Relation Between Oxidative Stress and Carotid Artery Atherosclerosis in Hemodyalisis Patients

Abstract

Abstract INTRODUCTION Oxidative stress represents a significant risk factor for the accelerated development of atherosclerosis in a population of patients on regular hemodialysis. Oxidative stress induced by hemodialysis can be triggered with both the bioincompatibility of dialysis membrane and increased endotoxin concentration in a hemodialysis solution. AIM The aim of this study was to investigate the correlation between the parameters of oxidative stress, microinflammation, nutrition, secondary hyperparathyroidism and carotid artery intima-media thickness in patients on regular hemodialysis. METHODS One hundred and twenty five patients treated with standard hemodialysis and on-line hemodiafiltration with “high-flux” polysulfone dialysis membrane were examined. The following parameters of oxidative stress were measured : index of lipid peroxidation - measured as TBARS, nitric oxide in the form of nitrite - NO2-, super oxide anion radical - O2- and hydrogen peroxide - H2O2, catalase, superoxide dismutase (SOD) and reduced glutathione activity. For statistical analysis of results, the following tests were used: the Kolmogorov-Smirnov test, the Spirman test and the Pearson correlation test. RESULTS Oxidative stress affects atherosclerosis of the carotid arteries in patients treated with regular hemodialysis and online hemodiafiltration. There is a statistically significant positive correlation between H2O2 concentration and the thickness of the carotid arteries` intima-media. High statistically significant positive correlation was found between TBARS concentration and carotid arteries intima-media thickness, while a high statistically significant negative correlation was found between SOD activity and a carotid artery intima-media thickness. There is a statistically significant negative correlation between the serum albumin and prealbumin concentration and a carotid artery intima-media thickness. CONCLUSION Oxidative stress may be a significant risk factor for the carotid artery atherosclerosis development in patients treated with regular hemodialysis.