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The Relationship Between Oxidative Stress and Osteoporosis in Chronic Dialysis Patients

Yıl 2023, , 99 - 103, 31.05.2023
https://doi.org/10.47565/ndthdt.2023.72

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.

Kaynakça

  • 1. Del Vecchio L, Locatelli F, Carini M. What we know about oxidative stress in patients with chronic kidney disease on dialysis-clinical effects, potential treatment, and prevention. Semin Dial. 2011;24(1):56-64.
  • 2. Taal MW, Roe S, Masud T, Green D, Porter C, Cassidy MJ. Total hip bone mass predicts survival in chronic hemodialysis patients. Kidney Int. 2003;63(3):1116-20.
  • 3. Park SH, Jia T, Qureshi AR, Bárány P, Heimbürger O, Larsson, TB, et al. Determinants and survival implications of low bone mineral density in end – stage renal disease patients. Nephrol. 2013;26(3):485-94.
  • 4. Aluoch AO, Jessee R, Habal H, Garcia-Rosell M, Shah R, Reed G, et al. Heart failure as a risk factor for osteoporosis and fractures. Curr Osteoporos Rep. 2012;10(4):258-69.
  • 5. Ogura-Tomomatsu H, Asano K, Tomomatsu K, Miyata J, Ohmori, N,Kodama, M, et al. Predictors of osteoporosis and vertebral fractures in patients presenting with moderate-to-severe chronic obstructive lung disease. COPD. 2012;9(4):332-7.
  • 6. Antonopoulou M, Bahtiyar G, Banerji MA, Sacerdote AS. Diabetes and bone health. Maturitas. 2013;76(3):253-9.
  • 7. U.S. Preventive Services Task Force. Screening for osteoporosis: recommendation statement. Am Fam Physician. 2011;83(10):1197-200.
  • 8. Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem. 2004;37(2):112–119.
  • 9. Locatelli F, Canaud B, Eckardt KU, Stenvinkel P, Wanner C, Zoccali C. Oxidative stress in end – stage renal disease: an emerging threat to patient outcome. Nephrol Dial Transplant. 2003;18(7):1272-80.
  • 10. Sugama K, Suzuki K, Yoshitani K, Shiraishi K, Miura, S, Yoshiok, H, et al. Changes of thioredoxin, oxidative stress, markers, inflammation and muscle/renal damage following intensive endurance exercise. Exerc Immunol Rev. 2015;21:130-42.
  • 11. Kayabasi H, Sit D, Atay AE, Yilmaz Z, Kadiroglu AK, Yilmaz ME. Parameters of oxidative stress and echocardiographic indexes in patients on dialysis therapy. Ren Fail. 2010;32(3):328-34.
  • 12. Filiopoulos V, Hadjiyannakos D, Takouli L, Metaxaki P, Sideris V, Vlassopoulos D. 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.
  • 13. Khalil SK, Amer HA, El Behairy AM, Warda M. Oxidative stress during erythroietin hyporesponsiveness anemia at end – stage renal disease: Molecular and biochemical studies.J Adv Res. 2016;7(3):348-58.
  • 14. Attallah N, Osman-Malik Y, Frinak S, Besarab A. Effect of intravenous ascorbic acid in hemodialysis patients with EPO-hyporesponsive anemia and hyperferritinemia. Am J Kidney Dis. 2006; 47(4):644-54.
  • 15. Kalantar–Zadeh K, Balakrishnan VS. The kidney disease wasting: inflammation, oxidative stress, and diet-gene interaction. Hemodial Int. 2006;10(4):315-25.
  • 16. Langote A, Ahearn M, Zimmerman D. Dialysate Calcium Concentration, Mineral Metabolism Disorders, and Cardiovascular Disease: Deciding the Hemodialysis Bath. Am J Kidney Dis. 2015;66(2):348-58.
  • 17. Gal–Moscovici A, Sprague SM. Osteoporosis and chronic kidney disease. Semin Dial. 2007;20(5):423-30.
  • 18. Baldini V, Mastropasqua M, Francucci CM, D'Erasmo E. Cardiovascular disease and osteoporosis. J Endocrinol Invest. 2005; 28(10 Suppl):69-72.
  • 19. Yalin S, Bagis S, Polat G, Dogruer N, Aksit Cenk, Hatungil, R, et al. Is there a role of free oxygen radicals in primary male osteoporosis? Clin Exp Rheumatol. 2005;23(5):689-92.
  • 20. Ozgocmen S, Kaya H, Fadillioglu E, Yilmaz Z. Effects of calcitonin, risedronate, and raloxifene on erythrocyte antioxidant enzyme activity, lipid peroxidation, and nitric oxide in postmenapausal osteoporosis. Arch Med Res. 2007;38(2):196-205.

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

Yıl 2023, , 99 - 103, 31.05.2023
https://doi.org/10.47565/ndthdt.2023.72

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.

