Comparison Between the Antioxidant Level of Uremic Patients Before and After Hemodialysis (Hd) and Vitamin E Therapy: Prospective cohort study

Abstract

A prospective cohort study of 18 males aged 19–45 years with chronic renal failure attending the Ibn Sina Teaching Hospital, Mosul for Hemodialysis (HD) between March 2007 and March 2008 assessed the oxidative stress, antioxidant status, serum urea and serum creatinine before and after hemodialysis and following subsequent supplementation with oral Vitamin E. Blood samples collected before starting hemodialysis, after three weeks of twice-weekly dialysis, and then after three weeks of oral vitamin E (400 i.u/day) showed significant decreases of total antioxidant status (TAS) after HD but a significant increase of TAS after Vitamin E therapy; a non-significant increase of lipid peroxidation indicator (serum malondialdehyde; MDA) after HD alone but a significant decrease of MDA after Vitamin E therapy; a highly significant decrease of serum urea after HD and a highly significant increase of serum urea after Vitamin E therapy; a highly significant decrease of serum creatinine after HD and a highly significant increase of serum creatinine after Vitamin E therapy; a highly significant decrease of serum uric acid after HD and a highly significant increase of serum uric acid after Vitamin E therapy. There were non-significant correlations between TAS and MDA, uric acid, serum urea and serum creatinine after HD and after Vitamin E therapy. It is concluded that in patients with chronic renal failure oxidative stress is further exacerbated, as shown by decreased TAS and increased MDA although serum uric acid is not the sole contributor. Vitamin E supplementation in such patients after HD does not enhance renal function but it decreases the oxidative stress by decreasing MDA and enhancing antioxidant body status by increasing significantly TAS and serum uric acid.