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腹膜透析患者的氧化应激:与透析充分性及技术存活的关联

Oxidative Stress in Peritoneal Dialysis Patients: Association with the Dialysis Adequacy and Technique Survival.

作者信息

Stepanova Natalia, Korol Lesya, Burdeyna Olena

机构信息

Department of Nephrology and Dialysis, Institute of Nephrology of the National Academy of Medical Sciences, Kyiv, Ukraine.

Biochemistry Laboratory, Institute of Nephrology of the National Academy of Medical Sciences, Kyiv, Ukraine.

出版信息

Indian J Nephrol. 2019 Sep-Oct;29(5):309-316. doi: 10.4103/ijn.IJN_242_18.

Abstract

INTRODUCTION

Increased oxidative stress is suggested as one of the possible mechanisms of structural and functional damage to the peritoneal membrane in peritoneal dialysis patients. But there are few available data on the association of oxidative stress with peritoneal dialysis adequacy and technique survival. The present study was undertaken to investigate the association of oxidative stress biomarkers with the peritoneal dialysis adequacy and technique survival.

METHODS

This prospective single-center observational study was conducted between January 2010 and May 2015. Adequacy of dialysis, malondialdehyde levels in the serum and erythrocytes (as an indicator of lipid peroxidation), the concentration of ceruloplasmin, transferrin, and sulfhydryl groups in the blood, and total peroxidase activity in erythrocyte (as indicators of antioxidant system) were determined in 44 stable ambulatory non-diabetic peritoneal dialysis patients.

RESULTS

The follow-up period was 3 years. We identified a negative correlation between the serum level of malondialdehyde in the patients and total weekly . Peritoneal weekly CrCl was positively correlated with the levels of transferrin, total peroxidase activity, and SH- groups. Daily peritoneal ultrafiltration had a positive correlation with the total peroxidase activity and the serum transferrin levels. The results of the Kaplan-Meier analysis and the log-rank test also demonstrated a significant difference in the cumulative technique survival rate between the patients with ceruloplasmin level ≤0.19 g/l and ≥0.2 g/l.

CONCLUSIONS

The results mentioned above could be considered as one of the ways to explain better technique survival in PD patients.

摘要

引言

氧化应激增加被认为是腹膜透析患者腹膜结构和功能损伤的可能机制之一。但关于氧化应激与腹膜透析充分性及技术存活之间关系的可用数据较少。本研究旨在探究氧化应激生物标志物与腹膜透析充分性及技术存活之间的关系。

方法

本前瞻性单中心观察性研究于2010年1月至2015年5月进行。测定了44例稳定的非糖尿病门诊腹膜透析患者的透析充分性、血清和红细胞中丙二醛水平(作为脂质过氧化的指标)、血浆铜蓝蛋白、转铁蛋白浓度、血液中巯基以及红细胞中的总过氧化物酶活性(作为抗氧化系统的指标)。

结果

随访期为3年。我们发现患者血清丙二醛水平与每周总肌酐清除率呈负相关。腹膜每周肌酐清除率与转铁蛋白水平、总过氧化物酶活性和巯基水平呈正相关。每日腹膜超滤与总过氧化物酶活性和血清转铁蛋白水平呈正相关。Kaplan-Meier分析和对数秩检验结果还显示,血浆铜蓝蛋白水平≤0.19 g/l和≥0.2 g/l的患者在累积技术存活率方面存在显著差异。

结论

上述结果可被视为更好地解释腹膜透析患者技术存活情况的一种方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37ef/6755929/477d0ea5a04b/IJN-29-309-g001.jpg

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