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Free oxygen radicals in acute renal failure
N K Dubey1, P Yadav, A K Dutta
1Department of Pediatric Intensive Care, Kalawati Saran Children's Hospital and Lady Hardinge Medical College, Bangla Sahib Marg, New Delhi 110 001, India. dubeyn.k@ndfdel.in
Objective:
To assess the levels of free oxygen radicals in acute renal failure and their predictive value in clinical outcome.
Design:
Prospective.
Setting:
Intensive care unit.
Methods:
Study was conducted in 50 children (25 with acute renal failure and 25 age and sex matched controls). Blood urea, serum creatinine, serum protein, uric acid and free oxygen radical markers were estimated in both groups. Superoxide dismutase (SOD), glutathione peroxidase(GPx) and lipid peroxide (LPO) were estimated in blood by standard techniques.
Results:
Hemolytic uremic syndrome (HUS) was a major cause of acute renal failure (52%), rest were due to acute glomerulonephritis (AGN), septicemia and renal venous thrombosis. In the renal failure group 56% of the patients were dialyzed (peritoneal) and the mortality was 28% (7/25). The levels of SOD, GPx and LPO were significantly raised in renal failure group. Higher values of LPO, SOD and GPx were documented in subjects who expired. The most important independent variable for predicting clinical outcome was LPO with a sensitivity of 89.4%, specificity of 93%, positive predictive value of 95%.
Conclusion:
Levels of free oxygen radicals (SOD, LPO and GPx) are raised in acute renal failure and these enzymes can be used as marker of renal injury. LPO levels are highly sensitivity and specific for predicting the clinical outcome