Kaynakça

  • 1. Del Vecchio L, Locatelli F, Carini M. What we know about oxidative stress in patients with chronic kidney disease on dialysis-clinical effects, potential treatment, and prevention. Semin Dial. 2011;24(1):56-64.
  • 2. Taal MW, Roe S, Masud T, Green D, Porter C, Cassidy MJ. Total hip bone mass predicts survival in chronic hemodialysis patients. Kidney Int. 2003;63(3):1116-20.
  • 3. Park SH, Jia T, Qureshi AR, Bárány P, Heimbürger O, Larsson, TB, et al. Determinants and survival implications of low bone mineral density in end – stage renal disease patients. Nephrol. 2013;26(3):485-94.
  • 4. Aluoch AO, Jessee R, Habal H, Garcia-Rosell M, Shah R, Reed G, et al. Heart failure as a risk factor for osteoporosis and fractures. Curr Osteoporos Rep. 2012;10(4):258-69.
  • 5. Ogura-Tomomatsu H, Asano K, Tomomatsu K, Miyata J, Ohmori, N,Kodama, M, et al. Predictors of osteoporosis and vertebral fractures in patients presenting with moderate-to-severe chronic obstructive lung disease. COPD. 2012;9(4):332-7.
  • 6. Antonopoulou M, Bahtiyar G, Banerji MA, Sacerdote AS. Diabetes and bone health. Maturitas. 2013;76(3):253-9.
  • 7. U.S. Preventive Services Task Force. Screening for osteoporosis: recommendation statement. Am Fam Physician. 2011;83(10):1197-200.
  • 8. Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem. 2004;37(2):112–119.
  • 9. Locatelli F, Canaud B, Eckardt KU, Stenvinkel P, Wanner C, Zoccali C. Oxidative stress in end – stage renal disease: an emerging threat to patient outcome. Nephrol Dial Transplant. 2003;18(7):1272-80.
  • 10. Sugama K, Suzuki K, Yoshitani K, Shiraishi K, Miura, S, Yoshiok, H, et al. Changes of thioredoxin, oxidative stress, markers, inflammation and muscle/renal damage following intensive endurance exercise. Exerc Immunol Rev. 2015;21:130-42.
  • 11. Kayabasi H, Sit D, Atay AE, Yilmaz Z, Kadiroglu AK, Yilmaz ME. Parameters of oxidative stress and echocardiographic indexes in patients on dialysis therapy. Ren Fail. 2010;32(3):328-34.
  • 12. Filiopoulos V, Hadjiyannakos D, Takouli L, Metaxaki P, Sideris V, Vlassopoulos D. 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.
  • 13. Khalil SK, Amer HA, El Behairy AM, Warda M. Oxidative stress during erythroietin hyporesponsiveness anemia at end – stage renal disease: Molecular and biochemical studies.J Adv Res. 2016;7(3):348-58.
  • 14. Attallah N, Osman-Malik Y, Frinak S, Besarab A. Effect of intravenous ascorbic acid in hemodialysis patients with EPO-hyporesponsive anemia and hyperferritinemia. Am J Kidney Dis. 2006; 47(4):644-54.
  • 15. Kalantar–Zadeh K, Balakrishnan VS. The kidney disease wasting: inflammation, oxidative stress, and diet-gene interaction. Hemodial Int. 2006;10(4):315-25.
  • 16. Langote A, Ahearn M, Zimmerman D. Dialysate Calcium Concentration, Mineral Metabolism Disorders, and Cardiovascular Disease: Deciding the Hemodialysis Bath. Am J Kidney Dis. 2015;66(2):348-58.
  • 17. Gal–Moscovici A, Sprague SM. Osteoporosis and chronic kidney disease. Semin Dial. 2007;20(5):423-30.
  • 18. Baldini V, Mastropasqua M, Francucci CM, D'Erasmo E. Cardiovascular disease and osteoporosis. J Endocrinol Invest. 2005; 28(10 Suppl):69-72.
  • 19. Yalin S, Bagis S, Polat G, Dogruer N, Aksit Cenk, Hatungil, R, et al. Is there a role of free oxygen radicals in primary male osteoporosis? Clin Exp Rheumatol. 2005;23(5):689-92.
  • 20. Ozgocmen S, Kaya H, Fadillioglu E, Yilmaz Z. Effects of calcitonin, risedronate, and raloxifene on erythrocyte antioxidant enzyme activity, lipid peroxidation, and nitric oxide in postmenapausal osteoporosis. Arch Med Res. 2007;38(2):196-205.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Hemşirelik
Bölüm Makale
Yazarlar

Hasan Kayabaşı 0000-0003-2754-5687

Dede Şit 0000-0003-1954-9784

Ali Kemal Kadiroğlu 0000-0002-7768-2455

Mehmet Emin Yılmaz 0000-0002-3218-2262

Yayımlanma Tarihi 31 Mayıs 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

Vancouver Kayabaşı H, Şit D, Kadiroğlu AK, Yılmaz ME. The Relationship Between Oxidative Stress and Osteoporosis in Chronic Dialysis Patients. NefroHemDergi. 2023;18(2):99-103.

Nefroloji Hemşireliği Dergisi/ Journal of Nephrology Nursing Creative Commons Lisansı Creative Commons Atıf-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.