The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital Toronto, Ontario, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
J Ren Nutr. 2010 May;20(3):199-208. doi: 10.1053/j.jrn.2009.09.002. Epub 2009 Nov 12.
Patients on conventional hemodialysis (HD) have elevated markers of oxidative stress and chronic inflammation, which may contribute to a high prevalence of cardiovascular disease. Glutathione (GSH), an important intracellular antioxidant, requires cysteine as a rate-limiting amino acid for its synthesis and riboflavin for its regeneration.
We aimed to examine whether erythrocyte GSH (eGSH) concentrations and riboflavin status are influenced by the increased dialysis dose provided to vitamin-supplemented patients receiving home nocturnal hemodialysis (HNHD) (6-8 hours/session, 5-7 nights/week) compared with patients on standard hemodialysis (SHD) (4 hours/session, 3 days/week).
This was a cross-sectional comparative study involving 30 patients undergoing SHD or HNHD regimens and a group of 15 healthy control subjects (HC). We measured eGSH concentration by liquid chromatography-tandem mass spectrometry, riboflavin status by eGSH reductase activity coefficient (EGRAC) as well as plasma total cysteine (Cys) and total homocysteine (Hcy), vitamin C by high-performance liquid chromatography, and C-reactive protein (CRP) by standard method. Estimated dietary protein and energy intakes were determined by 3-day food records, and nutritional status was assessed by subjective global assessment (SGA).
There were no significant differences among groups in eGSH concentration, EGRAC, dietary protein intake, and SGA score. SHD patients had significantly higher plasma Cys (P < .001) and Hcy compared with HNHD and HC groups (P = .048). Vitamin C was significantly lower (P = .01) and CRP significantly higher (P = .048) in both HD groups compared with HC.
eGSH concentration appears to be unaffected by dialysis dose in well-nourished HD patients.
接受常规血液透析（HD）的患者氧化应激和慢性炎症标志物升高，这可能导致心血管疾病高发。谷胱甘肽（GSH）是一种重要的细胞内抗氧化剂，其合成需要半胱氨酸作为限速氨基酸，其再生需要核黄素。
我们旨在研究与接受标准血液透析（SHD）（4 小时/次，每周 3 天）的患者相比，接受补充维生素的家庭夜间血液透析（HNHD）（6-8 小时/次，每周 5-7 晚）的患者的透析剂量增加是否会影响红细胞 GSH（eGSH）浓度和核黄素状态。
这是一项横断面比较研究，纳入了 30 名接受 SHD 或 HNHD 方案的患者和 15 名健康对照者（HC）。我们通过液相色谱-串联质谱法测定 eGSH 浓度，通过 eGSH 还原酶活性系数（EGRAC）测定核黄素状态，以及通过高效液相色谱法测定血浆总半胱氨酸（Cys）和总同型半胱氨酸（Hcy），通过标准方法测定 C 反应蛋白（CRP）。通过 3 天的食物记录确定估计的饮食蛋白和能量摄入，通过主观整体评估（SGA）评估营养状况。
各组间 eGSH 浓度、EGRAC、饮食蛋白摄入量和 SGA 评分无显著差异。SHD 患者的血浆 Cys 显著高于 HNHD 组和 HC 组（P <.001），与 HNHD 组和 HC 组比较，差异有统计学意义（P =.048）。与 HC 组相比，两组 HD 患者的维生素 C 明显较低（P =.01），CRP 明显较高（P =.048）。
在营养良好的血液透析患者中，透析剂量似乎对 eGSH 浓度没有影响。
