Reduced glomerular filtration rate, inflammation and HDL cholesterol as main determinants of superoxide production in non-dialysis chronic kidney disease patients

Abstract

Enhanced oxidative stress partly resulting from an over-production of superoxide anion (O₂^•−) represents a novel and particular risk factor in chronic kidney disease (CKD) patients. This study was therefore designed to evaluate O₂^•− determinants in this population. O₂^•− production was evaluated using chemiluminescence method in 136 CKD patients (79M/57F, median age: 69.5 [27.4–94.6]). Renal function (evaluated by the glomerular filtration rate using modification of diet in renal disease (MDRD)), inflammation, lipids, nutritional and bone mineral as well as clinical parameters were evaluated. Potential relationships between O₂^•− and these clinico-biological parameters were investigated to identify main determinants of such a pathological process. Enhanced O₂^•− production has been observed at the pre-dialysis phase: stages 4 and 5 of CKD (p = 0.0065). In multivariate analysis, low eGFR (MDRD <30 mL/min/1.73 m²; p = 0.046), high fibrinogen (≥3.7 g/L; p = 0.044) and abnormal HDL cholesterol (<1.42 mmol/L and ≥ 1.75 mmol/L; p = 0.042) were the main determinants of O₂^•− production in CKD patients.

Keywords::

• Chronic renal disease
• superoxide anion
• fibrinogen
• lipids

This paper was first published online on Early Online on 11 April 2011.