Google Scholar | Citations: 16429| h-index: 32 | i10-index: 482
Glutathione antioxidant mechanism in haemodialysis patients after 1 year: observational and longitudinal study
PDF

Keywords

Renal dialysis
Oxidative stress
Glutathione
Reactive oxygen species
Nutritional assessment

How to Cite

Glutathione antioxidant mechanism in haemodialysis patients after 1 year: observational and longitudinal study. (2026). Electronic Journal Collection Health, 26(5), e23666. https://doi.org/10.25248/reas.e23666.2026

Copyright © | All rights reserved.

The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.

Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.

Total reproduction
It is expressly prohibited and must be authorized by the journal.

Abstract

Objective: To analyze the variation in oxidative stress (OS) biomarkers, focusing on the glutathione mechanism, after a one-year period in the same patients on haemodialysis. Methods: Observational and longitudinal study performed in a dialysis clinic at two moments. The following biomarkers of the glutathione mechanism were analysed in the same individuals at baseline and after a one-year period: reduced glutathione (GSH), oxidized glutathione (GSSG), the GSH:GSSG ratio, glutathione peroxidase (GPx). For statistical analysis, the paired Student's t-test, Wilcoxon test, Chi-square test, and Pearson's or Spearman's correlation were adopted. Effect sizes were calculated with Hedges' g and Cliff’s delta. For the retrospective power analysis G*Power® software was used. P <0.05 was considered statistically significant. Results: Ten patients concluded the study. After a one-year period, an increase was observed in GSSG (P=0.000), GPx (P=0.041), and a decrease in GSH (P=0.007) and the GSH:GSSG ratio (P=0.000). Moderate positive not significant correlations were found between HD vintage and GSSG (rho = 0.4108, p=0.5), and a moderate negative correlation between GSH (rho = -0.5817, p=0.007) and the GSH:GSSG ratio (rho = -0.5123, p=0.025). Conclusion: There was a significant increase in OS related to glutathione mechanism.

PDF

References

ARANGO HG. Bioestatística teórica e computacional. 3 ed. Guanabara Koogan, 2009; 460p.

CANUSA. Adequacy of Dialysis and Nutrition in Continuous Peritoneal Dialysis: Association with Clinical Outcomes. CANADA-USA (CANUSA) Peritoneal Dialysis Study Group. J Am Soc Nephrol., 1996;7(2):198-207.

CEDERHOLM T, et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clin Nutr., 2019;38(1):1-9.

CHANDA D, et al. Editorial: The role of oxidative stress and systemic inflammation in diabetes and chronic kidney disease. Front Endocrinol., 2023;14:1272525.

COHEN J. A power primer. Psychol Bull., 1992;112(1):155-9.

DAENEN K, et al. Oxidative stress in chronic kidney disease. Pediatr Nephrol., 2019;34(6):975-91.

DIEPEVEEN SHA, et al. The effect of the initiation of renal replacement therapy on lipid profile and oxidative stress during the first 6 months of treatment. Clin Chim Acta, 2005;361(1-2):112-8.

DOMIJAN A-M, et al. Quantification of malondialdehyde by HPLC-FL – application to various biological samples. Biomed Chromatogr., 2015;29(1):41-6.

DURAK I, et al. Oxidative stress in patients with chronic renal failure: Effects of hemodialysis. Med Princ Pract., 2004;13(2):84-7.

GARCIA MF, et al. Diagnostic accuracy of handgrip strength in the assessment of malnutrition in hemodialyzed patients. Clin Nutr ESPEN, 2013;8(4):e181-6.

GIUSTARINI D, et al. Analysis of GSH and GSSG after derivatization with N-ethylmaleimide. Nat Protoc., 2013;8(9):1660-9.

GROTTO D, et al. Rapid quantification of malondialdehyde in plasma by high performance liquid chromatography – visible detection. J Pharm Biomed Anal., 2007;43(2):619-24.

