Oxidative stress during ex vivo hemodialysis of blood is decreased by a novel hemolipodialysis procedure utilizing antioxidants

Free Radic Biol Med. 2002 Jul 15;33(2):248-58. doi: 10.1016/s0891-5849(02)00875-4.

Abstract

The high cardiovascular mortality in patients receiving hemodialysis (HD) has been attributed, in part, to oxidative stress. Here we examined the effectiveness of antioxidants introduced by means of a novel hemolipodialysis (HLD) procedure in terms of reducing oxidative stress during ex vivo blood circulation. Oxidative stress was studied in a model HD system resembling the extracorporeal circulation of blood during clinical HD. Blood circulation produced an increase of up to 280% in free hemoglobin levels and an increase of 320% in electronegative LDL (LDL(-)) subfraction. A significant correlation between LDL(-) and free hemoglobin levels confirmed previous findings that LDL(-) formation during ex vivo circulation of blood can be mediated by the oxidative activity of free hemoglobin. These effects were significantly attenuated during HLD using a dialysis circuit containing vitamin E with or without vitamin C. By contrast, HLD with vitamin C alone had a marked pro-oxidant effect. TBARS, lipid hydroperoxides, vitamin E and beta-carotene content in LDL were not significantly altered by the HD procedure. These findings demonstrate the occurrence of oxidative stress in human plasma where lipoproteins are a target and indicate antioxidant-HLD treatment as a specific new approach to decreasing the adverse oxidative stress frequently associated with cardiovascular complications in high-risk populations of uremic patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antioxidants / therapeutic use*
  • Ascorbic Acid / therapeutic use
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / metabolism*
  • Cardiovascular Diseases / prevention & control
  • Drug Therapy, Combination
  • Humans
  • Lipid Peroxidation
  • Lipoproteins, LDL / blood*
  • Oxidative Stress / drug effects*
  • Renal Dialysis*
  • Thiobarbituric Acid Reactive Substances / metabolism
  • Vitamin E / therapeutic use

Substances

  • Antioxidants
  • Lipoproteins, LDL
  • Thiobarbituric Acid Reactive Substances
  • Vitamin E
  • Ascorbic Acid