Shetty Jeevan K, Prakash Mungli
Department of Biochemistry, Kasturba Medical College, Manipal.
Indian J Physiol Pharmacol. 2007 Apr-Jun;51(2):179-82.
The existence of oxidative stress in uremia is well proved but the relative importance of uremic status versus the role of free iron in exacerbating oxidative stress in patients with uremia is not been clarified. Serum creatinine, free iron both in ferrous and ferric state, protein thiols, lipid hydroperoxides levels were estimated by spectrophotometric methods. The study groups comprised of patients with chronic kidney disease on conservative management, on hemodialysis with and without iron supplementation, and compared with healthy controls. Free iron levels were higher in patients with chronic kidney disease on conservative management, hemodialysis patients with and without iron supplementation. Hemodialysis cases with iron supplementation had significantly higher free iron levels as compared to hemodialysis cases without iron supplementation. The levels of lipid hydroperoxides were higher and protein thiols were lower in patient groups. Creatinine correlated positively with free iron and lipid hydroperoxides, and negatively with protein thiols. In conclusion, uremia per se may be responsible for enhanced oxidative stress in patients with chronic kidney disease.
尿毒症中氧化应激的存在已得到充分证实,但尿毒症状态与游离铁在加重尿毒症患者氧化应激中的作用相比,其相对重要性尚未阐明。采用分光光度法测定血清肌酐、亚铁和高铁状态的游离铁、蛋白质巯基、脂质氢过氧化物水平。研究组包括接受保守治疗的慢性肾病患者、接受血液透析且补充或未补充铁剂的患者,并与健康对照进行比较。接受保守治疗的慢性肾病患者、接受血液透析且补充或未补充铁剂的患者的游离铁水平较高。与未补充铁剂的血液透析患者相比,补充铁剂的血液透析患者的游离铁水平显著更高。患者组中脂质氢过氧化物水平较高,蛋白质巯基水平较低。肌酐与游离铁和脂质氢过氧化物呈正相关,与蛋白质巯基呈负相关。总之,尿毒症本身可能是慢性肾病患者氧化应激增强的原因。