Role of free radical oxidation in the development of cardiovascular events in chronic renal failure


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Abstract

Aim. to refine a role of free radical oxidation (FRO), anemia, and endothelial dysfunction in the development of cardiovascular events in patients with chronic renal failure (CRF) at different stages of the disease.
Subjects and methods. Eighty-six patients, including 46 (53%) women and 40 (47%) men with Stages II-IV CRF, were examined. The patients' mean age was 43.6 ± 14 years. Echocardiography, measurements of the blood levels of hemoglobin, albumin, cholesterol, and uric acid, and determination of blood electrolytic composition were made. Blood creatinine concentrations in the group averaged 0.3 mmol/l. Glomerular filtration rate (GFR) calculated from the Cockroft-Goult formula averaged 33.96 ± 13 ml/min; the duration of CRF was 9.3 ± 1.6 years. Anemia was detected in 46 (53%) patients. Iron metabolism was estimated from serum ferritin levels. Special studies involved determination of FRO - malondialdehyde (MDA) and the activities of catalase and superoxide dismutase (SOD) in plasma and serum. The plasma concentrations of endohelin-1 (ET-1), thromboxane A2, and prostacyclin were measured by radioimmunoassay.
Results. The higher concentrations of MDA and the decreased activities of catalase and SOD, i.e. FRO, correlated with the progression of renal failure. There were also increases in the levels of ET-1 and thromboxane A2 and a reduction in the concentration of prostacyclin as blood creatinine levels elevated. Left ventricular hypertrophy was found in 43 (50%) of the 86 patients. Its severity depended on the decrease of creatine phosphokinase and the severity of anemia and arterial hypertension. There was a stable correlation between the changes in left ventricular myocardial mass, MDA levels, and catalase and SOD activities.
Conclusion. The higher level of MDA and the lower activities of catalase and SOD in patients with CRF, which correlate with diminished renal function, confirm that the disease is closely associated with FRO, that, by aggravating anemia and endothelial dysfunction, affects the magnitude of morphological and functional changes in the cardiovascular system in patients with CRF patients.

About the authors

Fira Solomonovna Dzgoeva

Email: elena_takoeva@mail.ru

Tamara Magometovna Gatagonova

Email: nosma@dol.ru

Fira Solomonovna Dzugkoeva

Email: elena_takoeva@mail.ru

Zalina Khasanovna Kochisova

Email: kochisova_zalina@mail.ru

Zarina Kazbekovna Kadzaeva

Ol'ga Vasil'evna Khamitsaeva

F U Dzgoyeva

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

T M Gatagonova

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

F S Dzugkoyeva

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

Z Kh Kochisova

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

Z K Kadzayeva

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

O V Khamitsayeva

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

Department of Therapy, Faculty of Postgraduate Medical Education, North Ossetian State Medical Academy

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