Effluent Free Radicals Are Associated with Residual Renal Function and Predict Technique Failure in Peritoneal Dialysis Patients
| Autor: | Hiroshi Morinaga, Kazushi Nakao, Masashi Kitagawa, Makoto Hiramatsu, Hirofumi Makino, Yoko Kikumoto, Ikuko Miyazaki, Hitoshi Sugiyama, Yohei Maeshima, Keiichi Takiue, Shigeru Akagi, Tatsuyuki Inoue, Masato Asanuma |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Free Radicals medicine.medical_treatment Radical Urology Renal function Oxidative phosphorylation Kidney medicine.disease_cause Peritoneal dialysis Humans Medicine Prospective Studies Survival analysis Aged Aged 80 and over Deoxyadenosines business.industry Electron Spin Resonance Spectroscopy Kidney metabolism Original Articles General Medicine Middle Aged Survival Analysis Surgery Oxidative Stress Nephrology Kidney Failure Chronic Female Peritoneum business Peritoneal Dialysis Oxidative stress |
| Zdroj: | Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis. 32:453-461 |
| ISSN: | 1718-4304 0896-8608 |
| DOI: | 10.3747/pdi.2011.00032 |
| Popis: | Objective Residual renal function (RRF) is associated with low oxidative stress in peritoneal dialysis (PD). In the present study, we investigated the relationship between the impact of oxidative stress on RRF and patient outcomes during PD. Methods Levels of free radicals (FRs) in effluent from the overnight dwell in 45 outpatients were determined by electron spin resonance spectrometry. The FR levels, clinical parameters, and the level of 8-hydroxy-2′-deoxyguanosine were evaluated at study start. The effects of effluent FR level on technique and patient survival were analyzed in a prospective cohort followed for 24 months. Results Levels of effluent FRs showed significant negative correlations with daily urine volume and residual renal Kt/V, and positive correlations with plasma β2-microglobulin and effluent 8-hydroxy-2′-deoxyguanosine. A highly significant difference in technique survival ( p < 0.05), but not patient survival, was observed for patients grouped by effluent FR quartile. The effluent FR level was independently associated with technique failure after adjusting for patient age, history of cardiovascular disease, and presence of diabetes mellitus ( p < 0.001). The level of effluent FRs was associated with death-censored technique failure in both univariate ( p < 0.001) and multivariate ( p < 0.01) hazard models. Compared with patients remaining on PD, those withdrawn from the modality had significantly higher levels of effluent FRs ( p < 0.005). Conclusions Elevated effluent FRs are associated with RRF and technique failure in stable PD patients. These findings highlight the importance of oxidative stress as an unfavorable prognostic factor in PD and emphasize that steps should be taken to minimize oxidative stress in these patients. |
| Databáze: | OpenAIRE |
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