A Study on Quality of Life, Oxidative Stress and Antioxidant Status Associated with Clinical and Biochemical Parameters in Chronic Kidney Disease Patients on Hemodialysis

Abstract

Background: Chronic Kidney Disease (CKD) is an emerging non-communicable disease of public health importance. Oxidative stress (OS) has been implicated in the pathogenesis of cardiovascular death and CKD patients are at increased risk of both OS and cardiovascular death. Among the many chronic diseases that affect the population, CKD is considered a pathology without expectation of the cure, with rapidly and progressive evolution, triggering diverse reactions for patients and compromise the quality of life (QOL).

   Methods: This cross sectional study consisted of 98 patients with CKD undergoing dialysis treatment in Hemodialysis unit of a tertiary care hospital Melmaruvathur Tamil Nadu. Patients included with CKD over 18 to 75 years old, both genders and dialysis treatment for more than six months. The routine biochemical, clinical, anthropometric parameters and duration of dialysis collected from medical recorded data. The venous blood collected from post Hemodialysis patient, serum separated and analysed for oxidative stress as Thiobarbituric acid substance (TBARS), Oxidised glutathione (GSSG) reduced glutathione (GSH) and antioxidant status as Superoxide dismutase (SOD), Catalase (CAT) and Glutathione Peroxidase (GPO) by spectrophotometer assay. Short form (SF) 12 is a tool of questionnaire used to assess quality of life.

    Results: Age grouped as three groups such as less than 30yrs, 30 to 50yrs and above 51yrs. Association between age, quality of life and gender in which pain interference (p value 0.024) and emotional problems with social activities  (p value 0.050), general health (p value 0.012)  were significant at 95% < 0.05 Level. Comparison of lipid parameters with BMI in Kg/m2, TBARS & GSSG/GSH ratio as Oxidative stress and SOD, CAT, GPX as antioxidant status  were highly significant (p value 0.0001) at 95% < 0.05 significance level by independent‘t’ test.  Correlation of oxidative stress (TBARS, GSSG/GSH) and antioxidant status (SOD, CAT, GPX) in which TBARS with Catalase (0.306),GPX (0.239), GSSG/GSH with SOD (0.478), CAT (0.601), GPX (0.465), SOD with CAT (0.668) and GPX (0.551), CAT with GPX (0.749) were significant but no difference with TBARS,SOD and similarly SBP, lipid parameters at 0.01 and 0.05 levels by Pearson correlation (2-tailed).

  Conclusions: Oxidative stress plays an important role and progress cardiovascular complications in chronic kidney disease by decreasing antioxidant status which is reduced by using antioxidant coated membranes such as Vitamin E coated dialyzer. Specialized nursing and health care providers is required to maintain and manage on physical and mental health status to improve QOL in HD patients.