Background: Patients suffering from chronic kidney disease (CKD) are exposed to increased oxidative stress and disturbances manifesting in the enzymatic and non-enzymatic antioxidative defence system. The object of the research was to assess the differences between conservative treatment, peritoneal dialysis and haemodialysis in moderating cellular antioxidative agents. Methods: The group examined comprised 145 patients. The activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glucose-6-phosphate dehydrogenase were obtained using kinetic methods. The spectrophotometric method established the concentrations of reduced glutathione, albumin, uric acid, glucose, total protein and lipids. Results: The type of treatment determined significant changes in antioxidative enzyme activities and concentrations of non-enzymatic antioxidative compounds. Conclusions: Peritoneal dialysis provides better antioxidant protection than other types of therapy in CKD and should be considered as first-choice treatment despite more metabolic disorders.

Keywords:
Chronic kidney disease, Dialysis, Oxidative stress, Free radicals
1.
Eggers PW: Mortality rates among dialysis patients in Medicare's End-Stage Renal Disease Program. Am J Kidney Dis 1990;15:414-421.
2.
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;24:56-64.
3.
Rahman K: Studies on free radicals, antioxidants, and co-factors. Clin Interv Aging 2007;2:219-236.
4.
Modlinger PS, Wilcox CS, Aslam S: Nitric oxide, oxidative stress, and progression of chronic renal failure. Semin Nephrol 2004;24:354-365.
5.
Sies H: Oxidative stress: oxidants and antioxidants. Exp Physiol 1997;82 291-295.
6.
Mekki K, Taleb W, Bouzidi N, Kaddous A, Bouchenak M: Effect of hemodialysis and peritoneal dialysis on redox status in chronic renal failure patients: a comparative study. Lipids Health Dis 2010;9:93.
7.
Peters AL, Van Noorden C: Glucose-6-phosphate dehydrogenase deficiency and malaria: cytochemical detection of heterozygous G6PD deficiency in women. J Histochem Cytochem 2009;57:1003-1011.
8.
De Flora A, Morelli A, Giuliano F: Human erythrocyte glucose 6-phosphate dehydrogenase. Content of bound coenzyme. Biochem Biophys Res Commun 1974;59:406-413.
9.
Djousse L, Kenneth JR, Cupples A, Arnett DK, Ellison RC: Relation between serum albumin and carotid atherosclerosis. The NHLBI Family Heart Study. Stroke 2003;34:53-57.
10.
Ferrucci L, Harris TB, Guralnik JM, Tracy RP, Corti MC, Cohen HJ: Serum IL-6 level and the development of disability in older persons. J Am Geriatr Soc 1999;47:639-646.
11.
Bito R, Shikano T, Kawabata H: Isolation and characterization of denaturated serum albumin from rats with endotoxicosis. Biochim Biophys Acta 2003;1646:100-111.
12.
Bito R, Hino S, Baba A, Tanaka M, Watabe H, Kawabata H: Degradation of oxidative stress-induced denatured albumin in rat liver endothelial cells. Am J Physiol Cell Physiol 2005;289:C531-C542.
13.
Dawson J, Walters M: Uric acid and xanthine oxidase: future therapeutic targets in the prevention of cardiovascular disease? Br J Clin Pharmacol 2006;62:633-644.
14.
Kanelis J, Feig DI, Johnson RJ: Does asymptomatic hyperuricaemia contribute to the development of renal and cardiovascular disease? An old controversy renewed. Nephrology 2004;9:394-399.
15.
Enomoto A, Kimua H, Chairoungdua A, Shigeta Y, Jutabha P, Cha SH: Molecular identification of a renal urate anion exchanger that regulates blood urate levels. Nature 2002;23 447-452.
16.
Whiteman M, Ketsawatsakul U, Halliwell B: A reassessment of the peroxynitrite scavenging activity of uric acid. Ann NY Acad Sci 2002;962:242-259.
17.
Waring WS: Uric acid: an important antioxidant in acute ischaemic stroke. QJM 2002;95 691-693.
18.
