Possibilities of correction of manifestations of oxidative stress in patients with chronic kidney disease G3A-5D


DOI: https://dx.doi.org/10.18565/therapy.2020.7.28-36

Negoda V.M., Batiushin M.M., Gasanov M.Z., Zatonskiy S.A., Gareev R.R.

1) Rostov Regional Children’s Clinical Hospital, Rostov-on-Don; 2) Rostov State Medical University of the Ministry of Healthcare of Russia, Rostov-on-Don; 3) Southern District Medical Center of the Federal Medical and Biological Agency, Rostov-on-Don
The aim: to explore various ways to influence oxidative stress in chronic kidney disease (CKD), including medication.
Material and methods. We conducted a retrospective comparative non-interventional study of 80 patients (men – 34, women – 46; average age 58,8±13,2 years) with CKD G3A-5D. The duration of CKD is 8,68±9,3 years (the spread is 0,5–37 years), the duration of hemodialysis is 53,6±47,4 months (the spread is 4–148 months). Serum levels of malon dialdehyde (MDA), superoxide dismutase (SOD), and asymmetric dimethylarginine (ADMA) were assessed by quantitative enzyme immunoassay. Bioimpedance analysis was performed in all patients once. In the course of a retrospective analysis, we registered types of therapy for patients with a duration of 12 months or more before including patients in the study Protocol.
Results. It was found that among the groups of antihypertensive drugs beta blockers, calcium channel blockers and diuretics did not affect the level of MDA, while the use of ACE inhibitors or angiotensin II receptor blockers (ARA II) was accompanied by a decrease in the severity of oxidative stress. Moxonidine, urate-reducing therapy and fibrates also had a similar effect. It has been shown that the use of ACE inhibitors or ARA II in combination with urate-lowering therapy is accompanied by a reduction in the risk of oxidative stress (increased MDA) due to the impact of each component of the treatment regimen.
Conclusion. Complex therapy of patients with CKD G3A-5D using ACE inhibitors, ARA II, moxonidine, uricosstatics, fibrates, vitamin D, cinacalcet, epoetins and iron preparations is accompanied by a pleotropic effect in the form of a decrease in the activity of oxidative stress (MDA in the blood). Correction of the treatment regimen for hemodialysis in the form of increasing the flow rate of the dialysate, reduction of ultrafiltration volume due to a decrease in gain of fluid in medialine days reduces the activity of oxidative stress.
Keywords: Keyword: oxidative stress, malon dialdehyde, chronic kidney disease
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About the Autors

Vladimir M. Negoda, chief freelance specialist in childhood nephrology of Rostov Regional Children’s Clinical Hospital. Address: 344015, Rostov-on-Don, 14 339th Strelkovoy divizii Str. Tel.: +7 (928)165-83-57. E-mail: v.nego@mail.ru. ORCID: 0000-0001-6872-8565
Mikhail M. Batyushin, MD, professor, professor of the Department of internal diseases No. 2, head of the nephrology Department of the clinic of Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane. Tel.: +7 (918) 501-88- 01. E-mail: batjushin-m@rambler.ru. ORCID: 0000-0002-2733-4524
Mitkhat Z. Gasanov, PhD, associate professor of the Department of internal diseases No. 1 of Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
Tel.: +7 (988) 947-37-50. E-mail: mitkhat@mail.ru. ORCID: 0000-0001-5856-0404
Stanislav A. Zatonsky, PhD, associate professor of the Department of internal diseases No. 2 of Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
Tel.: + 7 (863) 201-44-23. E-mail: zatonsk@bk.ru
Rustam R. Gareev, nephrologist, acting head of the ambulatory dialysis unit of Southern District Medical Center of the Federal Medical and Biological Agency. Address: 344022, Rostov-on-Don, 34 Peshkov Str. Tel.: +7 (918) 591-25-95. E-mail: mitkhat@mail.ru. ORCID: 0000-0002-1100-8011

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