Vural Abdulgaffar, Yilmaz Mahmut Ilker, Caglar Kayser, Aydin Ahmet, Sonmez Alper, Eyileten Tayfun, Acikel Cengizhan, Gulec Bulent, Kozak Orhan, Oner Koksal
Department of Nephrology, Gülhane School of Medicine, Etlik-Ankara, Turkey.
Am J Nephrol. 2005 May-Jun;25(3):250-5. doi: 10.1159/000086079. Epub 2005 May 27.
Oxidative stress is one of the leading causes of cardiovascular morbidity and mortality in chronic kidney disease. Although it is clear that many metabolic abnormalities improve, the effects of kidney transplantation on oxidative state are obscure.
Twenty-three kidney transplant patients were included in the study. Eleven patients (mean age 27.9+/- 9.1 years) were treated with cyclosporine A (CsA) whereas 12 patients (mean age 22.4 +/- 3.4 years) were treated with tacrolimus. Twenty-three healthy subjects served as controls. None of the patients or controls suffered from diabetes mellitus or an acute infection at the time of the study. Plasma malondialdehyde (MDA), plasma selenium (Se), erythrocyte glutathione peroxidase (GSH-Px), erythrocyte superoxide dismutase (SOD), erythrocyte Zn (EZn), and erythrocyte Cu (ECu) levels were studied before and in the 1st, 3rd, 7th, 14th and 28th days after the transplantation.
The GSH-Px, SOD, ECu, EZn and selenium levels were lower and MDA levels were higher in patients than controls before transplantation (p < 0.001 for all). MDA levels decreased and SOD, GSH-Px, ECu, EZn levels increased in parallel to the decrement of serum creatinine levels following the renal transplantation. No difference was found among the patients regarding the treatment regime.
The study data suggest that the improvement in oxidative state parameters begins at the first day of renal transplantation and continues at the 28th posttransplant day in living donor transplantations.
氧化应激是慢性肾脏病中心血管疾病发病和死亡的主要原因之一。尽管许多代谢异常有所改善这一点很明确，但肾移植对氧化状态的影响仍不清楚。
本研究纳入了23例肾移植患者。11例患者（平均年龄27.9±9.1岁）接受环孢素A（CsA）治疗，而12例患者（平均年龄22.4±3.4岁）接受他克莫司治疗。23名健康受试者作为对照。在研究期间，患者和对照均未患有糖尿病或急性感染。在移植前以及移植后的第1、3、7、14和28天研究血浆丙二醛（MDA）、血浆硒（Se）、红细胞谷胱甘肽过氧化物酶（GSH-Px）、红细胞超氧化物歧化酶（SOD）、红细胞锌（EZn）和红细胞铜（ECu）水平。
移植前患者的GSH-Px、SOD、ECu、EZn和硒水平低于对照，MDA水平高于对照（所有p<0.001）。肾移植后，MDA水平降低，SOD、GSH-Px、ECu、EZn水平随着血清肌酐水平的下降而平行升高。在治疗方案方面，患者之间未发现差异。
研究数据表明，在活体供肾移植中，氧化状态参数的改善从肾移植第一天开始，并持续至移植后第28天。
