Antioxidant status and lipid peroxidation in hemodialysis patients undergoing erythropoietin and erythropoietin-vitamin E combined therapy

In this study, plasma and red blood cell (RBC) antioxidant status and plasma lipid peroxidation were investigated in 46 hemodialysis patients. In addition, the effect of erythropoietin (EPO) and EPO-vitamin E combination therapy on plasma and RBC antioxidant status, and plasma lipid peroxidation were examined.

There were 10 healthy subjects in the control group and 10 hemodialysis patients in the untreated group. The third group included 36 hemodialysis patients that were given EPO (100 U/kg) for 3 months, 3 times per week. The fourth group included 36 hemodialysis-patients from the EPO group that were given EPO at a 50% decreased dose + vitamin E (300 mg/day) for 3 months.

MDA levels in the untreated group, the EPO group and the EPO + vitamin E groups were found to be higher than the control group (p<0.001, in both). Furthermore, MDA levels in both of the treatment groups were lower when compared to the untreated group (p<0.001, in both). Plasma vitamin E levels in the untreated, the EPO group and EPO + vitamin E groups were lower than the control group (p<0.001). In contrast, plasma vitamin E levels in the treatment groups were higher in comparison with the control group (p<0.05). SOD activities in the untreated, the EPO group and the EPO + vitamin E groups were found to be lower than the control group (p<0.001). SOD activities in the treatment groups were higher than the control group (p<0.001). The SOD activities in the EPO + vitamin E group increased when compared to the EPO group (p<0.001). CAT activities in the untreated, the EPO group and the EPO + vitamin E groups were found to be lower than the control group (p<0.001 in untreated and EPO groups, p<0.01 in EPO + vitamin E group). CAT activities in EPO and EPO + vitamin E groups were increased when compared to the untreated group (p<0.01).

In conclusion, our findings have shown that antioxidant status decreased and lipid peroxidation increased in hemodialysis patients. EPO has an antioxidant effect on the RBC and plasma antioxidant status, and plasma lipid peroxidation. These effects were moderately increased by the combination of vitamin E and EPO.