ALPHA–LIPOIC ACID ANTIOXIDANT EFFICIENCY IN TREATMENT OF PERITONEAL DIALYSIS PATIENTS
Abstract
The aim of the study was to evaluate the effectiveness of the antioxidant alpha–lipoic acid in peritoneal dialysis (PD) patients taking into account the state of lipid peroxidation (LPO) and antioxidant protection (AOP) before and after treatment.
Patients and methods. The research revealed the intensity of oxidative processes in 20 patients treated with continuous ambulatory peritoneal dialysis (CAPD) on the basis of а–lipoic acid applied parenterally in a dose of 600 mg for 2–weeks followed by a transfer to the 6 weeks of oral reception.
The intensity of oxidative processes was evaluated before and after treatment through determining the content of MDA in serum (MDAs) and erythrocytes (MDAe). AOP activity was evaluated by the content of the antioxidant enzyme ceruloplasmin (CP), transferrin (Tr), SH–groups and total peroxidase activity (TPA) of red blood cells. The control group consisted of30 individuals comparable on for age and sex.
Results. The effects on the study of PD patients (positive decrease of MDAs, increase in CP higher than control group, a significant increase in the content of SH–groups (p=0,04), TPA (p=0,009), Tr (p=0,002) and catalase serum) demonstrated a considerable positive dynamics of LPO /AOP influenced by the use of а–lipoic acid.
Conclusions. The research opens up the prospect for further study ofLPO /AOP blood in PD patients and proves the
application expediency of alpha–lipoic acid for this group. Use of the latter lowers the activity of oxidative processes significantly and restores AOP indicators substantially, which in turn minimizes the negative influence of oxidative stress on a patient’s body.
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Большова О. Препарати альфа–ліпоєвої кислоти у комплексному лікуванні діабетичної нейропатії у дітей і підлітків / Большова О. // Клінічна ендокринологія та ендокринна хірургія – 2011. – V. – 2(35). – Р. 54–59.
Реброва О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ БТАТІБТІСА / О.Ю. Реброва. – М. : Медиасфера, 2013. – 312 с.
Методичні рекомендації / Л. В. Король, Л. Я. Мигаль, Г. Г. Нікуліна, М. О. Колесник. – Київ, 2013. – 30с.
Antioxidant status of patients on peritoneal dialysis: associations with inflammation and glycoxidative stress / Sundl I, M. Roob J, Meinitzer A, Tiran B, [et al] // Perit Dial Int – 2009. – V. – 29. – P. 89–101.
Antioxidants for chronic kidney disease / Jun M, Venkataraman V, Razavian M, Cooper B, [et al] // Cochrane Database Syst Rev – 2012. – V. – 10. – P. 1–65.
Bengt Lindholm. Definition of metabolic syndrome in peritoneal dialysis // Perit Dial Int. – 2009. – V. – 29. – № 2. – Р. 137–144.
Bilska A. Lipoic acid – the drug of the future? / Bilska A., Wlodek L. // Pharmacological reports – 2005. – V. – 57. – P. 570–577.
Cardiac fibrosis and dysfunctionin experimental diabetic cardiomyopathy are amelioreted by alpha–lipoic acid / Li C. J., Lv L., Li H., Yu D. // Cardiovasc Diabetol – 2012. – V. – 11. – P. 142.
Ohronic inflammation in peritoneal dialysis: the search for the holy grail? / Pecoits–Filho R, Stenvinkel P, Yee– Moon Wang A, Heimburger O, and Bengt Lindholm // Perit Dial Int – 2004. – V. – 24. – P. 327–339.
Coombes J.S. Antioxidant therapy in hemodialysis patients: a systematic review / Coombes J.S. and Fassett R.G. // Kidney International advance online publication – 2011. – V. – 5. – P. 1–14.
Does Dialysis Modality Influence the Oxidative Stress of Uremic Patients / Capusa С, Stoian I, Rus E, Lixandru D, Barbulescu C, Mircescu G // Kidney Blood Press Res – 2012. – V. – 35. – P. 220–225.
Effect of oral n–acetylcysteine treatment on plasma inflammatory and oxidative stress markers in peritoneal dialysis patients: a placebo–controlled study/ Nascimento M, Suliman M, Silva M, Chinaglia T, [et al] // Perit Dial Int – 2010. – V. – 30. – P. 336–342.
