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

Barbara Dołęgowska, Wojciech Błogowski, Joanna Stępniewska, Krzysztof Safranow, Katarzyna Jakubowska, Maria Olszewska

Department of Laboratory Diagnostics and Molecular Medicine, Pomeranian Medical University, Al. Powstancow Wlkp. 72, 70-111, Szczecin, Poland.

International urology and nephrology 2012 Dec

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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. 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 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). 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.

Citation

Barbara Dołęgowska, Wojciech Błogowski, Joanna Stępniewska, Krzysztof Safranow, Katarzyna Jakubowska, Maria Olszewska. Presence of glucose in dialyzing fluid and synthesis of selected lipoxygenase-derived eicosanoids during hemodialysis. International urology and nephrology. 2012 Dec;44(6):1799-804