Nieto FJ, Iribarren C, Gross MD, Comstock GW, Cutler RG: Uric acid and serum antioxidant capacity: a reaction to atherosclerosis? Atherosclerosis 2000;148:131-139.
19.
Pandey NR, Kaur G, Chandra M, Sanwal GG, Misra MK: Enzymatic oxidant and antioxidants of human blood platelets in unstable angina and myocardial infarction. Int J Cardiol 2000;76:33-38.
20.
Hernández de Rojas A, Mateo MC: Superoxide dismutase and catalase activities in patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis. Ren Fail 1996;18:937-946.
21.
Durak I, Akyol O, Başeşme E, Canbolat O, Kavutçu M: Reduced erythrocyte defense mechanisms against free radical toxicity in patients with chronic renal failure. Nephron 1994;66:76-80.
22.
Coaccioli S, Standoli ML, Biondi R, Panaccione A, Landucci P, Del Giorno R, Paladini A, Standoli M, Puxeddu A: Assessment of the oxidative stress markers in patients with chronic renal insufficiency undergoing dialysis treatment. Clin Ter 2010;161:441-444.
23.
Ceballos-Picot I, Witko-Sarsat V, Merad-Boudia M, Nguyen AT, Thévenin M, Jaudon MC, Zingraff J, Verger C, Jungers P, Descamps-Latscha B: Glutathione antioxidant system as a marker of oxidative stress in chronic renal failure. Free Radic Biol Med 1996;21:845-853.
24.
Naga S, Ellakkany S, Barghash A, Eldeep E, Fawzy R: Effect of peritoneal dialysis and hemodialysis on oxidation end products in end-stage renal disease patients. Bull Alex Fac Med 2007;43:103-104.
25.
Martin-Mateo MC, Sanchez-Portugal M, Iglesias S, de Paula A, Bustamante J: Clinical study: oxidative stress in chronic renal failure. Ren Fail 1999;21:155-167.
26.
Knap B, Prezelj M, Buturovi-Ponikvar J, Ponikvar R, Bren AF: Antioxidant enzymes show adaptation to oxidative stress in athletes and increased stress in hemodialysis patients. Ther Apher Dial 2009;13:300-305.
27.
Santangelo F, Witko-Sarsat V, Drüeke T, Descamps-Latscha B: Restoring glutathione as a therapeutic strategy in chronic kidney disease. Nephrol Dial Transplant 2004;19:1951-1955.
28.
Ahmadpoor P, Eftekhar E, Nourooz-Zadeh J, Servat H, Makhdoomi K, Ghafari A: Glutathione, glutathione-related enzymes, and total antioxidant capacity in patients on maintenance dialysis. Iran J Kidney Dis 2009;3:22-27.
29.
Yonova D, Trendafilov I, Papazov V, Stanchen I, Zidarov R, Antonov S: Comparative study of oxidative stress in peritoneal dialysis and hemodialysis patients. Hoppokratia 2004;8:172-174.
30.
Ozden M, Maral H, Akaydin D, Cetinalp P, Kalender B: Erythrocyte glutathione peroxidase activity, plasma malondialdehyde and erythrocyte glutathione levels in hemodialysis and CAPD patients. Clin Biochem 2002;35:269-273.
31.
Yoshimura S, Suemizu H, Nomoto Y, Sakai H, Katsuoka Y, Kawamura N, Moriuchi T: Plasma glutathione peroxidase deficiency caused by renal dysfunction. Nephron 1996;73:207-211.
32.
Paşaoğlu H, Muhtaroğlu S, Güneş M, Utaş C: The change of glutathione dependent anti-oxidant mechanism in patients with chronic renal disease by hemodialysis. Turk J Med Sci 1998;28:75-78.
33.
Galli F, Rovidati S, Benedetti S, Buoncristiani U, Covarelli C, Floridi A, Canestrari F: Overexpression of erythrocyte glutathione S-transferase in uremia and dialysis. Clin Chem 1999;45:1781-1788.
34.
