Inflammation and Oxidative Stress in End-Stage Renal Disease Patients Treated with Hemodialysis or Peritoneal Dialysis

Abstract

Purpose The impact of different dialysis modalities on oxidative stress and inflammation and the factors implicated in this interrelationship have not been adequately studied. This study was designed to comparatively evaluate the effect of hemodialysis (HD) and peritoneal dialysis (PD) on oxidative stress and inflammatory biomarkers and to search for associated factors. Methods We studied 20 HD, 11 PD patients and 11 healthy controls. Calculations were based on total antioxidant capacity (TAC) and superoxide dismutase (SOD), by spectrophotometry, as oxidative stress biomarkers; and high sensitivity CRP (hs-CRP), lnterleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α), by ELISA, as inflammation biomarkers. Results HD and PD patients showed significantly increased levels of TAC, SOD and hs-CRP compared to healthy controls. No significant difference was observed in TNF-α and IL-6. Compared to HD patients, PD patients showed TNF-α levels that were increased, although non-significantly and significantly higher homocysteine (Hcy). No differences were observed for IL-6, hs-CRP, TAC and SOD. In HD patients, significant positive correlations were found between intact parathyroid hormone (iPTH) and TNF-α, and between uric acid (UA) and TAC. β2-microglobulin (β2M) was negatively correlated with TAC, total cholesterol (TC) positively with TNF-α and negatively with SOD, and triglycerides (TG) correlated positively with TNF-α. In PD patients, TG correlated positively with TNF-α, HDL-cholesterol negatively with TNF-α, LDL-cholesterol negatively with SOD, and β2M negatively with SOD. Conclusions HD and PD patients show similar degrees of inflammation and oxidative stress activation. Factors such as UA, iPTH, β2M and lipid profile correlate to oxidative stress and inflammatory biomarkers in both HD and PD patients.