Clinic of Nephrology and Hemodialysis, Clinical Center, Nis, Serbia.
Int J Med Sci. 2012;9(9):808-15. doi: 10.7150/ijms.4910. Epub 2012 Oct 26.
End-stage renal disease is a state of enhanced oxidative stress (OS) and hemodialysis (HD) and renal anemia further augment this disbalance. Anemia correction with erythropoietin (EPO) may improve oxidative status. However, there is no evidence of time dependent effects of EPO therapy on redox status of HD patients.
The aim of this study was to evaluate whether the duration of EPO treatment may affect OS parameters in uremic patients.
104 HD patients and 29 healthy volunteers were included. Patients were divided into 3 groups according to the duration of EPO treatment. Forth group consisted of HD patients without EPO treatment. Plasma and erythrocyte malondialdehyde (MDA, MDA(rbc)), reactive carbonyl groups (RCG), plasma sulfhydryl (-SH) groups and total antioxidative capacity (TAC) levels were evaluated.
HD patients both with and without EPO treatment, showed a significant increase in all oxidative parameters without significance between EPO treated and -untreated group. The decrease in MDA and MDA(rbc) levels coincided with the duration of EPO treatment. A negative correlation was observed between the duration of EPO treatment and serum MDA (r=-0.309, p=0.003). Increasing periods of EPO treatment were associated with decrease in RCG, without significance between EPO groups. Increase in TAC accompanied increasing durations of EPO treatment, with EPO treatment for more than 24 months causing the most striking changes (p<0.05). There were no significant differences in -SH levels between EPO subgroups.
Our results suggest that long term administration of EPO attenuated the lipid peroxidation process and restored the levels of antioxidants.
终末期肾病是氧化应激（OS）增强的状态，血液透析（HD）和肾性贫血进一步加剧了这种失衡。促红细胞生成素（EPO）纠正贫血可能改善氧化状态。然而，目前尚无证据表明 EPO 治疗对 HD 患者氧化还原状态的时间依赖性影响。
本研究旨在评估 EPO 治疗时间是否会影响尿毒症患者的 OS 参数。
纳入 104 例 HD 患者和 29 名健康志愿者。根据 EPO 治疗时间将患者分为 3 组。第四组为未接受 EPO 治疗的 HD 患者。评估血浆和红细胞丙二醛（MDA、MDA（rbc））、反应性羰基基团（RCG）、血浆巯基（-SH）基团和总抗氧化能力（TAC）水平。
接受和未接受 EPO 治疗的 HD 患者的所有氧化参数均显著增加，EPO 治疗组与未治疗组之间无显著性差异。MDA 和 MDA（rbc）水平的降低与 EPO 治疗时间有关。EPO 治疗时间与血清 MDA 呈负相关（r=-0.309，p=0.003）。随着 EPO 治疗时间的延长，RCG 逐渐减少，但 EPO 组之间无显著性差异。TAC 的增加伴随着 EPO 治疗时间的延长，EPO 治疗超过 24 个月会引起最显著的变化（p<0.05）。EPO 亚组之间 -SH 水平无显著差异。
我们的结果表明，长期给予 EPO 可减轻脂质过氧化过程并恢复抗氧化剂水平。
