ارزیابی عوامل مؤثر در پراکسیداسیون لیپیدی بیماران همودیالیزی و پیوندی

Evaluation the Affecting Factors in Lipid Peroxidation of Hemodialysis and Renal Transplanted Patients GR. Moshtaghi Kashanian PhD , N. Rashtchi PhD , H. Ardakani MD , A. Ghorbani Haghjoo PhD2 Received: 23/07/05 Sent for Revision: 25/09/06 Received Revised Manuscript: 21/01/07 Accepted: 26/02/07 Background and Objective: Atherosclerosis is the most important cause of death in hemodialysis and renal transplanted patients while hyperlipidemia and lipid peroxidation are considered major risk factors of it. For this reason, the most important goals of therapy are elimination of risk factors of atherosclerosis among these patients. Since peroxidation of lipids are a multifactorial process and all factors have not been investigated in one study, we decided to investigate, serum concentrations of total cholesterol, triglycerides, cholesterol contained of high density lipoprotein (HDL-c), concentration of albumin, total magnesium (Mg), malondialdehyde (MDA) and total antioxidant of these patients and compare the results with corresponding data obtained for age and sex matched control group. Materials and Methods: In this cross-sectional study, 30 patients who were on hemodialysis and 30 renal transplanted patients were participated. Parameters mentioned above were measured using sera separated from the fasting blood collected from the patients. Evaluation of these parameters were done by following protocols provided by the manufactures of the kits, The results obtained were compared with the corresponding data of 30 healthy persons who served as control group. In addition, the cholesterol contained of low density lipoprotein (LDL-c) was calculated and plasma level of cyclosporine was measured for renal transplanted patients. Results: Evaluated data showed elevation in the serum levels of triglycerides (p<0.05), MDA (p<0.001) and decrease in the serum levels of total antioxidant among hemodialysis and renal transplanted patients (p<0.001). In addition, the serum levels of magnesium in hemodialysis patients were higher than control group (p<0.01), while it was lower in renal transplant patients (p<0.01). Finally, Serum albumin levels were significantly lower in the patient groups, when compared with control group (p<0.01). Pearson regression analysis showed a positive and significant correlation between triglycerides level and MDA (r= -0.47, p<0.001) and negative correlation with total antioxidant (r=-0.42, p<0.001). In addition, there was a negative and significant correlation between Mg and cyclosporine level (r=-0.44, p<0.01) among renal transplanted patients. Conclusion: In conclusion, present results demonstrated that cyclosporine is the most important cause of hypomagnesaemia in renal transplanted patients. Therefore, oral magnesium supplement should be used for these patients, when cyclosporine recommended. In addition, low levels of antioxidant detected among the patient groups suggest that prescription of oral antioxidant such as vitamin C and E could reduce the risk of atherosclerosis in these patients. Key words: Renal Transplant, Hemodialysis, Antioxidant, MDA, Magnesium, Lipid Profile