Abstract
Chronic renal failure, which typically results in end-stage renal failure, is commonly associated with metabolic and functional disturbance, leading to calcium phosphate metabolism and nutritional inadequacies (1). Among the causes of malnutrition, abnormal muscle metabolism, endocrine abnormalities, impaired metabolic kidney functions, and disturbances in nutrient metabolism such as amino acids, vitamins and trace elements, have been described in renal failure patients (1–3). Moreover, hemodialysis (HD) performed to compensate for kidney failure appears to be related to metabolic abnormalities. Dialysis membranes may therefore induce the activation of cellular systems leading to production of multiple inflammatory agents (4), with increased and uncontrolled formation of oxidative products (5, 6). Oxygen-activated species cause a wide array of molecular alterations including lipid peroxidation with generation of aldehydes, eg, malondialdehyde, protein and nucleic acid damages, ultimately resulting in cell death. Intracellular antioxidant defence mechanisms primarily involve constitutive and inducible proteins (8, 9). The greater part of the glutathione peroxidase enzyme (GPX), which catalyzes the reduction of all peroxides in the soluble compartment of the cell, is selenium-(Se) independant in humans. Animal and human studies concerning selenium-dependant GPX have shown a close correlation between enzyme activity and Se status. The major hydrophobic membrane antioxidant is alpha-tocopherol, the principal compound of the vitamin E group. Oxidative injury related to dialysis may therefore occur in patients with serious disturbances of the status of micronutrients involved in antioxidant defence mechanisms, i.e., selenium, zinc and copper (10). This phenomenon is involved in some pathologic manifestations related to dialysis such as osteoarthropathies (11, 12), or numerous others grouped under the term “accelerated dialysis aging” (13, 14).
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Malvy, D.J.M. et al. (1996). Abnormalities of Antioxidant Micronutrient Status in Hemodialysis Patients. In: Nève, J., Chappuis, P., Lamand, M. (eds) Therapeutic Uses of Trace Elements. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0167-5_31
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