Elevated plasma F2-isoprostanes in patients on long-term hemodialysis.

Abstract

BACKGROUND:

End-stage renal disease (ESRD) patients on long-term hemodialysis (HD) may be under increased oxidative stress, caused by either HD or renal failure. Plasma F2-isoprostanes have been established as an important indicator of in vivo oxidative stress.

METHODS:

Plasma esterified F2-isoprostanes were measured in 25 HD patients and 23 controls with normal renal function, employing gas chromatography-mass spectrometry with negative chemical ionization (GC-MS-NCI). C-reactive protein (CRP) was determined concurrently in patients and controls by enzyme-linked immunosorbent assay (ELISA). alpha-Tocopherol, retinol, albumin and creatinine were also determined.

RESULTS:

The average total esterified F2-isoprostanes in the ESRD patients was 1.62 +/- 0.73 vs. 0.27 +/- 0.10 ng/mL in controls (P < 0.001), with no overlap between patients and controls. Plasma F2-isoprostanes in diabetic ESRD patients were similar to F2-isoprostanes in patients with other causes for renal failure. In a subset of 10 of these ESRD patients evaluated eight months after the initial measurement, plasma-esterified F2-isoprostanes were not altered by an individual dialysis session. Average plasma CRP values were also higher in HD patients (P < 0.02), but some patients had CRP values that were similar to controls. In the HD patients, total plasma F2-isoprostanes and plasma CRP were correlated (r = 0.48, P = 0.015). Plasma alpha-tocopherol did not differ between patients and controls, but plasma retinol was higher in patients (3.15 +/- 1.71 micromol/L) than in controls (1.97 +/- 0.51 micromol/L, P < 0.05).

CONCLUSIONS:

These results are consistent with the hypothesis that oxidative stress in ESRD patients contributes to increased values of esterified plasma F2-isoprostanes, with concurrent increases in plasma CRP levels in some patients. Impaired clearance of esterified F2-isoprostanes may contribute to the elevated levels in renal failure. Plasma esterified F2-isoprostanes may be a useful indicator to evaluate effectiveness of interventions to decrease oxidative stress and associated inflammation.

• Authors: G J Handelman, M F Walter, R Adhikarla, J Gross, G E Dallal, N W Levin, J B Blumberg
• Journal: Kidney international (Kidney Int) Vol. 59 Issue 5 Pg. 1960-6 (May 2001) ISSN: 0085-2538 [Print] United States
• PMID: 11318969 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• F2-Isoprostanes
• Vitamin A
• Vitamin E
• C-Reactive Protein
• Dinoprost

Topics

• Aged
• C-Reactive Protein (metabolism)
• Case-Control Studies
• Dinoprost (analogs & derivatives, blood, chemistry)
• Esterification
• F2-Isoprostanes
• Female
• Gas Chromatography-Mass Spectrometry
• Humans
• Kidney Failure, Chronic (blood, therapy)
• Male
• Middle Aged
• Oxidative Stress
• Renal Dialysis (adverse effects)
• Vitamin A (blood)
• Vitamin E (blood)