Dialysis – Transplantation
Kidney International (2003) 64, 704–714; doi:10.1046/j.1523-1755.2003.00118.x
Reduced hemodialysis-induced oxidative stress in end-stage renal disease patients by electrolyzed reduced water
Kuo-Chin Huang1, Chih-Ching Yang1, Kun-Tai Lee and Chiang-Ting Chien
Departments of Family Medicine and Medical Research, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; Taipei Municipal Hoping Hospital, Taipei, Taiwan; and Wan-Hwa Regional Hospital, Taipei, Taiwan
Correspondence: Chiang-Ting Chien, Ph.D., No. 7 Chung-Sun South Road, Department of Medical Research, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. E-mail: ctchien@ha.mc.ntu.edu.tw
1Dr. Huang and Dr. Yang contributed equally to this work.
Received 11 September 2002; Revised 19 December 2002; Re-revised 12 March 2003; Accepted 28 March 2003.
Abstract
Reduced hemodialysis-induced oxidative stress in end-stage renal disease patients by electrolyzed reduced water.
Background
Increased oxidative stress in end-stage renal disease (ESRD) patients may oxidize macromolecules and consequently lead to cardiovascular events during chronic hemodialysis. Electrolyzed reduced water (ERW) with reactive oxygen species (ROS) scavenging ability may have a potential effect on reduction of hemodialysis-induced oxidative stress in ESRD patients.
Methods
We developed a chemiluminescence emission spectrum and high-performance liquid chromatography analysis to assess the effect of ERW replacement on plasma ROS (H2O2 and HOCl) scavenging activity and oxidized lipid or protein production in ESRD patients undergoing hemodialysis. Oxidized markers, dityrosine, methylguanidine, and phosphatidylcholine hydroperoxide, and inflammatory markers, interleukin 6 (IL-6), and C-reactive protein (CRP) were determined.
Results
Although hemodialysis efficiently removes dityrosine and creatinine, hemodialysis increased oxidative stress, including phosphatidylcholine hydroperoxide, and methylguanidine. Hemodialysis reduced the plasma ROS scavenging activity, as shown by the augmented reference H2O2 and HOCl counts (RH2O2 and RHOCl, respectively) and decreased antioxidative activity (expressed as total antioxidant status in this study). ERW administration diminished hemodialyis-enhanced RH2O2 and RHOCl, minimized oxidized and inflammatory markers (CRP and IL-6), and partly restored total antioxidant status during 1-month treatment.
Conclusion
This study demonstrates that hemodialysis with ERW administration may efficiently increase the H2O2- and HOCl-dependent antioxidant defense and reduce H2O2- and HOCl-induced oxidative stress.
Keywords:
hemodialysis, electrolyzed reduced water, reactive oxygen species, end-stage renal diseases
