Effects of vitamin C infusion and vitamin E-coated membrane on hemodialysis-induced oxidative stress

C. C. Yang, S. P. Hsu, M. S. Wu, S. M. Hsu, C. T. Chien

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Abstract

Chronic hemodialysis (HD) patients manifest anemia and atherosclerosis with associated oxidative stress. We explored whether intravenous infusion of vitamin C (VC) and/or use of vitamin E (VE)-coated dialysis membrane could palliate HD-evoked oxidative stress. Eighty patients undergoing chronic HD were enrolled and randomly assigned into four groups: HD with intravenous VC (n = 20), HD with VE-coated dialyzer (n = 20), HD with both (n = 20), and HD with neither (n = 20). We evaluated oxidative stress in blood and plasma, erythrocyte methemoglobin/ferricyanide reductase (red blood cells (RBC)-MFR) activity, plasma methemoglobin, and pro-inflammatory cytokines in these patients. All patients showed marked increases (14-fold) in blood reactive oxygen species (ROS) after HD. The types of ROS were mostly hydrogen peroxide, and in lesser amounts, O2•- and HOCl. HD resulted in decreased plasma VC, total antioxidant status, and RBC-MFR activity and increased plasma and erythrocyte levels of phosphatidylcholine hydroperoxide (PCOOH) and methemoglobin. Intravenous VC significantly palliated HD-induced oxidative stress, plasma and RBC levels of PCOOH, and plasma methemoglobin levels and preserved RBC-MFR activity. The VE-coated dialyzer effectively prevented RBCs from oxidative stress, although it showed a partial effect on the reduction of total ROS activity in whole blood. In conclusion, intravenous VC plus a VE-coated dialyzer is effective in palliating HD-evoked oxidative stress, as indicated by hemolysis and lipid peroxidation, and by overexpression of proinflammation cytokines in HD patients. Using VE-coated dialyzer per se is, however, effective in reducing lipid peroxidation and oxidative damage to RBCs.

Original languageEnglish
Pages (from-to)706-714
Number of pages9
JournalKidney International
Volume69
Issue number4
DOIs
Publication statusPublished - 2006 Feb 1

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Keywords

  • Hemodialysis
  • Methemoglobin
  • Oxidative stress
  • Vitamin C
  • Vitamin E

ASJC Scopus subject areas

  • Nephrology

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