Presence of glucose in dialyzing fluid and synthesis of selected lipoxygenase-derived eicosanoids during hemodialysis

Int Urol Nephrol. 2012 Dec;44(6):1799-804. doi: 10.1007/s11255-011-0089-5. Epub 2011 Nov 30.

Abstract

Purpose: Active metabolites of arachidonic acid (AA), eicosanoids, are exerting a significant influence on renal homeostasis. In our recent paper, we demonstrated that high levels of lipoxygenase (LOX)-derived AA metabolites, hydroxyeicosatetraenoic acids (HETEs), unfavorably influence post-transplant function of kidney allografts. Hence, in this study, we wanted (1) to analyze 5-, 12- and 15-HETE levels in non-diabetic chronic kidney disease (CKD) patients, already undergoing regular hemodialysis treatment, and determine factors that may influence these eicosanoids' generation, as well as, (2) to verify whether application of glucose-containing, instead of glucose-free, dialyzing fluids may be beneficial for the limitation of 5-, 12- and 15-HETE synthesis during a single hemodialysis session.

Methods: Twenty-four healthy individuals and 50 CKD patients undergoing regular hemodialysis treatment were included in the study. CKD patients were divided into two subgroups depending on presence/absence of glucose in dialyzing fluid. LOX-derived HETEs were measured using liquid chromatography.

Results: Results demonstrated higher levels of examined eicosanoids in CKD patients (P<0.05 for all). Older age and higher C-reactive protein levels were associated with HETEs concentrations. Presence of glucose in dialyzing fluid significantly diminished the increase in 5- and 12-HETE synthesis (411.24% vs. 107.29%, P<0.006; 301.70% vs. 98.21%, P<0.0008, respectively), however, it did not influence 15-HETE generation (156.98% vs. 135.24%, P=0.26).

Conclusions: Non-diabetic CKD patients have higher levels of LOX-derived HETEs, which are associated mainly with age and intensified inflammatory process. The presence of glucose in the dialysate is associated with a reduced synthesis of selected LOX-derived HETEs in these patients; hence, we speculate that the application of such a simple hemodialysis fluid modification may have a favorable influence on post-transplant outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Glucose / analysis*
  • Hemodialysis Solutions / chemistry*
  • Humans
  • Hydroxyeicosatetraenoic Acids / biosynthesis*
  • Lipoxygenase / metabolism
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Renal Insufficiency, Chronic / metabolism*
  • Renal Insufficiency, Chronic / therapy*

Substances

  • Hemodialysis Solutions
  • Hydroxyeicosatetraenoic Acids
  • Lipoxygenase
  • Glucose