Abstract
Aims
Nephropathic patients show higher levels of advanced glycation end products (AGEs) and oxidized human serum albumin (HSAox) compared to healthy subjects. These two classes of compounds are formed as the result of oxidative insults; for this reason, they can be useful oxidative stress biomarkers. The present study examines the variation of AGEs and HSAox in hemodialysis (HD) patients before and after dialysis session, evaluating the impact of different dialytic techniques and filters on their removal.
Methods
A total of 50 healthy subjects (control group) and 130 HD patients were enrolled in the study. Hemodialysis patients were subdivided based on dialytic techniques: 109 in diffusive technique and 22 in convective technique. We monitored HSAox, AGEs and other laboratory parameters at early morning in healthy subjects and in HD patients before and after the dialysis procedures.
Results
The level of HSAox decreases after a single dialytic session (from 58.5 ± 8.8% to 41.5 ± 11.1%), but the concentration of total AGEs increases regardless of adopted dialytic techniques (from 6.8 ± 5.2 µg/ml to 9.2 ± 4.4 µg/ml). In our study, levels of HSAox and total AGEs are similar in diabetic and non-diabetic HD patients. The increase in total AGEs after dialysis was only observed using polysulfone filters but was absent with polymethacrylate filters.
Conclusions
HSAox is a simple and immediate method to verify the beneficial effect of a single dialysis session on the redox imbalance, always present in HD patients. Total AGEs assayed by ELISA procedure seem to be a less reliable biomarker in this population.
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Data availability
The data used to support the findings of this study are available from the corresponding author upon request.
Abbreviations
- AGEs:
-
Advanced glycation end products
- BSA:
-
Bovine serum albumin
- CKD:
-
Chronic kidney disease
- DTNB:
-
5,5′-Dithiobis(2-nitrobenzoic) acid
- ESRD:
-
End-stage renal disease
- e-GFR:
-
Estimated glomerular filtration rate
- GFR:
-
Glomerular filtration rate
- Glo 1:
-
Glyoxalase 1
- HD:
-
Hemodialysis
- HF:
-
Hemoperfusion
- HSAox:
-
Oxidized human serum albumin
- IGF-1:
-
Insulin growth factor-1
- IL-1β:
-
Interleukin-1β
- MG:
-
Methylglyoxal
- NADPH:
-
Nicotinamide adenine dinucleotide phosphate
- Pdiast:
-
Diastolic blood pressure
- Psyst:
-
Systolic blood pressure
- PTV:
-
Policlinico Tor Vergata
- RAGE:
-
AGE cell receptor
- RCTs:
-
Randomized clinical trials
- ROS:
-
Reactive oxygen species
- SD:
-
Standard deviation
- sRAGE:
-
AGE soluble receptor
- TNF-α:
-
Tumor necrosis factor-α
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Acknowledgements
We would like to thank Caterina Gola for her English language revision.
Funding
The present study was supported by Federazione Medico Sportiva Italiana; by Mission: Sustainability Grant to A.B. [Decreto Rettorale 2817/2016].
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee “Comitato Etico Indipendente”—Azienda Ospedaliera Universitaria Policlinico Tor Vergata (experimentation Register Number 60/16) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Noce, A., Rovella, V., Marrone, G. et al. Hemodialysis biomarkers: total advanced glycation end products (AGEs) against oxidized human serum albumin (HSAox). Acta Diabetol 56, 1323–1331 (2019). https://doi.org/10.1007/s00592-019-01413-7
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DOI: https://doi.org/10.1007/s00592-019-01413-7