The aim of study was to showed the influence of glucose in the dialysate on the intensity of oxidative stress, activity of glutathione peroxidase (GSHPx) in patients undergoing regular hemodialysis.

The study included 85 subjects (38 women, 47 men), who were divided into 4 groups: patients with chronic renal failure on conservative treatment (n=21), patients with chronic renal failure treated with hemodialysis using fluid not containing glucose (HD-g(-))(n=21), patients with chronic renal failure treated with hemodialysis using fluid containing glucose (HD-g(+))(n=22) and control group (C) (n=21). The concentrations of the products of reaction with thiobarbituric acid (TBARS) and the activity of glutathione peroxidase were determined. TBARS concentration in plasma was determined with spectrofluorometric method, in which the products of reaction with thiobarbituric acid. Glutathione peroxidase was determined with enzymatic method.

TBARS concentration (indicator of oxidative stress) was significantly higher in the group of hemodialyzed patients (before and after HD) and patients with CRF on conservative treatment (p<0.001) compared to control group. TBARS concentration and TBARS/plasma protein ratio in HD-g(-) group, before and after HD, were significantly higher compared to the group of patients with CRF on conservative treatment. In HD-g(+) group TBARS and TBARS/protein ratio were significantly higher compared to the group of patients with CRF on conservative treatment, however, only before HD session. After HD, TBARS concentrations were similar to those in the group of patients with CRF on conservative treatment. There were significant differences before and after HD for TBARS and TBARS/protein ratio between the groups of patients undergoing HD. TBARS concentrations were always higher in HD-g(-) group compared to HD-g(+) group (before dialysis:1.56±0.27 vs. 1.36 ± 0.30; after dialysis: 1.36 ± 0.30 vs. 1.17 ± 0.31).

Glutathione peroxidase had significantly higher activity in HD-g(-) group before HD than in control group. After HD session the activity increased, however, the increase was not statistically significant. In HD-g(+) group before HD the activity of GSHPx was significantly lower than in control group. After HD the activity showed statistically significant increase (p<0.05) and achieved the value similar to control group. The activity of GSHPx in CRF group was significantly higher than in control group (p<0.05) and HD-g(+) group both before and after HD (p<0.001). The activity of GSHPx in the group of patients with CRF on conservative treatment was similar to the activity in HD-g(-) group.

Glucose present in dialysate provides normal HMP cycle and significantly decreases the intensity of oxidative stress. In both groups of hemodialyzed patients hemodialysis caused the increase of glutathione peroxidase activity.

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