Skip to main content
Log in

Oxidative stress, inflammation and early cardiovascular damage in children with chronic renal failure

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

The relationship between inflammation, oxidant stress and cardiovascular damage in children with chronic renal failure (CRF) has not previously been investigated. The aim of this study was to investigate markers of oxidative stress, inflammation and early cardiovascular abnormalities. Therefore, erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities; blood glutathione (GSH) and serum malondialdehyde (MDA) levels; C-reactive protein (CRP) and proinflammatory cytokines (IL-6, TNF-α,); and left ventricular masses (LVM) and intima media thicknesses (IMT) were measured in children with CRF. A total of 29 children with CRF (19 nondialysis, 10 peritoneal dialysis) were included. The control group consisted of 25 healthy subjects. CRF children had significantly increased IL-6, TNF-α, CRP and MDA concentrations and decreased SOD, CAT and GSH levels compared with controls (P<0.05). Nondialysis and peritoneal dialysis subgroups had similar oxidative stress and inflammation biomarkers (P>0.05). Erythrocyte CAT was positively correlated with CRP, TNF-α, and IL2-R in the study group. Positive correlations were found between cytokine concentrations, CRP and urea/creatinine levels. Significantly increased LVM and IMT values were found in CRF children (P<0.05). In conclusion, increased oxidant stress and inflammation together with early cardiovascular damage were found in CRF children. Further studies with more patients are needed to verify these results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Vaziri ND, Dicus M, Ho ND, Boroujerdi-Rad L, Sindhu RK (2003) Oxidative stress and dysregulation of superoxide dismutase and NADPH oxidase in renal insufficiency. Kidney Int 63:179–185

    Article  PubMed  CAS  Google Scholar 

  2. Durak I, Akyol O, Basesme E, Canbolat O, Kavutcu M (1994) Reduced erythrocyte defence mechanisms against free radical toxicity in patients with chronic renal failure. Nephron 66:76–80

    Article  PubMed  CAS  Google Scholar 

  3. Lucchi L, Bergamini S, Iannone A, Perrone S, Stipo L, Olmeda F, Caruso F, Tomasi A, Albertazzi A (2005) Erythrocyte susceptibility to oxidative stress in chronic renal failure patients under different substitutive treatments. Artif Organs 29:67–72

    Article  PubMed  CAS  Google Scholar 

  4. Stenvinkel P, Ketteler M, Johnson RJ, Lindholm B, Pecoits-Filho R, Riella M, Heimbürger O, Cederholm T, Girndt M (2005) IL-10, IL-6, and TNF-α: Central factors in the altered cytokine network of uremia—the good, the bad, and the ugly. Kidney Int 67:1226–1233

    Google Scholar 

  5. Stenvinkel P, Heimburger O, Paultre F, Diczfalusy U,Wang T, Berglund L, Jogestrand T (1999) Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney Int 55:1899–1911

    Article  PubMed  CAS  Google Scholar 

  6. Panichi V, Migliori M, DePietro S, Taccola D, Bianchi AM, Giovannini L, Norpoth M, Metelli MR, Cristofani R, Bertelli A, Sbragia G, Tetta C, Palla R (2002) C-reactive protein and interleukin-6 levels are related to renal function in predialytic chronic renal failure. Nephron 91:594–600

    Article  PubMed  CAS  Google Scholar 

  7. Heitzer T, Schlinzig T, Krohn K, Meinertz T, Munzel T (2001) Endothelial dysfunction, oxidative stress and risk of cardiovascular events in patients with coronary artery disease. Circulation 104:2673–2678

    Article  PubMed  CAS  Google Scholar 

  8. Locatelli F, Canaud B, Eckardt KU, Stenvinkel P, Wanner C, Zoccali C (2003) Oxidative stress in end-stage renal disease: an emerging threat to patient outcome. Nephrol Dial Transplant 18:1272–1280

