Review Article

Oxidative Stress in Hemodialysis Patients: A Review of the Literature

Table 2

Effect of antioxidant supplementation on OS in HD patients.

Study (ref.)PatientsOS biomarkerAntioxidantStudy periodResult

Vitamin C
Yang et al. [28]40 on Vit. C
40 controls
ROSi.v. 1 g4 hours↓ OS
Ghiadoni et al. [124]20 on Vit. CMDA
Lipoperoxides
Ferric-reducing plasma ability
p.o 2 g4 hours↓ OS
Fumeron et al. [159]33 on Vit. CSerum carbonyls, RBC concentrations of reduced and oxidized glutathionep.o 0.25 g ×3/week8 weeksSame OS
Candan et al. [160]17 on Vit. C
17 on placebo
MDA
RBC osmotic fragility
p.o 0.25 g12 weeks↓ OS
Abdollahzad et al. [161]21 on Vit. C
21 on placebo
MDAp.o 0.25 g12 weeks↓ OS
Eiselt et al. [155]20 on Fe i.v.
5 on Fe i.v. + Vit. C
TBARSi.v. continuous
2 mg/min
4 weeks↑ OS
Chan et al. [156]10 on 250 mg p.o
11 on i.v.
F2-isoprostanesp.o/iv12 weeksSame OS
Ramos et al. [157]17 on Vit. C
17 on placebo
TBARS
Lipoperoxides
p.o 1 g/d1 yearSame OS
Washio et al. [158]16 on Vit. CCu/Zn-SODp.o 0.2 to 1 g3 weeksSame OS

Vitamin E
Diepeveen et al. [162]12 on Vit. E
11 on placebo
Ox-LDLp.o 800 IU/d12 weeksSame OS
Lu et al. [163]14 on Vit. E
13 on placebo
Oxidative protein modifications
Lipoperoxides
p.o 800 IU/d24 weeksSame OS
Kamgar et al. [164]20 on multivitamin (including Vit. E)
17 on placebo
F2-isoprostane protein carbonylp.o 800 IU/d8 weeksSame OS
O’Byrne et al. [165]16 on Vit. EOx-LDL antibodiesp.o 800 IU/d12 weeksSame OS
Sanaka et al. [166]11 on Vit. E
11 on placebo
PCOOHp.o 500 mg/dSame OS
Smith et al. [167]11 on Vit. EF2-isoprostanesp.o 400 IU/d8 weeksSame OS
Antoniadi et al. [168]27 on Vit. E
20 on placebo
TAS
RBC SOD activity
GSH-Px
p.o 500 mg/d1 year↑ OS
Inal et al. [170]36 on EPO (100 U/kg)
36 on 50% decreased EPO dosage + Vit. E
MDA
SOD activity
CAT activity
p.o 300 mg/d12 weeks↓ OS
Badiou et al. [173]14 on Vit. ECu-induced LDL oxidation
TBARS
p.o 500 mg/d24 weeks↓ OS
Galli et al. [174]7 on Vit. EGSH
TBARS
NO
p.o 800 mg/d3 weeks↓ OS
Giray et al. [175]36 on Vit. EGSH-Px
SOD + CAT
TBARS
p.o 600 mg/d14 weeks↓ OS
Domenici et al. [176]29 on Vit. E8-OHdGp.o 300 mg/d
×3/week
4 weeks↓ OS
Ono [177]30 on Vit. ERBC osmotic fragilityp.o 600 mg/d4 weeks↓ OS
Cristol et al. [178]7 on ESA + Vit. E
30 control
MDA
RBC SOD
RBS GSH
RBC Vit. E
p.o 500 mg/d24 weeks↓ OS
↑ Hb
Nemeth et al. [179]10 children on ESA for 2 weeks, then ESA + Vit. E for 2 weeksGSSG/GSHp.o 15 mg/kg/d4 weeks↓ OS
↑ Hb
Uzum et al. [180]19 on Vit. E
15 controls
MDA
RBC osmotic fragility
p.o 300 mg/d20 weeks↓ OS
Hodkova et al. [181]7 on i.v. iron + Vit. EAOPPs
PMNLs burst
p.o 200 mg/d7 daysSame OS

NAC
Swarnalatha et al. [102]14 on NAC
14 on placebo
MDAp.o 600 mg ×2/day
Prior to i.v. iron
10 days↓ OS
Garcia-Fernandez et al. [191]10 iron 50
10 iron 50 + NAC
10 iron 100
10 iron 100 + NAC
MDAi.v. 2 g
Prior to i.v. iron
10 days↓ OS
Trimarchi et al. [188]12 on NAC
12 control
MDAp.o 600 mg ×2/day30 days↓ OS
Witko-Sarsat et al. [189]16 HD
Cells incubated
with NAC
(in vitro study)
Serum albumin AOPPs2 mg/mL30↓ OS
Thaha et al. [190]20 on NAC
20 on placebo
ADMAi.v. 5 g4 hours↓ OS

Statins
Diepeveen et al. [162]12 on atorvastatin
11 on placebo
Ox-LDLp.o 40 mg/d12 weeks↓ OS 30–43%
Ando et al. [192]11 on EPA
11 on placebo
Ox-LDLp.o 1.8 g/d12 weeks↓ OS 38%
Nishikawa et al. [193]38 on simvastatinMDAp.o 5 mg/d24 weeks↓ OS

RBC: red blood cell; TBARS: thiobarbituric acid-reactive substances; Ox-LDL: oxidized low-density lipoprotein; PCOOH: phosphatidylcholine hydroperoxide; EPO: erythropoietin; CAT: catalase; NO: nitric oxide; 8-OHdG: 8-hydroxy 2-deoxyguanosine; AOPPs: advanced oxidation protein products; GSSG: oxidized glutathione; EPA: eicosapentaenoic acid.