Relation of oxidant stress with endothelial activation in hemodialysis.

Introduction and Aims: Enhanced oxidative stress may be implicated in the pathogenesis of atherosclerosis in hemodialysed patients (HDs). We hypothesized that in hypertensive HDs oxidative stress should be elevated and associated to endothelial activation, and inflammation. Methods:We examined oxidative stress, as measured by 8-ISO-PGF2alpha, endothelial activation by measuring endothelin-1 (ET-1) and adhesion molecules ICAM-1 and VCAM-1, and the biomarker of acute-phase inflammation CRP. In 52 mild HDs and in 50 healthy controls (Cs) we analysed, in the interdialytic day, plasma levels of 8-ISO-PGF2alpha, ET-1, ICAM-1 and VCAM-1, and high sensitivity CRP. Results: The comparison between Cs and HDs demonstrated in the latter group significantly higher levels of 8-ISO-PGF2alpha (p<0.0001), CRP (p<0.001), ET-1 (p< 0.001), and ICAM-1 and VCAM-1 (p<0.001). We divided successively the overall group according to tertiles of 8-ISOPGF2alpha, and we observed increasing levels of adhesion molecules, ET-1, and CRP along with the increasing tertiles, with significant differences between tertiles in each parameter. The multiple regression analysis carried out considering 8-ISO-PGF2alpha as dependent variable in a model including adhesion molecules, ET-1, CRP, systolic and diastolic blood pressure, serum creatinine and glucose, age, sex, and BMI demonstrated a significant relationship of 8-ISO-PGF2alpha with VCAM-1 (Beta 0.56, p = 0.00001), and ET-1 (Beta 0.55, p = 0.0002). Conclusions: In conclusion, our findings show that in long term hypertensive HDs oxidative stress is increased and related to endothelial activation, in the presence of augmented index of acute inflammation.