    Article  PubMed  CAS  Google Scholar 

  9. Himmelfarb J, Stenvinkel P, Ikizler TA, Hakim RM (2002) The elephant in uremia: Oxidant stress as a unifying concept of cardiovascular disease in uremia. Kidney Int 62:1524–1538

    Article  PubMed  CAS  Google Scholar 

  10. Parekh RS, Gidding SS (2005) Cardiovascular complications in pediatric end-stage renal disease. Pediatr Nephrol 20:125–131

    Article  PubMed  Google Scholar 

  11. Mitsnefes MM, Kimball TR, Witt SA, Glascock BJ, Khoury PR, Daniels SR (2004) Abnormal carotid artery structure and function in children and adolescents with successful renal transplantation. Circulation 110:97–101

    Article  PubMed  Google Scholar 

  12. Diepeveen SHA, Verhoeven GH, van der Palen J, Dikkeschei B, van Tits LJ, Kolsters G, Offerman J, Bilo HJG, Stalenhoef AFH (2004) Oxidative stress in patients with end-stage renal disease prior to the start of renal replacement therapy. Nephron Clin Pract 98:c3–c7

    Google Scholar 

  13. Oberg BP, McMenamin E, Lucas FL, McMonagle E, Morrow J, Ikizler TA, Himmelfarb J (2004) Increased prevalence of oxidant stress and inflammation in patient with moderate to severe chronic renal disease. Kidney Int 65:1009–1016

    Article  PubMed  Google Scholar 

  14. Asayama K, Shiki Y, Ito H, Hasegawa O, Miyao A, Hayashibe H, Dobashi K, Kato K (1990) Antioxidant enzymes and lipoperoxide in blood in uremic children and adolescents. Free Radic Biol Med 9:105–109

    Article  PubMed  CAS  Google Scholar 

  15. Zwolinska D, Grzeszczak W, Kilis-Pstrusinska K, Szprynger K, Szczepanska M (2004) Lipid peroxidation and antioxidant enzymes in children with chronic renal failure. Pediatr Nephrol 19:888–892

    Article  PubMed  Google Scholar 

  16. Zachwieja J, Zaniew M, Bobkowski W, Stefaniak E, Warzywoda A, Ostalska-Nowicka D, Dobrowolska-Zachwieja A, Lewandowska-Stachowiak M, Siwinska A (2005) Beneficial in vitro effect of N-acetyl-cysteine on oxidative stress and apoptosis. Pediatr Nephrol 20:725–731

    Google Scholar 

  17. Van Rossum LK, Mathot RA, Cransberg K, Zietse R, Vulto AG (2005) Estimation of the glomerular filtration rate in children: which algorithm should be used? Pediatr Nephrol 20:1769–1775

    Google Scholar 

  18. Winterbourn CC, Hawkins RE, Brian M, Earrell RW (1975) The estimation of red cell superoxide dismutase activity. J Lab Clin Med 85:337–339

    PubMed  CAS  Google Scholar 

  19. Aebi H (1984) Catalase in vitro. Methods Enzymol 105:21–25

    Google Scholar 

  20. Van Kampen EJ, Zijlstra WG (1965) Determination of hemoglobin and its derivatives. Adv Clin Chem 8:141–187

    PubMed  Google Scholar 

  21. Beutler E, Duran O, Kelly BM (1963) Improved method for the determination of blood glutathione. J Lab Clin Med 61:882–886

    PubMed  CAS  Google Scholar 

  22. Asakawa T, Matsushita S (1980) Coloring conditions of thiobarbituric acid test for detecting lipid hydroperoxides. Lipids 15:137–141

    Article  CAS  Google Scholar 

  23. Devereux RB, Reichec N (1977) Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 55:613–618

    PubMed  CAS  Google Scholar 

  24. Colan SD, Borow KM, Neumann A (1984) Left ventricular end-systolic wall stress-velocity of fiber shortening relation: a load-independent index of myocardial contractility. J Am Coll Cardiol 4:715–724

