Oxidant stress may play a role in the accelerated pathology of patients on dialysis, especially in the development of
cardiovascular disease, which is a frequent condition in
end-stage renal disease (
ESRD) patients. Measurement of
hydrocarbons can be employed to assess
oxidant stress since breath
hydrocarbons have been directly traced to in vivo breakdown of
lipid hydroperoxides. We undertook to measure
ethane, a major breath
hydrocarbon, in 15 control subjects, 13 patients on
peritoneal dialysis (PD), and 35 patients on
hemodialysis (HD). Within the HD group, we separately examined 12 diabetic and 23 nondiabetic patients. Breath samples were collected after patients had breathed purified air for 4 min, and
ethane content was measured by GC and expressed as pmoles/kg-
body weight-minute (pmol/kg-min). As the data for the
hemodialysis patients appeared skewed, nonparametric statistical techniques were employed to analyze these data, which are reported as median and interquartile range (IQR).
Ethane levels were similar in 15 control subjects (median, 2.50 pmol [1.38-3.30]/kg-min] and 13 PD patients (median, 2.51 pmol [1.57-3.17]/kg-min). Breath
ethane was significantly elevated in a portion (18 of 35 patients, 52%) of the HD patients (median, 6.16 pmol [4.46-8.88]/kg-min) (p <.001 vs. control, Mann-Whitney U test). Two of the diabetic HD patients showed extremely high values of breath
ethane. Breath
ethane was not altered by a single
hemodialysis session, suggesting that long-term metabolic processes contribute to its elevation. Measurement of breath
ethane may provide insight into severity of
oxidant stress and metabolic disturbances, and provide guidance for optimal
therapy and prevention of pathology in patients on long-term
hemodialysis.