Evaluation of Plasma Concentrations of Homocysteine, IL-6, TNF-Alpha, Hs-CRP, and Total Antioxidant Capacity in Patients with End-Stage Renal Failure
It has been proved that hyperhomocysteinemia has a high prevalence in patients with end-stage renal disease (ESRD), which may contribute to the high cardiovascular risk in these patients. Cardiovascular disease is the first cause of high mortality rate in ESRD patients. The aim of the present study was to assess five important factors in patients with ESRD (the amount of homocysteine, IL-6, TNF-alpha, hs-CRP, and Total Antioxidant Capacity). These factors were surveyed in ESRD patients to compare with healthy subjects. In a cross-sectional study, we enrolled 80 patients on maintenance hemodialysis and measured the inflammatory and oxidative stress indicators. The plasma samples were assayed for five above mentioned variables using standard protocols. Two-hour post hemodialysis plasma samples were also assayed for TAC. Plasma levels of inflammation markers, IL-6 and hs-CRP, homocysteine were significantly increased in ESRD group versus control group. This increase was also found in TNF-α levels as compared to the controls, but the differences were not statistically significant. Also, the post dialysis samples had significantly lower levels of TAC as compared to predialysis ones.
Van Guldener C, Kulik W, Bergar R, et al. Homocysteine and methionine metabolism in ESRD: A stable isotope study. Kidney Int 1999;56(3):1064-71.
van Guldener C. Homocysteine and the Kidney. Curr Drug Metab 2005;6(1):23-6.
Stadnyk AW. Cytokine production by epithelial cells. Faseb J 1994;8(13):1041-7.
Chun S, Kim SB, Min W. Total Antioxidant Capacities in Patients with End-Stage Renal Disease and Effect of Hemodialysis. Korean J Clin Pathol 2000;20:275-8.
Tepel M, van der Giet M, Statz M, et al. The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failure: a randomized, controlled trial. Circulation 2003;107(7):992-5.
Stenvinkel P, Alvestrand A. Inflammation in end-stage renal disease: sources, consequences, and therapy. Semin Dial 2002;15(5):329-37.
O'Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst 2004;96(19):1420-5.
Vester B, Rasmussen K. High-performance liquid chromatography method for rapid and accurate determination of homocysteine in plasma and serum. Eur J Clin Chem Clin Biochem 1991;29(9):549-54.
Benzie IF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of "antioxidant power": the FRAP assay. Anal Biochem 1996;239(1):70-6.
Ueland PM, Refsum H. Plasma homocysteine, a risk factor for vascular disease: plasma levels in health, disease, and drug therapy. J Lab Clin Med 1989;114(5):473-501.
Nguyen-Khoa T, Massy ZA, De Bandt JP, et al. oxidative stress and haemodialysis: role of inflammation and duration of dialysis treatment. Naphrol Dial Transplant 2001;16(2):335-40.
Simmons EM, Langone A, Sezer MT, et al. Effect of renal transplantation on biomarkers of inflammation and oxidative stress in end-stage renal disease patients. Transplantation 2005;79(8):914-9.
Stenvinkel P, Ketteler M, Johnson RT, et al. IL-10, IL-6, and TNF-alpha: central factors in the altered cytokine network of uremia--the good, the bad, and the ugly. Kidney Int 2005;67(4):1216-33.
Filiopoulos V, Hadjiyannakos D, Takouli L, et al. Inflammation and oxidative stress in end-stage renal disease patients treated with hemodialysis or peritoneal dialysis. Int J Artif Organs 2009;32(12):872-82.
Hutchinson WL, Koenig W, Fröhlich M, et al. Immunoradiometric assay of circulating C-reactive protein: age- related values in the adult general population. Clin Chem 2000;46(7):934-8.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.