Asymmetric dimethylarginine and homocysteine levels in dialysis patients

ERDEM ,S Sami; YERLİKAYA ,F Hümeyra; TONBUL ,Zeki; TÜRKMEN ,Kültigin; ERDUR ,F Mehmet; TANER ,Alpaslan; ÇİÇEKLER ,Hümeyra; MEHMETOĞLU ,İdris

S Sami ERDEM

(Konya Eğitim ve Araştırma Hastanesi, Biyokimya Birimi, Konya, Türkiye)

F Hümeyra YERLİKAYA

(Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Biyokimya Anabilim Dalı, Konya, Türkiye)

Zeki TONBUL

(Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Nefroloji Bilim Dalı, Konya, Türkiye)

Kültigin TÜRKMEN

(Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Nefroloji Bilim Dalı, Konya, Türkiye)

F Mehmet ERDUR

(Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Nefroloji Bilim Dalı, Konya, Türkiye)

Alpaslan TANER

(Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Biyokimya Anabilim Dalı, Konya, Türkiye)

Hümeyra ÇİÇEKLER

(Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Biyokimya Anabilim Dalı, Konya, Türkiye)

İdris MEHMETOĞLU

(Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Biyokimya Anabilim Dalı, Konya, Türkiye)

European Journal of General Medicine

Yıl: 2013Cilt: 10Sayı: 2ISSN: 1304-3889 / 1304-3897Sayfa Aralığı: 90 - 95Metin Dili: Türkçe

92 0

Türkçe
İngilizce

Asymmetric dimethylarginine and homocysteine levels in dialysis patients

Öz: Kardiyovasküler hastalıklar ve endotelyal disfonksiyon son dönem böbrek yetmezliği hastalarında en önemli ölüm nedenleridir. Periton diyalizi ve hemodiyaliz gibi tedavi yöntemlerinin farklı parametreler üzerine farklı etkileri vardır. Asimetrik dimetilarjinin endojen nitrik oksit sentaz inhibitörüdür ve kronik böbrek yetmezliğinin progresyonunda yeni bir belirteç olduğu gösterilmiştir. Homosistein endotel hasarı, damar düz kas hücre proliferasyonu ve koagülasyon anormallikleri yoluyla trombogenez ve atero- geneze neden olur. Daha önceki çalışmalarda periton diyalizi (PD) ve hemodiyalizin (HD) oksidan ve antioksidan sistemler üzerine etkisiyle ilgili çelişkili bulgular vardır. Bu çalışmada HD, PD ve sağlıklı kişilerde ADMA, homosistein ve CRP düzeylerini belirlemeyi amaçladık. Çalışmaya 44 PD (23E,21K), 26HD (13E,13K) hastası ve 29 (15E,14K) sağlıklı kişi katıldı. ADMA, homosistein, arjinin ve CRP düzeyleri ölçüldü. Son dönem böbrek yetmezliği (SDBY) hastalarının ADMA, homosistein ve CRP düzeyleri sağlıklı kontrol grubuna göre yüksek (p<0.001), arjinin düzeyleri düşük olarak bulundu(p<0.001). HD ve PD gruplarında ADMA, homosistein ve CRP seviyeleri açısından farklılık bulunamadı (sırasıyla p:0.287, p: 0.587, p: 0.835) Bizim sonuçlarımız HD,PD hastalarında sağlıklı kontrole göre ADMA ve homosistein düzeylerinin yüseldiğini gösterdi. Bu bulgular; diyaliz hastalarında endotel disfonksiyonu, inflamasyon ve oksidatif stresin arttığını ve ADMA ve homosistein düzeylerinin diyaliz tedavi yönteminden etkilenmediğini gös- termektedir

Anahtar Kelimeler:

Konu Alanı: Fen > Tıp > Cerrahi

Diyaliz hastalarında asimetrik dimetilarjinin ve homosistein düzeyleri

Öz:Cardiovascular diseases and endothelial disfunction are major causes of mortality in patients with end stage renal disease (ESRD). Treatment strategies like continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) have different effects on dif- ferent parameters. Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide (NO) synthase inhibitor and it has been reported to be a novel marker for the progression of chronic kidney disease (CKD). Homocysteine is believed to cause atherogen- esis and thrombogenesis via endothelial damage, vascular smooth muscle proliferation and coagulation abnormalities. In previ- ous studies, conflicting findings have been reported about the effect of HD and CAPD on oxidant and antioxidant systems. In this study, we aimed to investigate ADMA, homocysteine and C- reactive protein (CRP) levels in patients with ESRD having HD and CAPD treatment and healthy individuals. This study was performed on 44 (23M, 21F) CAPD patients, 26 (13M, 13F) HD patients and 29 (15M, 14F) age and sex matched healthy control subjects. The lipid profile, ADMA, homocysteine, arginine and CRP levels were measured. Serum ADMA, homocysteine and CRP levels of the ESRD patients were significantly higher, whereas serum arginine levels were significantly lower in both HD and CAPD patients compared to control subjects. No differences were found between serum ADMA, homocysteine and CRP levels of the CAPD and HD patients. Our results suggest that ADMA, homocysteine and CRP levels were increased in HD and CAPD patients compared to the control subjects. These findings suggest that ESRD patients are prone to inflammation, oxidative stress and endothelial dysfunction. We conclude that endothelial dysfunction, inflammation and oxidative stress are increased in dialysis patients and ADMA concentrations are not affected by the modality of dialysis treatment.

Anahtar Kelimeler:

Konu Alanı: SCIENCE > MEDICINE > SURGERY

Belge Türü: DergiMakale Türü: Araştırma MakalesiErişim Formatı: Erişime Açık

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