Inflammation and oxidative stress in end-stage renal disease patients treated with hemodialysis or peritoneal dialysis.

PURPOSE

The impact of different dialysis modalities on oxidative stress and inflammation and the factors implicated in this interrelationship have not been adequately studied. This study was designed to comparatively evaluate the effect of hemodialysis (HD) and peritoneal dialysis (PD) on oxidative stress and inflammatory biomarkers and to search for associated factors.

METHODS

We studied 20 HD, 11 PD patients and 11 healthy controls. Calculations were based on total antioxidant capacity (TAC) and superoxide dismutase (SOD), by spectrophotometry, as oxidative stress biomarkers; and high sensitivity CRP (hs-CRP), Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-alpha), by ELISA, as inflammation biomarkers.

RESULTS

HD and PD patients showed significantly increased levels of TA C, SOD and hs-CRP compared to healthy controls. No significant difference was observed in TNF-alpha and IL-6. Compared to HD patients, PD patients showed TNF-alpha levels that were increased, although non-significantly, and significantly higher homocysteine (Hcy). No differences were observed for IL-6, hs-CRP, TA C and SOD. In HD patients, significant positive correlations were found between intact parathyroid hormone (iPTH) and TNF-alpha, and between uric acid (UA) and TAC. Beta2-microglobulin (Beta2M) was negatively correlated with TAC, total cholesterol (TC) positively with TNF-alpha and negatively with SOD, and triglycerides (TG) correlated positively with TNF-alpha. In PD patients, TG correlated positively with TNF-alpha, HDL-cholesterol negatively with TNF-alpha, LDL-cholesterol negatively with SOD, and Beta2M negatively with SOD.

CONCLUSIONS

HD and PD patients show similar degrees of inflammation and oxidative stress activation. Factors such as UA, iPTH, Beta2M and lipid profile correlate to oxidative stress and inflammatory biomarkers in both HD and PD patients.