İhsan ATEŞ, Nihal Özkayar, Fatma Meriç Yılmaz, Nergiz Bayrakçı, Salim Neselioğlu, Özcan Erel, Ezgi Coşkun yenigün, Fatih Dede

Kronik böbrek hastalığı olan hastalarda oksidatif stress düzeyi

Amaç: Bu çalışmada kronik böbrek hastalığı olan hastalarda dinamik tiyol/disülfid dengesinin araştırılması amaçlandı.Gereç ve Yöntem: Çalışmaya evre 1-5 (non diyaliz) 150 (57 erkek, 93 kadın) kronik böbrek hastası ve (76 (30 erkek, 46 kadın) sağlıklı kontrol grubu alındı. Kan tiyol/disülfid dengesi yeni geliştirilen otomatik ve kalorimetrik bir yöntemle ölçüldü. Bulgular: Tüm popülasyonun serum thiol düzeyi ortalaması 320.8±57.8 µmol/L, total thiol düzeyi ortalaması 352.0±61.5 µmol/L, ortalama disülfid düzeyi 15.6±5.3 µmol/L idi. Kronik böbrek hastalarında ortalama serum thiol (p<0.001), total thiol (p<0.001) ve disülfid düzeyleri (p<0.001) kontrol grubuna kıyasla anlamlı olarak daha düşüktü. Kronik böbrek hastaları ve kontrol grubu arasında disülfid/thiol, disülfid/total tihol ve thiol /total thiol oranları açısından olarak anlamlı farklılık saptanmadı. Sonuç: Çalışamızda hem tiyol hem disülfid düzeyinde azalma olması Kronik böbrek hastalarında serum tiyol düşüklüğünün sadece tiyol gruplarının disülfide çevrimine değil, vücuttaki total tiyol rezervinin azalmasına da bağlı olduğunu göstermektedir. Bu nedenle kronik böbrek hastalığında tiyol rezervini attırmaya yönelik nutrisyonel destek sağlanması önerilebilir.

Anahtar Kelimeler:

: Merkaptanlar, oksidatif stres, sülfidril, tiyol oksidasyonu, üremi

Oxidative stress level in patients with chronic kidney disease

Background: In this study, we aimed to evaluate the presence of oxidative stress in chronic kidney disease (CKD) by measuring dynamic thiol/disulphide homeostasis.Material and Method: A hundred fifty patients (57 men, 93 women) followed with a diagnosis of CKD (stages 1-5, not on dialysis) and 76 healthy, disease-free individuals (30 men, 46 women) were included in the study. Blood thiol/disulphide homeostasis was measured by newly developed automatic and colorimetric method by Erel and Neselioglu.Results: The mean serum native thiol (p = 0.001), total thiol (p = 0.001) and disulphide (p = 0.041) levels were lower in CKD than in the control group. No significant difference was found between the CKD and control groups in terms of disulphide/thiol, disulphide/total thiol and thiol/total thiol ratios (p > 0.05). Serum native thiol and total thiol levels were correlated negatively with both BMI and serum phosphorous level while both the parameters were correlated positively with glomerular filtration rate, total protein level and albumin level. A negative correlation was found between total thiol and age. Disulphide levels were correlated positively with albumin and total protein and negatively with uric acid levels. Conclusion: Our study shows that low serum thiol levels in CKD is due to a decrease in total thiol reserve of the body and not due to conversion of thiol groups into disulphides.

Keywords:

Mercaptans, oxidative stress, sulfhydryl, thiol oxidation, uremia,

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