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Effect of phosphate binders on oxidative stress and inflammation markers in hemodialysis patients
Authors:Aline T PERES  Maria A DALBONI  Maria E CANZIANI  Silvia R MANFREDI  Jose Tarcisio G CARVALHO  Marcelo C BATISTA  Lilian CUPPARI  Aluisio B CARVALHO  Rosa M A MOYSES  Nadia GUIMARÃES  Vanda JORGETTI  Maria C ANDREOLI  Sergio A DRAIBE  Miguel CENDOROGLO
Affiliation:Department of Internal Medicine, Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil;;Department of Internal Medicine, Division of Nephrology, University of São Paulo, São Paulo, Brazil
Abstract:It has been suggested that phosphate binders may reduce the inflammatory state of hemodialysis (HD) patients. However, it is not clear whether it has any effect on oxidative stress. The objective of this study was to evaluate the effect of sevelamer hydrochloride (SH) and calcium acetate (CA) on oxidative stress and inflammation markers in HD patients. Hemodialysis patients were randomly assigned to therapy with SH (n=17) or CA (n=14) for 1 year. Before the initiation of therapy (baseline) and at 12 months, we measured in vitro reactive oxygen species (ROS) production by stimulated and unstimulated polymorphonuclear neutrophils and serum levels of tumor necrosis factor α, interleukin-10, C-reactive protein, and albumin. There was a significant reduction of spontaneous ROS production in both groups after 12 months of therapy. There was a significant decrease of Staphylococcus aureus stimulated ROS production in the SH group. There was a significant increase in albumin serum levels only in the SH group. In the SH group, there was also a decrease in the serum levels of tumor necrosis factor α and C-reactive protein. Our results suggest that compared with CA treatment, SH may lead to a reduction in oxidative stress and inflammation. Therefore, it is possible that phosphate binders exert pleiotropic effects on oxidative stress and inflammation, which could contribute toward decreasing endothelial injury in patients in HD.
Keywords:Hemodialysis  phosphate binders  reactive oxygen species  inflammation
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