    Article  PubMed  CAS  Google Scholar 

  25. Quaschning T, Krane V, Metzger T, Wanner C (2001). Abnormalities in uremic lipoprotein metabolism and its impact on cardiovascular disease. Am J Kidney Dis 38:S14–S19

    PubMed  CAS  Google Scholar 

  26. Mimic-Oka J, Simic T, Djukanovic L, Reljic Z, Davicevic Z (1999) Alteration in plasma antioxidant capacity in various degrees of chronic renal failure. Clin Nephrol 51:233–241

    PubMed  CAS  Google Scholar 

  27. Konukoglu D, Ercan M, Ayaz M, Onen S (2001) Plasma and erythrocytes antioxidant status and trace element levels in proteinuric patients with moderate glomerular function. J Trace Elem Med Biol 15:119–122

    Article  PubMed  CAS  Google Scholar 

  28. Ozden M, Maral H, Akaydin D, Cetinalp P, Kalender B (2002) Erythrocyte glutathione peroxidase activity, plasma malonyldialdehyde and erythrocyte glutathione levels in hemodialysis and CAPD patients. Clin Biochem 35:269–273

    Article  PubMed  CAS  Google Scholar 

  29. Himmelfarb J, McMonagle E (2001) Albumin is the major plasma protein target of oxidant stress in uremia. Kidney Int 60:358–363

    Article  PubMed  CAS  Google Scholar 

  30. Ece A, Atamer Y, Gürkan F, Davutoglu M, Koçyigit Y, Tutanç M (2005) Paraoxonase, total antioxidant response, and peroxide levels in children with steroid-sensitive nephrotic syndrome. Pediatr Nephrol 20:1279–1284

    Article  PubMed  Google Scholar 

  31. Ece A, Atamer Y, Gurkan F, Davutoglu M, Bilici M, Tutanc M, Gunes A (2005) Paraoxonase, anti-oxidant response and oxidative stress in children with chronic renal failure. Pediatr Nephrol 21:239–245

    Google Scholar 

  32. Sommerburg O, Grune T, Ehrich JH, Siems WG (2002) Adaptation of glutathion-peroxidase activity to oxidative stress occurs in children but not in adult patients with end-stage renal failure undergoing hemodialysis. Clin Nephrol 58(Suppl 1):S31–S36

    Google Scholar 

  33. Pecoits-Filho R, Heimburger O, Barany P, Suliman M, Fehrman-Ekholm I, Lindholm B, Stenvinkel P (2003) Associations between circulating inflammatory markers and residual renal function in CRF patients. Am J Kidney Dis 41:1212–1218

    Article  PubMed  Google Scholar 

  34. Enia G, Mallamaci F, Benedetto FA, Panuccio V, Parlongo S, Cutrupi S, Giacone G, Cottini E, Tripepi G, Malatino LS, Zoccali C (2001) Long-term CAPD patients are volume expanded and display more severe left ventricular hypertrophy than haemodialysis patients. Nephrol Dial Transplant 16:1459–1464

    Article  PubMed  CAS  Google Scholar 

  35. Sorof JM, Cardwell G, Franco K, Portman RJ (2002) Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 39:903–908

    Article  PubMed  CAS  Google Scholar 

  36. Saygili A, Barutcu O, Cengiz N, Tahran NC, Pourbagher A, Niron EA, Saatci U (2002) Carotid intima media thickness and left ventricular changes in children with end-stage renal disease. Transplant Proc 34: 2073–2075

    Google Scholar 

  37. Massy ZA, Nguyen-Khoa T (2002) Oxidative stress and chronic renal failure: markers and management. J Nephrol 15:336–341

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aydın Ece.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ece, A., Gürkan, F., Kervancıoğlu, M. et al. Oxidative stress, inflammation and early cardiovascular damage in children with chronic renal failure. Pediatr Nephrol 21, 545–552 (2006). https://doi.org/10.1007/s00467-006-0039-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-006-0039-0

Keywords

Navigation