Uticaj dijalizne membrane obložene vitaminom E na oksidacioni stres u toku pojedinačne seanse on-line hemodijafiltracije

  • Svetlana Antić Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
  • Nevena Draginić University of Kragujevac, Faculty of Medical Sciencies, Department of Pharmacy, Kragujevac, Serbia
  • Dejan Pilčević Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
  • Vladimir Živković University of Kragujevac, Faculty of Medical Sciencies, Department of Physiology, Kragujevac, Serbia
  • Ivan Srejović University of Kragujevac, Faculty of Medical Sciencies, Department of Physiology, Kragujevac, Serbia
  • Nevena Jeremić University of Kragujevac, Faculty of Medical Sciencies, Department of Pharmacy, Kragujevac, Serbia
  • Dejan Petrović University of Kragujevac, Faculty of Medical Sciencies, Department of Internal Medicine, Kragujevac, Serbia
  • Vladimir Jakovljević University of Kragujevac, Faculty of Medical Sciencies, Department of Physiology, Kragujevac, Serbia
DOI: https://doi.org/10.2298/VSP190730097A
Ključne reči: hemodijafiltracija, membrane, veštačke, stres, oksidativni, vitamin e

Sažetak


Uvod/Cilj. Oksidacioni stres je značajan faktor rizika od razvoja kardiovaskularnih aterosklerotskih bolesti u populaciji bolesnika koji se leče redovnom hemodijalizom. Bioinkompatibilnost dijalizne membrane i povećana koncentracija endotoksina u rastvoru za hemodijalizu su dva glavna faktora koja mogu da podstaknu oksidacioni stres. Rad je imao za cilj da ispita uticaj membrane obložene vitaminom E na oksidacioni stres u toku pojedinačne seanse on-line hemodijafiltracije. Metode. Ispitana su 24 bolesnika koja su lečena on-line hemodijafiltracijom sa polisulfonskom dijaliznom membranom obloženom vitaminom E (Leoceed 21H), a zatim i polisulfonskom dijaliznom membranom neobloženom vitaminom E (FX800). Glavni parametri oksidacionog stresa, koji su praćeni, bili su: superoksidni anjon (O2-), vodonik peroksid (H2O2), reaktivne supstancije vezane za tiobarbituričnu kiselinu


(TBARS), azotni oksid (NO2-), katalaza (CAT), superoksid dizmutaza (SOD) i aktivnost redukovanog glutationa (GSH). Za statističku analizu korišćeni su: Kolmogorov-Smirnov test, Student-ov t-test za vezane uzorke i Wilcoxon-ov test. Rezultati. On-line hemodijafiltracija sa high-flux polisulfonskom membranom obloženom vitaminom E statistički je značajno smanjivala koncentraciju TBARS i aktivnost SOD u serumu. Nakon seanse on-line hemodijafiltracije sa high-flux polisulfonskom membranom koja nije bila oboložena vitaminom E statistički se značajno povećala koncentracija H2O2 u serumu, dok se aktivnost SOD značajno smanjila. Kod ostalih ispitivanih parametara oksidacionog stresa nije utvrđena statistički značajna razlika između korišćenih membrane. Zaključak. Pojedinačna seansa on-line hemodijafiltracije sa polisulfonskom membranom obloženom vitaminom E statistički značajno utiče na oksidacioni stres. Koncentracija TBARS u serumu je statistički značajno niž posle pojedinačne seanse on-line hemodijafiltracije sa membranom obloženom vitaminom E. Smanjena aktivnost SOD mogla bi da bude posledica pojačanog gubitka mikroelemanata u toku seanase on-line hemodijafiltracije sa high-flux polisulfonskom membranom. Izbor bolesnika, on-line hemodijafiltracija sa polisulfonskom membranom obloženom vitaminom E kontinuirano u vremenskom periodu od 3–6 meseci i povećanje kapaciteta antioksidacione zaštite mogli bi da smanje rizik od kardiovaskularnog morbiditeta i mortaliteta kod bolesnika na hemodijalizi.

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Objavljeno
2021/06/14
Broj časopisa
Vol. 78 Br. 5 (2021): Vojnosanitetski pregled
Rubrika
Originalni članak