Effect Of Arachidonic Acid And TNF-α On Oxidative Stress In Chronic Kidney Disease

Objective: Oxidative stress exists in chronic kidney disease (CKD) patients, which has been demonstrated. However, the exact changes and influencing factors of oxidative stress in different stage of CKD are still unknown. Arachidonic acid (AA) and tumor necrosis factor (TNF)-αare two important inflammatory cytokines which have complicated interrelationship with oxidative stress. Malondialdehyde(MDA) is a biomarker of oxidative stress. The aim of this paper is to discuss the changes and impact factors of oxidative stress in different stages of CKD by studying AA, TNF-αand MDA.Methods: The total number of subjects is 105 which contains①79 non-diabetic patients with primary glomerular diseases confirmed by clinical and renal biopsy (55 men,24 women; 29 at CKD stages 1 to 2, 21 at stages 3 to 4, 29 at CKD5 among whom 10 patients were selected to do CAPD treatment, compared with themselves before and after 3 months of CAPD );②12 non-hemodialysis patients with diabetic nephropathy (DN) at CKD5 confirmed by clinical examination and renal biopsy (7 men,5 women);③14 healthy control subjects (7 man,7 women). All patients were abstracted 3ml blood from elbow veins before the breakfast. Blood samples were collected in disposable test-tube and left in room temperature for two hours, and then separated the serum. The serum samples were stored in EP at -70℃until analysis. Enzyme linked immunosolid assay(ELISA) is used to detect free AA,TNF-α,MDA,hs-CRP levels in serum .Results:①In primary glomerular diseases: the levels of MDA in CKD1/2 and CKD3/4 were significantly higher than that in CKD5 (P<0.05) , without significant difference between CKD1/2 and CKD3/4 (P>0.05) . AA was negatively related to MDA and had anti-oxidation effect. TNF-αwas positively related to MDA and had pro-oxidation effect. The level of hs-CRP had no difference in patients with different stage of CKD.②The levels of MDA and hs-CRP in patients with DN at CKD5 were significantly higher than those in patients with primary glomerular diseases at CKD5. AA had pro-oxidation effect in DN.③There were no significent differences in the levels of MDA and hs-CRP before and after continuous ambulatory peritoneal dialysis (CAPD) in primary glomerular diseases at CKD5 patients.Conclusions:①In primary glomerular diseases: the level of oxidative stress decreased gradually with the progression of CKD;the inflammation levels were almost same in each group,except infection.②The levels of oxidative stress and inflammation in patients with DN at CKD5 were significantly higher than those in patients with primary glomerular diseases at CKD5.③There were no significant effects on the levels of oxidative stress and inflammation in primary glomerular diseases at CKD5 after short term CAPD treatment.④TNF-αpromoted the level of oxidative stress in CKD patients caused by primary glomerular diseases. The effects of AA on oxidative stress in CKD were different because of different causes of CKD.