Soejima A, Matsuzawa N, Miyake N, Karube M, Fukuoka K, Nakabayashi K, Kitamoto K, Nagasawa T
First Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Clin Nephrol. 1999 Feb;51(2):92-7.
Persistent hypoalbuminemia is a long-term poor prognostic factor in chronic hemodialysis patients.
We investigated the correlation between the degree of peroxidation of erythrocyte membrane lipids, erythrocyte alpha tocopherol content, erythrocyte glutathione peroxidase activity and serum albumin concentration in twelve patients with uremia not undergoing hemodialysis and fifteen patients on maintenance hemodialysis.
The glutathione peroxidase activity in erythrocytes was higher in patients of uremia not undergoing hemodialysis than in chronic hemodialysis patients. A significant negative correlation was observed between the erythrocyte alpha tocopherol content and the degree of erythrocyte membrane lipid peroxidation in chronic hemodialysis patients. There was a statistically significant difference in the degree of erythrocyte membrane lipid peroxidation between patients with chronic hemodialysis-associated hypoalbuminemia and chronic hemodialysis patients having normal serum albumin levels.
This study suggested that serum albumin inhibits peroxidation of erythrocyte membrane lipids and that hemodialysis induces recovery of serum reductivity. We conclude that persistent hypoalbuminemia worsens the serum antioxidant activity in chronic hemodialysis patients and may contribute to increased oxidative cell damage.
持续性低白蛋白血症是慢性血液透析患者长期预后不良的因素。
我们研究了12例未接受血液透析的尿毒症患者和15例维持性血液透析患者红细胞膜脂质过氧化程度、红细胞α-生育酚含量、红细胞谷胱甘肽过氧化物酶活性与血清白蛋白浓度之间的相关性。
未接受血液透析的尿毒症患者红细胞中的谷胱甘肽过氧化物酶活性高于慢性血液透析患者。在慢性血液透析患者中，观察到红细胞α-生育酚含量与红细胞膜脂质过氧化程度之间存在显著负相关。慢性血液透析相关性低白蛋白血症患者与血清白蛋白水平正常的慢性血液透析患者之间，红细胞膜脂质过氧化程度存在统计学显著差异。
本研究表明血清白蛋白可抑制红细胞膜脂质过氧化，血液透析可诱导血清还原性恢复。我们得出结论，持续性低白蛋白血症会使慢性血液透析患者的血清抗氧化活性恶化，并可能导致细胞氧化损伤增加。
