Increased lipid peroxidation in patients on maintenance hemodialysis

Lipid peroxidation products, lipid hydroperoxide and malonaldehyde were measured in the serum of patients on maintenance hemodialysis and compared with values obtained from a group of healthy controls. Dialysis patients had significantly elevated levels of lipid peroxidation products (12.9 +/- 1.9 vs. 9.3 +/- 1.3 nmol/ml, mean +/- SD, patients vs. controls, p less than 0.0001). In contrast, the serum transferrin level was significantly lower in the dialysis patients (217 +/- 71 vs. 290 +/- 50 mg/dl, patients vs. controls, p less than 0.0002). Compared to normal controls HDL cholesterol was lower (40 +/- 11 vs. 53 +/- 8, p less than 0.0001) and triglycerides were higher (206 +/- 103 vs. 142 +/- 64, p less than 0.007) in the patient group. The patient group was then divided on the basis of using polysulfone or cupraphane dialyzers. Patients using polysulfone dialyzers had lower levels of 2-thiobarbituric acid-reactive substances (12.3 +/- 0.9 vs. 13.6 +/- 2.1, polysulfone vs. cupraphane, p = 0.05), and higher transferrin concentrations (248 +/- 84 vs. 194 +/- 37, p = 0.03). Thus, in patients on maintenance hemodialysis there was evidence for accelerated lipid peroxidation. This abnormality was more marked in patients using traditional cupraphane dialyzers. The mechanism for this observation remains unclear.