The Intervention Of Vitamin E For Oxidative Stress In Dialysis Patients

Background The level of oxidant substances in blood circulation are increased in patients with chronic renal failure (CRF). The extra high level of oxidant substances and their effects are called oxidative stress. It has been demonstrated in many studies that oxidative stress has been incriminated in the development of the dialysis-related diseases, especially in cardiovascular disease (CVD) and ? 2-microglobulin amyloid arthropathy. And these diseases are the common complications and the main causes of death in the dialysis patients. The condition of oxidative stress was exist in these dialysis patients, such as the incompatibility of dialysis membrane, the low degrade of antioxidants glutathione and selenium, the descending activity antioxidant enzymes of GSHPx and SOD. So when the antioxidants are replenished in these dialysis patients, the oxidative stress would be improved and the morbidity of CVD would decline. As an important antioxidant, Vitamin E has been widely dispersed over the surface of biomembranes in various tissues and organs. Whenever the oxidants attack the biomembranes, vitamin E is first consumed in order to protect tissues and organs, then series of reactions on the biomembranes are well proceeding. The foreign reports have been demonstrated that the mortality and morbidity of CVD were decreased when-5 -high dose vitamin E were provided to the dialysis patients. They also reported that vitamin E coated cellulose membrane dialysers can reduce the LDL oxidants and the progress of aortic calcification.Advanced oxidation protein products (AOPP) was first described by Witko-Sarsat in 1996, there are oxidative modified proteins which have dityrosine structures and have absorption peak of OD at 340nm in acid condition in HD patients. In following research it was found that AOPP has already significantly increased in the early stage of CRF, and following the reduction of GFR, AOPP level increasingly ascend, reach the peak and maintain a high level in HD patients. Otherwise, AOPP could trigger the respiration burst of neutrophils and monocytes in vitro; it is a sensitive marker of oxidative stress and novel mediator of inflammation in CRF patients. Witko-Sarsat et al. also find that AOPP level of circulation is correlated with Intima-medial Thickness(IMT). Hideaki Kaneda et al. researched the coronary artery disease patients and found that their circular AOPP levels were significantly higher than healthy controls, and obviously correlated with the serious degree of CVD, and AOPP was an independent risk factor for CVD. Therefore AOPP is selected as an important observing mark. And Malondialdehyde(MDA) Glutathione peroxidase(GHSPx) are also selected as lipid peroxidant and antioxidant marks.Objective To research the intervention of vitamin E for oxidative stress in dialysis patients.Methods 1. Cases Selection: 56 maintainous hemodialysis patients (32 males, 24 females) and 4 CARD patients (2 males, 2 females), mean serum-6-creatine 966. 4?3. 2Hraol/L (754, 6~1215. IWnol/L), mean age 52.6 +16. 7 years (16~84 years). 66 healthy volunteers(31 males, 35 females) were as controls, mean age 49.4+17. 8years(21-83years).2. Intervention Procedures: At first we determined the serum concentrations of AOPPN MDA GSHPx and Vit E in 66 healthy controls, and set up the normal reference; At the same time we determined the serum concentrations of AOPPN MDA GSHPx and Vit E in 60 dialysis patients, and then compared their averages. Secondly we observed the 60 dialysis patients for one month and compared their differences to observe fluctuations of OS status; at last randomized split the 60 dialysis patients to two groups (each group 30 cases) and received different intervention respectively: (1) low dose group toke Vit E 200 mg per day; (2) high dose group toke Vit E 400 mg per day; One month after intervention we determined the OS markers and made the statistical differences. All values are reported as the MEAN+ SD, and statistical significance was set at P<0.05.3. Assay Procedures: Venous blood...