The Relationship Between Oxidative Stress and Osteoporosis in Chronic Dialysis Patients

Öz

Aim: End Stage Renal Disease (ESRD) patients are subjected to enhanced oxidative stress (OS), and osteoporosis (OP) is an important cause of morbidity in patients with ESRD. Although it is controversial, in many studies made in population without renal disease, OS is related to increased OP risk. In recent study we aimed to investigate the association between OS and OP in dialysis patients. Materials and methods: Sixty two patients on maintenance dialysis programme were included into the study. Total oxidant status (TOS), lipid hydroperoxides (LOOH), and total antioxidant capacity (TAC) and bone mineral density was measured. Demographic and biochemical parameters were recorded. Patients were divided as group 1: Hemodialysis and group 2: Peritoneal Dialysis and compared. Results: Twentynine of 62 patients were on HD and 33 were on PD. In Bone mineral density BMD T–scores while there was no statistically significant difference between two groups at femur neck, according to lumbar spine among HD patients T score was better then PD patients. Mean serum concentration of LOOH was 6.07±2.91 and 5.82±2.20 µmolH2O2Eq/L, TOS was 8.89±5.89 and 7.62±3.99 µmol H2O2Eq/L, and the TAC was 1.01±0.20 and 0.93±0.16 mmolTroloxEq/L in group 1 and in group 2 respectively. Among all patients there was a positive correlation between TAC and T score in FN. There was no correlation between TOS and T-scores. Conclusion: Although enhanced OS and reduced antioxidant capacity in dialysis patients we did not find any effect of OS on OP. This result may be due to low OP rate in our patients and this novel topic needs further large scale studies in dialysis population.

Anahtar Kelimeler

• end stage renal disease
• oxidative stress
• osteoporosis
• Dialysis

The Relationship Between Oxidative Stress and Osteoporosis in Chronic Dialysis Patients/ Kronik Diyaliz Hastalarında Oksidatif Stres ile Osteoporoz Arasındaki İlişki

Öz

Amaç: Son dönem böbrek yetmezliği hastaları, artmış morbiditeye yol açan oksidatif stres (OS) ve osteoporoz (OP) ile karşı karşıyadırlar. Tartışmalı olmakla birlikte, böbrek hastalığı olmayan popülasyonda yapılan birçok çalışmada OS, artmış OP riski ile ilişkilidir. Bu çalışmada, kronik diyaliz hastalarında OS ve OP arasındaki ilişkiyi araştırmayı amaçladık. Materyal ve metod: Kronik diyaliz programında olan 62 hasta çalışmaya dahil edildi. Total oksidan durum (TOS), lipid hidroperoksid (LOOH), total antioksidan kapasite (TAC) ve kemik mineral yoğunluğu ölçüldü. Demografik ve biyokimyasal veriler kaydedildi. Hastalar Grup1: Hemodiyaliz ve Grup2: Periton Diyalizi olarak 2 gruba ayrılarak bulgular karşılaştırıldı. Bulgular: Altmış iki hastanın 29'u HD ve 33'ü PD hastası idi. Kemik mineral yoğunluğu ölçümlerinde T-skorları femur boynunda iki grup arasında istatistiksel olarak anlamlı bir fark göstermezken, lomber omurga ölçümlerinde sonuçlar HD hastalarında PD hastalarına göre daha iyiydi. Grup 1 ve 2’de sırasıyla ortalama serum LOOH konsantrasyonu 6,07±2,91 ve 5,82±2,20 µmolH2O2Eq/L, TOS 8,89±5,89 ve 7,62±3,99 µmol H2O2Eq/L ve TAC 1,01±0,20 ve 0,93±0,16 mmol TroloxEq/L idi. Tüm hastalarda TAC ile femur boynu T-skor arasında pozitif bir korelasyon bulunurken, TOS ve T-skor arasında ilişki bulunmadı. Sonuç: Yapmış olduğumuz bu çalışmada kronik diyaliz hastala-rında OS artmış, antioksidan kapasite azalmış olmasına rağmen, OS'in OP üzerinde herhangi bir etkisini gösterememiş olmakla birlikte, bu sonucun hastalarımızdaki düşük OP oranına bağlı olabileceğini düşünmekteyiz. Diyaliz popülasyonunda OS ile OP ilişkisini irdeleyen daha geniş ölçekli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• son dönem böbrek yetersizliği
• oksidatif stres
• osteoporoz
• diyaliz

Kaynakça

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