Department of Pediatrics, Chung-Ang Jeil Hospital, Chungbuk, South Korea.
Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, South Korea.
BMC Nephrol. 2024 May 4;25(1):155. doi: 10.1186/s12882-024-03584-0.
Oxidative stress, an imbalance between reactive oxygen species production and antioxidant capacity, increases in patients with coronavirus disease (COVID-19) or renal impairment. We investigated whether combined COVID-19 and end-stage renal disease (ESRD) would increase oxidative stress levels compared to each disease alone.
Oxidative stress was compared among three groups. Two groups comprised patients with COVID-19 referred to the hospital with or without renal impairment (COVID-ESRD group [n = 18]; COVID group [n = 17]). The third group (ESRD group [n = 18]) comprised patients without COVID-19 on maintenance hemodialysis at a hospital.
The total oxidative stress in the COVID-ESRD group was lower than in the COVID group (p = 0.047). The total antioxidant status was higher in the COVID-ESRD group than in the ESRD (p < 0.001) and COVID (p < 0.001) groups after controlling for covariates. The oxidative stress index was lower in the COVID-ESRD group than in the ESRD (p = 0.001) and COVID (p < 0.001) groups. However, the three oxidative parameters did not differ significantly between the COVID and COVID-ESRD groups.
The role of reactive oxygen species in the pathophysiology of COVID-19 among patients withESRD appears to be non-critical. Therefore, the provision of supplemental antioxidants may not confer a therapeutic advantage, particularly in cases of mild COVID-19 in ESRD patients receiving hemodialysis. Nonetheless, this area merits further research.
氧化应激是活性氧生成与抗氧化能力失衡的结果,在患有冠状病毒病(COVID-19)或肾功能损害的患者中会增加。我们研究了 COVID-19 合并终末期肾病(ESRD)与两种疾病单独存在时相比是否会增加氧化应激水平。
比较了三组患者的氧化应激情况。两组包括因 COVID-19 而出现肾功能损害(COVID-ESRD 组[n=18];COVID 组[n=17])或无肾功能损害(COVID 组[n=17])而被转诊到医院的患者。第三组(ESRD 组[n=18])为在医院接受维持性血液透析的无 COVID-19 的患者。
COVID-ESRD 组的总氧化应激低于 COVID 组(p=0.047)。控制协变量后,COVID-ESRD 组的总抗氧化状态高于 ESRD(p<0.001)和 COVID(p<0.001)组。COVID-ESRD 组的氧化应激指数低于 ESRD(p=0.001)和 COVID(p<0.001)组。然而,COVID 和 COVID-ESRD 组之间的这三个氧化参数差异无统计学意义。
在 ESRD 患者的 COVID-19 病理生理学中,活性氧的作用似乎并不关键。因此,补充抗氧化剂可能不会带来治疗优势,特别是在接受血液透析的 ESRD 患者中出现轻度 COVID-19 的情况下。尽管如此,这一领域值得进一步研究。