Background: Oxidative stress is one of the leading causes of cardiovascular morbidity and mortality in chronic kidney disease. Although it is clear that many metabolic abnormalities improve, the effects of kidney transplantation on oxidative state are obscure. Methods: Twenty-three kidney transplant patients were included in the study. Eleven patients (mean age 27.9± 9.1 years) were treated with cyclosporine A (CsA) whereas 12 patients (mean age 22.4 ± 3.4 years) were treated with tacrolimus. Twenty-three healthy subjects served as controls. None of the patients or controls suffered from diabetes mellitus or an acute infection at the time of the study. Plasma malondialdehyde (MDA), plasma selenium (Se), erythrocyte glutathione peroxidase (GSH-Px), erythrocyte superoxide dismutase (SOD), erythrocyte Zn (EZn), and erythrocyte Cu (ECu) levels were studied before and in the 1st,3rd, 7th, 14th and 28th days after the transplantation. Results: The GSH-Px, SOD, ECu, EZn and selenium levels were lower and MDA levels were higher in patients than controls before transplantation (p < 0.001 for all). MDA levels decreased and SOD, GSH-Px, ECu, EZn levels increased in parallel to the decrement of serum creatinine levels following the renal transplantation. No difference was found among the patients regarding the treatment regime. Conclusion: The study data suggest that the improvement in oxidative state parameters begins at the first day of renal transplantation and continues at the 28th posttransplant day in living donor transplantations.

Sies H: Oxidative stress: Oxidants and antioxidants. Exp Physiol 1997;82:291–295.
Luke RG: Chronic renal failure: A vasculopathic state. N Engl J Med 1998;339:841–843.
Chauhan DP, Gupta PH, Nampoothiri MR, Singhal PC, Chugh KS, Nair CR: Determination of erythrocyte superoxide dismutase, catalase, glucose-6-phosphate dehydrogenase, reduced glutathione and malonyldialdehyde in uremia. Clin Chim Acta 1982;123:153–159.
Taylor JE, Scott N, Hill A, Bridges A, Henderson IS, Stewart WK, Belch JJ: Oxygen free radicals and platelet and granulocyte aggregability in renal transplant patients. Transplantation 1993;55:500–504.
Pirsch JD, Miller J, Deierhoi MH, Vincenti F, Filo RS: A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group. Transplantation 1997;63:977–983.
Andoh TF, Burdmann EA, Bennett WM: Nephrotoxicity of immunosuppressive drugs: Experimental and clinical observations. Semin Nephrol 1997;17:34–45.
Varghese Z, Fernando RL, Turakhia G, Psimenou E, Brunton C, Fernando ON, Davenport A, Burns A, Sweny P, Powis SH, Moorhead JF: Oxidizability of low-density lipoproteins from Neoral and tacrolimus-treated renal transplant patients. Transplant Proc 1998;30:2043–2046.
Varghese Z, Fernando RL, Turakhia G, Psimenou E, Fernando ON, Sweny P, Powis SH, Moorhead JF: Calcineurin inhibitors enhance low-density lipoprotein oxidation in transplant patients. Kidney Int 1999;71:S137–S140.
McGrath LT, Treacy R, McClean E, Brown JH: Oxidative stress in cyclosporin and azathioprine treated renal transplant patients. Clin Chim Acta 1997;264:1–12.
Morris-Stiff GJ, Oleesky DA, Smith SC, Jurewicz WA: Sequential changes in plasma selenium concentration after cadaveric renal transplantation. Br J Surg 2004;91:339–343.
Singh A, Naidu PS, Kulkarni SK: Possible antioxidant and neuroprotective mechanisms of FK506 in attenuating haloperidol-induced orofacial dyskinesia. Eur J Pharmacol 2003;477:87–94.
Zamauskaite A, Cohen S, Sweny P, Madrigal A, Varghese Z, McLean A, Powis SH: FK506 and CsA differ in their effect on intracellular cytokine expression following kidney transplantation. Transplant Proc. 2001;33:1046–1047.
Fitzgerald SP, Campbell JJ, Lamont JV: The establishment of reference ranges for selenium. The selenoenzyme glutathione peroxidase and metalloenzyme superoxide dismutase in blood fractions. The Fifth International Symposium on Selenium Biology and Medicine. Tennessee, 1992, pp 20–23.
Pleban PA, Munyani A, Beachum J: Determination of selenium concentration and glutathione peroxidase activity in plasma and erythrocytes. Clin Chem1982;28:311–316.