HENDRIKS FK, et al. End-stage renal disease patients lose a substantial amount of amino acids during hemodialysis. J Nutr., 2020;150(5):1160-6.

HENSLEY K, et al. New perspectives on vitamin E: γ-tocopherol and carboxyethylhydroxychroman metabolites in biology and medicine. Free Radic Biol Med., 2004;36(1):1-15.

IBRAHIM VARAN H, et al. Acute effects of hemodialysis on oxidative stress parameters in chronic uremic patients: Comparison of two dialysis membranes. Int J Nephrol Renovasc Dis., 2010;3:39-45.

IKIZLER TA, et al. Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis.,

;76(3):S1-S107.

IRAZABAL MV, TORRES VE. Reactive Oxygen Species and Redox Signaling in Chronic Kidney Disease. Cells, 2020;9(6):1342.

KHAZIM K, et al. Glutathione redox potential is low and glutathionylated and cysteinylated hemoglobin levels are elevated in maintenance hemodialysis patients. Transl Res., 2013;162(1):16-25.

KOCA T, et al. Effects of hemodialysis period on levels of blood trace elements and oxidative stress. Clin Exp Nephrol., 2010;14(5):463-8.

LAKENS D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol., 2013;4:1-12.

LIAKOPOULOS V, et al. Oxidative stress in hemodialysis patients: A review of the literature. Oxid Med Cell Longev., 2017;3081856.

LIAKOPOULOS V, et al. Oxidative stress in hemodialysis: Causative mechanisms, clinical implications, and possible therapeutic interventions. Semin Dial., 2019;32(1):58-71.

LU SC. Glutathione synthesis. Biochim Biophys Acta, 2013;1830(5):3143-53.

MARTINS ML, et al. Vitamin C decreases reduced glutathione in chronic haemodialysis patients: a pilot, randomised, double-blind trial. Int Urol Nephrol., 2021;53(8):1695-1704.

MORENA M, et al. Oxidative stress in hemodialysis patients: Is NADPH oxidase complex the culprit? Kidney Int Suppl., 2002;(80):109-114.

POULIANITI KP, et al. Systemic redox imbalance in chronic kidney disease: A Systematic Review. Oxid Med Cell Longev., 2016:8598253.

PUPIM LB, et al. Influence of initiation of maintenance hemodialysis on biomarkers of inflammation and oxidative stress. Kidney Int., 2004;65(6):2371-9.

RAPA SF, et al. Inflammation and oxidative stress in chronic kidney disease—potential therapeutic role of minerals, vitamins and plant-derived metabolites. Int J Mol Sci., 2020;21(1):1-26.

ROEHRS M, et al. The relationships between exogenous and endogenous antioxidants with the lipid profile and oxidative damage in hemodialysis patients. BMC Nephrol., 2011;12(59):1-9.

RYSZ J, et al. Oxidative stress in ESRD patients on dialysis and the risk of cardiovascular diseases. Antioxidants, 2020;9(11):1-24.

STEVENS PE, et al. KDIGO 2024 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int., 2024;105(4):S117-S314.

TOUAT-HAMIC Z, et al. Selective up-regulation of human selenoproteins in response to oxidative stress. J Biol Chem., 2014;289(21):14750-61.

URSINI F, MAIORINO M. Lipid peroxidation and ferroptosis: The role of GSH and GPx4. Free Radic Biol Med., 2020;152:175-85.

VALENTINI J, et al. The influence of the hemodialysis treatment time under oxidative stress biomarkers in chronic renal failure patients. Biomed Pharmacother., 2008;62(6):378-82.

WENDEL A. Glutathione peroxidase. Methods Enzymol., 1981;77:325-33.

YEH E-L, et al. Higher glutathione demand may be necessary for assisting haemodialysis patients to cope with increased oxidative stress. Nephrology, 2020;25(1):90-5.

ZHENG C-M, et al. Potential role of molecular hydrogen therapy on oxidative stress and redox signaling in chronic kidney disease. Biomed & Pharmacother., 2024;176:1-15.