Dessì M, Noce A, Dawood KF, Galli F, Taccone-Gallucci M, Fabrini R, Bocedi A, Massoud R, Fucci G, Pastore A, Manca di Villahermosa S, Zingaretti V, Federici G, Ricci G: Erythrocyte glutathione transferase: a potential new biomarker in chronic kidney diseases which correlates with plasma homocysteina. Amino Acids 2012;43:347-354.
35.
El-Rashidy FH, Al-Turk WA, Stohs SJ: Glutathione, glutathione reductase and glutathione S-transferase activities in erythrocytes and lymphocytes in chronic renal disease. Res Commun Chem Pathol Pharmacol 1984;44:423-430.
36.
Carmagnol F, Sinet PM, Rapin J, Jerome H: Glutathione-S-transferase of human red blood cells; assay, values in normal subjects and in two pathological circumstances: hyperbilirubinemia and impaired renal function. Clin Chim Acta 1981;117:209-217.
37.
Kharbanda R, Lauder J, Thomson D, Gouldesbrough DR, Harrison DJ: Heterogeneity of glutathione S-transferase isoenzyme expression in renal disease. Nephrol Dial Transplant 1991;6:695-700.
38.
Tandoğan B, Ulusu N: Kinetic mechanism and molecular properties of glutathione reductase. FABAD J Pharm Sci 2006;31:230-237.
39.
Beutler E: Glucose-6-phosphate dehydrogenase deficiency: a historical perspective. Blood 2008;111:16-24.
40.
Alhamdani MS, Al-Najjar AF, Al-Kassir AH: The effect of hemodialysis and dialyzer biocompatibility on erythrocyte glutathione-defense system in chronic hemodialysis patients. Int J Artif Organs 2005;28:576-582.
41.
Stepniewska J, Dolegowska B, Ciechanowski K, Kwiatkowska E, Millo B, Chlubek D: Erythrocyte antioxidant defense system in patients with chronic renal failure according to the hemodialysis conditions. Arch Med Res 2006;37:353-359.
42.
Dolegowska B, Stepniewska J, Ciechanowski K, Safranow K, Millo E, Bober J, Chlubek D: Does glucose in dialysis fluid protect erythrocytes in patients with chronic renal failure? Blood Purif 2007;25:422-429.
43.
Dolegowska B, Blogowski W, Domanski L: Association between the perioperative antioxidative ability of platelets and early post-transplant function of kidney allograft. A pilot study. PLoS One 2012;10:1371.
44.
Ross EA, Koo LC, Moberly JB: Low whole blood and erythrocyte levels of glutathione in hemodialysis and peritoneal dialysis patients. Am J Kidney Dis 1997;30:489-494.
45.
Nguyen-Khoa T, Massy ZA, De Bandt JP, Kebede M, Salama L, Lambrey G, Witko-Sarsat V, Drüeke TB, Lacour B, Thévenin M: Oxidative stress and haemodialysis: role of inflammation and duration of dialysis treatment, Nephrol Dial Transplant 2001;16:335-340.
46.
Tarng DC, Wen Chen T, Huang TP, Chen CL, Liu TY, Wei YH: Increased oxidative damage to peripheral blood leukocyte DNA in chronic peritoneal dialysis patients. J Am Soc Nephrol 2002;13:1321-1330.
47.
Hemmati M, Kadkhodaee M, Zahmatkesh M, Mahdavi-Mazde M, Ghaznavi R, Mirershadi F: Blood antioxidant levels and alterations of serum calcium and pH in hemodialysis patients. Tehran Univ Med J 2008;66:12-17.
48.
Zachara BA, Salak A, Koterska D, Manitius J, Wasowicz W: Selenium and glutathione peroxidases in blood of patients with different stages of chronic renal failure. J Trace Elem Med Biol 2004;17:291-299.
49.
Grzegorzewska A: Factors influencing survival of patients on regular dialysis treatment. Adv Clin Exp Med 2006;15:689-694.
50.
Nakamoto H, Suzuki H: Hypoproteinemia in patients with diabetes undergoing continuous ambulatory peritoneal dialysis is attributable to high permeability of peritoneal membrane. Perit Dial Int 2003;23:72-78.
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2014
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