DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20163313

To evaluate the hemoglobin concentration, lipid peroxidation and antioxidant status in patients with chronic kidney disease

Sheeba V., Arun Kumar P., Swarnalatha P. K.

Abstract


Background: Oxidative stress plays an important role in the progression of CKD as well as in many of the complications associated with the disease. ROS promotes inflammation, accelerated ageing, fibrosis and apoptosis leading to progression of CKD. Therefore, the present study was carried out to evaluate the serum markers for early diagnosis of patients at different stages of chronic kidney disease.

Methods: The study group consisted of 50 patients with chronic kidney disease who were on conservative treatment with the age group of 20 to 60 years. Based on the creatinine clearance values the patients were assigned in to 3 groups; Stage 3, Stage- 4 and Stage- 5 as per NKF DOQI guidelines. Control group consisted of 50 age and sex matched, non-diabetic, nonsmoker healthy volunteers. About 5 ml of blood was collected and serum was used for the estimation of superoxide dismutase, ceruloplasmin and malondialdehyde and haemoglobin level using standard methods. The data was analyzed by applying student’s t test. The p value of ≤0.05 was taken as the level of significance.

Results: The haemoglobin concentration in all the 3 CKD stages was found to be significantly decreased (p<0.000) whereas, the serum malondialdehyde (MDA) was significantly increased (p=0.000) in patients with CKD. But serum SOD and ceruloplasmin levels of normal and patients with CKD showed significant decline (p<0.000) only in stage 5 whereas, in stage-2 and stage-3 patients it did not show significant variation.

Conclusions: The results of the study reinforce the possibility that antioxidant supplementation may be helpful in correcting anaemia in chronic kidney disease. Treatment of renal anaemia is an effective intervention to ensure better quality of life, to prevent adverse cardiovascular outcomes and to retard the progression of chronic kidney disease so as to reduce the burden of end stage renal disease in the long run.


Keywords


Superoxide dismutase, Ceruloplasmin, Malondialdehyde, Haemoglobin, Chronic kidney disease

Full Text:

PDF

References


Shyam C, Duggal AK, Sunder S. Chronic kidney disease: A perspective. Journal Indian Acad Med. 2007;8(2):150-63.

Obrador GT, Periera BJG. Early referral to the nephrologist and timely initiation of renal replacement therapy. A paradigm shift in the management of patients with chronic renal failure. American Journal of Kidney Diseases. 1998;31:398-417.

Vasudevan DM, Sreekumari S. Text book of Biochemistry. 4th edition, Jay Pee Brothers, Medical Publishers, private Ltd. 2011;338-42.

Galle J. Oxidative stress in chronic renal failure, Nephrology Dialysis and Transplantation. 2001(16);2135-7.

Vaziri ND. Oxidative stress in uremia. Nature Mechanisms and Potential consequences. Seminars in nephrology. 2004;469-73.

Salahudeen AK. Free radicals in kidney disease and Transplantation, Saudi J Kidney Disease and Transplantation. 1999;10(2):137-43.

Sasikala M, Subrahmanyam C, Sadasivadu B. Early oxidative change in low density lipoproteins during progressive chronic renal failure. Indian J Clinical Biochemistry. 1994;14(2):176-83.

Vaziri ND, Dicuo M, Ho ND, Rad LB, Sindhu RK. Oxidative stress and dysregulation of superoxide dismutase and NADPH oxidase in renal insufficiency. Kidney International. 2003;63:179-85.

K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation classification and stratification part 4: Defenition and classification of stages of chronic kidney disease. 2002.

Perazella MA, Reilly RF. Chronic Kidney Disease: A new classification and staging system. Clinical review article. Hospital Physician. 2003;2:18-22.

Annuk M, Zilmer M, Linde L Fellstrom B. Oxidative stress and endothelial function in chronic renal failure. J Am Society Nephrology. 2001;12(12):2742-52.

Bhagwat VR, Mane SD. Anaemia in progressive renal failure. Cause or consequence of oxidative stress. The Indian Practitioner. 2004;57(4):216-20.

Clemens MR, Bursa-Zanetti Z. Lipid abnormalities and peroxidation of erythrocytes in nephritic syndrome. Nephron. 1989:53:325-9.

Mircescu G, Capusa C, Stotian I, Vargolici B, Barbulescu C, Ursea N. Global assessment of serum antioxidant status in haemodialysis patients. Review J Nephrology. 2005;18:599-605.

Robert T. Means Anaemias secondary to chronic disease and systemic disorders; Wintrobe’s Clinical Haematology. Lippincott Williams and Wilkins. 11th ed. 2014;1:1445-65.

Radtke HW, Erbs ACPM, Ernst H, Wilhelm and Carl M. Koch Serum erythropoietin concentration in chronic renal failure; Relationship to degree of anaemia and excretory renal function. Blood. 1979;54(4):19-24.

Clellan WM, Aronoff SL, Bolton WK, Hood S, Lorber DL, Tang KL, Tse TF. Brian Wasserman and Marc leiserowitz The prevalence of anaemia in patients with chronic kidney disease; Current Medical Reasearch and Opinion. 2004;20(9):1501-10.

Subrahmanyam S, Madhavankutty K. Text book of human physiology. 6th edition, S. Chand and company Ltd. P426.

Nagane NS, Ganu JV, Gandhi R. Oxidative stress, serum homocysteine and serum nitric oxide in different stages of chronic renal failure. Biomedical Research. 2009;20(1):71-4.

Weinstein T, Chagnac A, Korzets A, Boaz M, Ori Y, Herman M, et al. Haemolysis in hemodialysis patients: Evidence for impaired defence mechanisms against oxidative stress. Nephrology Dialysis and Transplantation. 2000;15:883-7.

Martin Mateo MC, Sanchez-Portugal M, Iglesias S, de Paula A, Bustamente J. Oxidative stress in renal failure. Renal failure. 1999;21(2):155-61.

Carluccio SW, Radenkovic S, Hampl GTH. Oxidative stress in renal anaemia of haemodialysis patients is mitigated by epoetin treatment. Kidney Blood Pressure Research. 2005;28(5-6):295-301.

Tak WT, Yoon SC. Clinical significance of blood level of zinc and copper in chronic renal failure patients. Korean J Nephrology. 2001;20(5):863-71.

Osaki S, Johnson DA, Frieden E. The possible significance of ferrous oxidase activity of ceruloplasmin in normal human serum. J Biological Chemistry. 1996;241(12):2746-51.

Balasubrahmanian P, Malathi A. Comparitive study of haemoglobin estimated by Drabkin’s and Sahli’s methods. 1992;38(1):8-9.