Increased whole blood chemiluminescence in patients with chronic renal failure independent of hemodialysis treatment
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Introduction: The luminol-enhanced whole blood chemiluminescence (LBCL) assay is a rapid assay for the measurement of reactive oxygen species (ROS) generation by circulating phagocytes. This study's aim was to determine if patients on maintenance hemodialysis (HD) and non-dialyzed patients with chronic renal failure (CRF) have altered LBCL and if dialysis itself affects ROS production in the blood. Materials and Methods: Twenty-six HD patients, 11 non-dialyzed patients with CRF, and 20 gender- and age-matched healthy controls were studied. Resting (rCl) and 210?5 M n-formyl-methionyl-leucyl-phenylalanine-stimulated LBCL (peak chemiluminescence: pCl, total light emission after agonist addition: tCl) calculated per 104 phagocytes present in the 3-l blood samples were measured with a Bio-Orbit? 1251 luminometer at 37?C for 11 min. Results: Prior to the HD session, median rCL, pCL, and tCL were 1.5, 3.0, and 2.8 times higher in HD patients than in healthy controls (p<0.01) and tended to increase at the end of the session. Significant increases in tCl were observed at 30 min and 240 min (end) of HD (1023.5 vs. 1810.6 vs. 2006.8 arbitrary unitss/104 phagocytes, n=9, p<0.05). Median pCl and tCl were 5.0 and 4.3 times higher in non-dialyzed patients with CRF than in healthy controls (p<0.001). However, no significant differences were found between pre- and post-HD LBCL of HD patients and the LBCL of non-dialyzed patients with renal failure. Conclusions: Blood from patients with renal failure generates elevated amounts of oxidants independently of HD treatment. This may add to the understanding of the nature of oxidative stress and suggests the need of antioxidant treatment in these patients.
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Dariusz Nowak, Department of Experimental and Clinical Physiology, Institute of Physiology and Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland