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Effect of Hemodialysis on Plasma Myeloperoxidase Activity in End Stage Renal Disease Patients

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Abstract

End stage renal disease (ESRD) patients on hemodialysis (HD) have an increased oxidative stress, with a high risk of atherosclerosis and other co-morbid conditions. Recent studies have suggested that myeloperoxidase (MPO)—mediated oxidative stress may play a role in the pathogenesis of cardiovascular complications in dialysis patients. Furthermore, dialysis treatment ‘per se’ can aggravate oxidative stress. Hence this study was designed to determine whether HD leads to an alteration in the plasma levels of MPO and malondialdehyde (MDA), a marker of oxidative stress in ESRD patients on maintenance HD. To study the effect of HD, plasma MPO and MDA were determined before and after HD in forty ESRD patients (24 men and 16 women, age between 8 and 71 years, median being 40.5 years) on maintenance HD. Plasma MPO and MDA were assayed by spectrophotometric methods. Haematological and other biochemical parameters were obtained from patients’ case records. Plasma MPO and MDA levels were significantly higher after HD when compared with pre-dialysis levels (p < 0.05). There was no correlation between MPO and MDA (r = 0.184, p = 0.10) and other biochemical parameters (p > 0.05). However, there was a significant correlation between MPO and MDA with haemodialysis vintage (p < 0.05). In univariate regression analysis duration of HD (β = 1.470, p = 0.045, β = 0.388, p = 0.013), was independently associated with MPO and MDA. Although HD is indispensable for survival of patients with ESRD, it is fraught with undesirable side-effects, such as an increase in the plasma MPO and MDA levels. The elevated levels of MPO contribute to the increased oxidative stress as free radicals are produced by the reaction catalyzed by it.

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References

  1. Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH. Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med. 2004;164:659–63.

    Article  PubMed  Google Scholar 

  2. Himmelfarb J. Hemodialysis complications. Am J Kidney Dis. 2005;45:1122–31.

    Article  PubMed  Google Scholar 

  3. Arnhold J. Properties, functions, and secretion of human myeloperoxidase. Biochemistry. 2003;69:4–9.

    Google Scholar 

  4. Nicholls SJ, Hazen SL. Myeloperoxidase and cardiovascular disease. Arterioscler Thromb Vasc Biol. 2005;25:1102–11.

    Article  PubMed  CAS  Google Scholar 

  5. Brennan ML, Penn MS, Van Lente F, Nambi V, Shishehbor MH, Aviles RJ, et al. Prognostic value of myeloperoxidase in patients with chest pain. N Engl J Med. 2003;349:1595–604.

    Article  PubMed  CAS  Google Scholar 

  6. Tang WH, Wu Y, Nicholls SJ, Hazen SL. Plasma myeloperoxidase predicts incident cardiovascular risks in stable patients undergoing medical management for coronary artery disease. Clin Chem. 2011;57:1–7.

    Article  Google Scholar 

  7. Bansal V, Cunanan J, Hoppensteadt D, Wahi R, Fareed J. Up regulation of myeloperoxidase in end stage renal disease and its modulation by hemodialysis. J Thromb Haemost. 2007;52:S609.

    Google Scholar 

  8. Kalantar-Zadeh K, Brennan ML, Hazen SL. Serum myeloperoxidase and mortality in maintenance hemodialysis patients. Am J Kidney Dis. 2006;48:59–68.

    Article  PubMed  CAS  Google Scholar 

  9. Wu CC, Chen JS, Wu WM, et al. Myeloperoxidase serves as a marker of oxidative stress during single haemodialysis session using two different biocompatible dialysis membranes. Nephrol Dial Transplant. 2005;20:1134–9.

    Article  PubMed  CAS  Google Scholar 

  10. Madhusudhana Rao A, Anand U, Anand CV. Myeloperoxidase in chronic kidney disease. Indian J Clin Biochem. 2011;26:28–31.

    Article  PubMed  CAS  Google Scholar 

  11. Krueger AJ, Yang JJ, Roy TA, Robbins DJ, Mackerer CR. An automated myeloperoxidase assay. Clin Chem. 1990;36:158.

    PubMed  CAS  Google Scholar 

  12. Wilbur KM, Bernheim F, Shapiro OW. The TBARS reagent as a test for the oxidation of unsaturated fatty acids by various agents. Arch Biochem Biophys. 1943;24:305–13.

    Google Scholar 

  13. Krieter DH, Lemke HD, Wanner C. Myeloperoxidase serves as a marker of oxidative stress during single haemodialysis session using two different biocompatible membranes. Nephrol Dial Transplant. 2006;21:546.

    Article  PubMed  Google Scholar 

  14. Rutgers A, Heeringa P, Kooman JP, et al. Peripheral blood myeloperoxidase activity increases during hemodialysis. Kidney Int. 2003;64:760.

    Article  PubMed  Google Scholar 

  15. Borawski J. Myeloperoxidase as a marker of hemodialysis biocompatibility and oxidative stress: the underestimated modifying effects of heparin. Am J Kidney Dis. 2006;47:37–41.

    Article  PubMed  Google Scholar 

  16. Gritters M, Grooteman MPC, Schoorl M, et al. Citrate anticoagulation abolishes degranulation of polymorphonuclear cells and platelets and reduces oxidative stress during haemodialysis. Nephrol Dial Transplant. 2006;21:153–9.

    Article  PubMed  CAS  Google Scholar 

  17. Himmelfarb J, Stenvinkel P, Ikizler TA, et al. The elephant in uremia: oxidant stress as a unifying concept of cardiovascular disease in uremia. Kidney Int. 2002;62:1524–38.

    Article  PubMed  CAS  Google Scholar 

  18. Nguyen-Khoa T, Massy ZA, De Bandt JP, et al. Oxidative stress and haemodialysis: role of inflammation and duration of dialysis treatment. Nephrol Dial Transplant. 2001;16:335–40.

    Article  PubMed  CAS  Google Scholar 

  19. Drueke T, Witko-Sarsat V, Massy Z, et al. Iron therapy, advanced oxidation protein products and carotid artery intima-media thickness in end-stage renal disease. Circulation. 2002;106:2212–7.

    Article  PubMed  Google Scholar 

  20. Capeillere BC, Gausson V, Nguyen AT, Descamps LB, Drueke T, Witko SV. Respective role of uraemic toxins and myeloperoxidase in the uraemic state. Nephrol Dial Transplant. 2006;21:1555–63.

    Article  Google Scholar 

  21. Hawkins CL, Davies MJ. Hypochlorite-induced oxidation of proteins in plasma: formation of chloramines and nitrogen-centered radicals and their role in protein fragmentation. Biochem J. 1999;340:539–48.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors thank the Indian Council of Medical Research (ICMR), New Delhi, for their financial support.

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The authors declare that they have no competing interests.

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Correspondence to C. V. Anand.

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All the authors contributed in research design, data collection, analysis of data and drafting article.

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Rao, A.M., Apoorva, R., Anand, U. et al. Effect of Hemodialysis on Plasma Myeloperoxidase Activity in End Stage Renal Disease Patients. Ind J Clin Biochem 27, 253–258 (2012). https://doi.org/10.1007/s12291-012-0194-y

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  • DOI: https://doi.org/10.1007/s12291-012-0194-y

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