Richard MJ, Arnaud J, Jurkovitz C, Hachache T, Meftahi H, Laporte F, Foret M, Favier A, Cordonnier D: Trace elements and lipid peroxidation abnormalities in patients with chronic renal failure. Nephron 1991;57:10–15.
Foster LH, Sumar S: Selenium in health and disease: A review. Crit Rev Food Sci Nutr 1997;37:211–228.
Avissar N, Ornt DB, Yagil Y, Horowitz S, Watkins RH, Kerl EA, Takahashi K, Palmer IS, Cohen HJ: Human kidney proximal tubules are the main source of plasma glutathione peroxidase. Am J Physiol 1994;266:C367–C375.
Whitin JC, Tham DM, Bhamre S, Ornt DB, Scandling JD, Tune BM, Salvatierra O, Avissar N, Cohen HJ: Plasma glutathione peroxidase and its relationship to renal proximal tubule function. Mol Gen Metab 1998;65:238–245.
Descamps-Latscha B, Drüeke T, Witko-Sarsat V: Dialysis-induced oxidative stress: biological aspects, clinical consequences, and therapy. Semin Dial 2001;14:193–199.
Canaud B, Cristol J, Morena M, Leray-Moragues H, Bosc J, Vaussenat F: Imbalance of oxidants and antioxidants in haemodialysis patients. Blood Purif 1999;17:99–106.
Campise M, Bamonti F, Novembrino C, Ippolito S, Tarantino A, Cornelli U, Lonati S, Cesana BM, Ponticelli C: Oxidative stress in kidney transplant patients. Transplantation 2003;76:1474–1478.
Endemann DH, Schiffrin EL: Nitric oxide, oxidative excess, and vascular complications of diabetes mellitus. Curr Hypertens Rep 2004;6:85–89.
Finkel T, Holbrook NJ: Oxidants, oxidative stress and the biology of ageing. Nature 2000;408:239–247.
Yilmaz MI, Baykal Y, Kilic M, Sonmez A, Bulucu F, Aydin A, Sayal A, Kocar IH: Effects of statins on oxidative stress. Biol Trace Elem Res 2004;98:119–127.
Donmez G, Derici U, Erbas D, Arinsoy T, Onk A, Sindel S, Hasanoglu E: The effects of losartan and enalapril therapies on the levels of nitric oxide, malondialdehyde, and glutathione in patients with essential hypertension. Jpn J Physiol 2002;52:435–440.
Morris-Stiff GJ, Oleesky D, Jurewicz WA: Is selenium deficiency an important risk factor for chronic graft nephropathy? A pilot study. Transplantation 2003;78;1100–1104.
Shah SV: Role of reactive oxygen metabolites in experimental glomerular disease. Kidney Int 1989;35:1093–1106.
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;18:1272–1280.
Apanay DC, Neylan JF, Ragab MS, Sgoutas DS: Cyclosporine increases the oxidizability of low-density lipoproteins in renal transplant recipients. Transplantation 1994;58:663–669.
Stadtman ER, Oliver CN: Metal-catalyzed oxidation of proteins. Physiological consequences. J Biol Chem 1991;266:2005–2008.
Ahmed SS, Strobel HW, Napoli KL, Grevel J: Adrenochrome reaction implicates oxygen radicals in metabolism of cyclosporine A and FK-506 in rat and human liver microsomes. J Pharmacol Exp Ther 1993;265:1047–1054.
Remuzzi G, Perico N: Cyclosporine-induced renal dysfunction in experimental animals and humans. Kidney Int Suppl 1995;52:S70–S74.
Watschinger B, Sayegh MH: Endothelin in organ transplantation. Am J Kidney Dis 1996;27:151–161.
Granot E, Elinav H, Kohen R: Markers of oxidative stress in cyclosporine-treated and tacrolimus-treated children after liver transplantation. Liver Transplant 2002;5:469–475.
Granot E, Shemesh P, Rivkin L, Kohen R: Plasma and low-density lipoprotein lipid peroxidation in cyclosporine A-treated children after liver transplant. Transplant Proc 1998;30:4057–4059.
Simic-Ogrizovic S, Simic T, Reljic Z, Markovic S, Blagojevic R, Radivojevic D, Lezaic V, Djukanovic L, Mimic-Oka J: Markers of oxidative stress after renal transplantation. Transpl Int 1998;11(suppl 1):S125–S129.
Zachara BA, Wlodarczyk Z, Masztalerz M, Adamowicz A, Gromadzinska J, Wasowicz W: Selenium concentrations and glutathione peroxidase activities in blood of patients before and after allogenic kidney transplantation. Biol Trace Elem Res 2004;97:1–13.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.