Oxidative stress has been shown in (
ESRD) patients specially those receiving regular haemodialysis (HD) in relation with an increased production of toxic
free radicals due to membrane-induced
complement leukocyte activation. An imbalance between
oxidants and antioxidans has been suggested in uremic patients on HD. The respective influence of
uremia and dialysis procedure has not been evaluated. Studies that have probed into the mechanism of
oxygen radical production have implicated the bio-incompatibility of dialysis membranes. The effect of different dialysis membranes on
lipid,
lipoproteins, lipid peroxidation and total
antioxidant capacity in
ESRD patients on regular HD was studied. One hundred subjects were selected; 20 healthy controls, 20
chronic renal failure (CRF) patients on conservative
drug management and 60 CRF patients on maintenance HD (20 dialyzed by
polysulfone, 20 by
hemophan and 20 by
cuprophane membranes). All patients were matched for age, sex, gender and etiology of
ESRD and HD patients for duration of dialysis. In addition to routine tests (Hb% and
creatinine clearance in healthy control group and CRF patients on
conservative management), total
cholesterol,
triglycerides,
high density lipoprotein (HDL-C) and
low density lipoprotein (
LDL-C),
apolipoprotein A (
Apo A),
apolipoprotein B (
Apo B), serum
malondialdehyde (MDA) and plasma total
antioxidant status (TAS) were estimated. MDA was significantly higher and TAS was lower in uremic patients treated conservatively or by HD than in controls. MDA was significantly higher in HD than CRF patients on
conservative management with least significant difference in HD patients treated by
polysulfone followed by
hemophan and then
cuprophane membrane, while only
cuprophane group showed lower levels of TAS compared to CRF patients on
conservative management. HDL-C and
Apo A was higher in
polysulfone and
hemophan than
cuprophane group while triglyderide was lower.
Polysulfone group showed lower levels of
LDL-C than both
cuprophane and
hemophane groups thus providing less atherogenic
lipid profile. There was a positive correlation between Hb% and TAS and a significant negative correlation between MDA and Hb%. There was a significant negative correlation between TAS and duration of dialysis in HD patients. In CRF patients on
conservative management we obtained a significant positive correlation with TAS and a significant negative correlation with MDA.