be increased by decreased urinary elimination or by oxidation injury. Hemodialysis may lower the serum LPO level by clearance through dialyzer or by improvement of antioxidant activity. And endogenous antioxidant like ceruloplasmin may play a important role in the protection from oxidation injury and decreased antioxidant activity may be one of the causes of pathological process induced by membrane bioincompatibility.