Evans L.J. а–Lipoic Acid: A Multifunctional Antioxidant That Improves Insulin Sensitivity in Patients with Type 2 Diabetes / Evans L.J., Goldfine D. I., // Diabetes technology & therapeutics volume – 2000. – V. – 2(3). – P. 401–413.
Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alphalipo– ic acid: a randomized double–blinded placebocontrolled study / Porasuphatana S., Suddee S., Nartnampong A., Konsil J., [et al] // Asia Pac J Clin Nutr – 2012. – V. – 21(1). – P. 12–21.
Golbidi S. Diabetes and alpha lipoic Acid / Golbidi S., Badran M., Laher I. // Front Pharmacol – 2011. – V. – 2. – P. 69.
Gomes M.B. Alpha–lipoic acid as a pleiotropic compound with potential therapeutic use in diabetes and other chronic diseases / Gomes M.B., Negrato C.A. // Diabetology & Metabolic Syndrome – 2014. – V. – 6. – P. 80.
Insulin resistance and glucose homeostasis in peritoneal dialysis / Paulo Cezar Fortes, Thyago Proenja de Moraes, Jamille Godoy Mendes, Andrea E. Stinghen, Silvia Carreira Ribeiro, and Roberto Pecoits–Filho // Perit Dial Int. – 2009. – V. – 29. – № 2. – Р. 145–148.
Linkage of Some Trace Elements, PeripheralBlood Lymphocytes, Inflammation, and Oxidative Stressin Patients Undergoing Either Hemodialysisor Peritoneal Dialysis / Chih–Hung Guo, Chia–Liang Wang, Pei– Chung Chen, and Te–Cheng Yang // Perit Dial Int – 2011. – V. – 31(5). – P. 583–591.
Maxwell SRJ. Free radicals and antioxidants in cardiovascular disease / Maxwell SRJ, Lip GYH // Br J Clin Pharmacol – 1997. – V. – 44. – P. 307–317.
Oxidative Stress and Chronic Renal Disease – Clinical Aspects / Del Vecchio L, Carini M, Cavalli A, Locatelli F // System Biology of free Radicals and Antioxidants – 2014. – P. 2625–2644.
Oxidative stress in end–stage renal disease: an emerging threat to patient outcome / Locatelli F, Canaud B, Eckardt KU, Stenvinkel P, Wanner C, Zoccali C // Nephrol Dial Transplant – 2003. – V. – 18(7). – P. 1272–1280.
Poh Z.X. A Current Update on the Use of Alpha Lipoic Acid in the Management of Type 2 Diabetes Mellitus / Poh Z. X. and Goh K. P. // Endocrine, Metabolic & Immune Disorders – Drug Targets – 2009. – V. – 9. – P. 392–398.
Provision of antioxidant therapy in hemodialysis (PATH): a randomized clinical trial / Himmelfarb J. Ikizler TA. Ellis C. Wu P, [et al] // J Am Soc Nephrol – 2014. – V. – 25(3). – P. 623–633.
Secondary prevention with antioxidants of cardiovascular disease in endstage renal disease (SPACE): randomised placebo–controlled trial / Boaz M, Smetana 5, Weinstein T, Matas Z, Gafter U,Iaina A, [et al.] // Lancet – 2000. – V. – 356. – P. 1213–1218.
Seo E.Y. а–lipoic acid reduced weight gain and improved lipid profile in rats fed with high fat diet / Seo E.Y., Ha A.W., Kim W.K. // Nutr Res Pract – 2012. – V. – 6. – P. 195–200.
The antioxidant acetylcysteine reduces cardiovascular events in patients with end–stage renal failure: a randomized, controlled trial / Tepel M, van der Giet M, Statz M, Jankowski J, Zidek W. // Circulation – 2003. – V. – 107. – P. 992–995.
The effect of alphalipoic acid on mitochondrial superoxide and glucocorticoid–induced hypertension / Ong S.L., Vohra H., Zhang Y., Sutton M., Whitworth J.A. // Oxid Med Cell Longev – 2013. – V. – 2013. – P. 1–9.
The elephant in uremia: Oxidant stress as a unifying concept of cardiovascular disease in uremia / Himmelfarb J, Stenvinkel P, Alp Ikizer T, M. Hakim // Kidney Int – 2002. – V. – 62. – P. 1524–1538.
