| Objectives: Oxidative stress is generally defined as an imbalancebetween the generation of reactive oxygen species (ROS) and impairedantioxidant defense systems. It has been observed in Chronic kidney disease(CKD) patients, which led to a variety of tissue damage. It is commonknowledge that the superoxide dismutase (SOD) is a natural antibody ofoxygen free radicals in organism. Malondialdehyde (MDA), as one of themost popular markers, was designed to indicate lipid peroxidation. Proteinsthat are exquisitely vulnerable to ROS in vivo have been designated asadvanced oxidation protein products (AOPP). It will increase the oxidativestress, and promote the development of inflammation. Peritoneal dialysis isone of the replacement therapy for treating the end-stage renal disease.Residual renal function (RRF) correlates with the survival rate of patients withperitoneal dialysis (PD). The aim of the present study was to describe therelationship between RRF and oxidative stress in PD patients, by studyingSOD, MDA and AOPP.Methods: The experimental group:81uremia patients (mean age45.32±13.59years,39males,42females) on PD for＞3months, excludingspecial medication history, infection, acute cardiovascular andcerebrovascular events, active hepatitis or cirrhosis, malignancy, trauma,surgical and other complications. Based on RRF, all patients were divided into2groups: RRF≥1ml/min, RRF＜1ml/min. The normal control group:12healthy control subjects (mean age40.92±5.32years,5males,7females).Activity of SOD was detected by xanthine oxidase technique. Serum MDAcontents were assayed according to thiobarbituric acid method.Enzyme-linked immunoassay (ELISA) was used to detect AOPP in serum.Clinical data were collected such as high sensitive c-reactive protein (hsCRP), hemoglobin (Hb), serum albumin (ALB), total cholesterol (CHOL), ureanitrogen (BUN), serum creatinie (Scr), serum calcium (Ca), serum phosphorus(Phos). The general condition of patients and urea kinetics (KT/V) wererecorded. All the data were processed and analysed by SPSS13.0software.Results:1The levels of serum SOD, MDA and AOPP in PD patients: the levelsof serum SOD in PD patients (64.30±26.95) U/ml were significantly lowerthan that in control group(88.34±15.58) U/ml, the levels of serum MDA(5.80±1.21) umol/ml were significantly higher than that (3.34±0.71) umol/mlin control group(P＜0.01), and the levels of serum AOPP (141.13±42.83)pmol/L were significantly higher than that (84.76±29.01) pmol/L in controlgroup(P＜0.01);2The comparisons of the levels of oxidative stress in PD patients withdifferent RRF: all patients were divided into2groups:55cases have RRF(RRF≥1ml/min), accounted for67.90%(27males,28females), and26casesno RRF (RRF＜1ml/min),12males,14females. The levels of serum SOD inhave RRF group (63.12±27.80)U/ml and no RRF group (68.90±24.95)U/mlwere both significantly lower than that in control group(88.34±15.58)U/ml (P＜0.01, P＜0.05), but there was no statistically significantly differencebetween the two groups. The levels of serum MDA in have RRFgroup(5.88±1.00) umol/ml and no RRF group (5.97±1.37) umol/ml were bothsignificantly higher than that in control group (3.34±0.71) umol/ml(P＜0.01,P＜0.05), but there was no statistically significantly difference between thetwo groups. The levels of serum AOPP in have RRF group(131.13±43.80)pmol/L and no RRF group (159.57±42.56) pmol/L were both significantlyhigher than that in control group(84.76±29.00) pmol/L (P＜0.01, P＜0.05),and the levels of serum AOPP in on RRF group was significantly higher thanthat in have RRF group (P＜0.01).3The comparisons of the levels of oxidative stress in PD patients withdifferent time on dialysis: all patients were divided into2groups,35cases(43.21%) PD longer than12months (time＞12months),46cases(45.79%) PD shorter than12months (time≤12months). The levels of serum SOD in time＞12months group (71.11±26.60) U/ml was significantly higher than that in time≤12months group (59.11±26.33) U/ml (P＜0.05). But there were nostatistically significantly difference about the levels of serum MDA and AOPPbetween the two groups (P＞0.05).4Results of correlation analysis: the levels of serum SOD among PDpatients were positively correlated with time on PD (r=0.220, P=0.049), andnot correlated with age, BMI, blood pressure, Hb, ALB, CHOL, BUN, Scr,hsCRP, KT/V, Ccr (P＞0.05). The levels of serum MDA among PD patientswere positively correlated with age (r=0.320, P=0.004), BMI (r=0.262,P=0.018), CHOL (r=0.427, P=0.000), negatively correlated with KT/V(r=-0.276, P=0.013), and not correlated with blood pressure, time on PD, Hb,ALB, BUN, Scr, hsCRP, Ccr (P＞0.05). The levels of serum AOPP amongPD patients were positively correlated with systolic blood pressure (r=0.225,P=0.043), diastolic blood pressure (r=0.253, P=0.022), BUN (r=0.319,P=0.004), hsCRP (r=0.279, P=0.012), negatively correlated with Urine（r=-326, P=0.003), and not correlated with age, BMI, time on PD, Hb, ALB,CHOL, Scr, KT/V, Ccr (P＞0.05). Serum SOD was negatively correlated withserum MDA (r=-0.210, P=0.043), not significant correlated with serum AOPP(r=-0.195, P=0.061), serum MDA was positively correlated with serum AOPP(r=0.358, P=0.000).Conclusions:1Enhanced oxidative stress has been observed in peritoneal dialysispatients.2Oxidative stress of peritoneal dialysis patients may be correlated withthe decline of residual renal function.3Advanced oxidation protein products were accurate and sensitive, forwhat it could be used to test the oxidative stress at an early stage. |
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