2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Himmelfarb, J. Articles by The PICARD Group, Search for Related Content PubMed PubMed Citation Articles by Himmelfarb, J. Articles by The PICARD Group,

Oxidative Stress Is Increased in Critically Ill Patients with Acute Renal Failure

Jonathan Himmelfarb^*,, Ellen McMonagle, Stephanie Freedman, Jennifer Klenzak^*, Elizabeth McMenamin, Phuong Le, Lara B. Pupim, T. Alp Ikizler and The PICARD Group

*Maine Medical Center, Portland, Maine; Maine Medical Center Research Institute, Scarborough, Maine; and Vanderbilt University Medical Center, Nashville, Tennessee

Correspondence to Dr. Jonathan Himmelfarb, Division of Nephrology and Transplantation, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102. Phone: 207-871-2417; Fax: 207-871-6306; E-mail: himmej{at}mmc.org

ABSTRACT. Patients with acute renal failure (ARF) experience a high mortality rate. Dysregulated inflammation and altered metabolism may increase oxidative stress in ARF patients. Thirty-eight patients who met the Program to Improve Care in Acute Renal Disease (PICARD) Study inclusion criteria underwent plasma protein oxidation and plasma cytokine measurements. For comparison, similar measurements were also performed in 21 critically ill patients without ARF, 28 patients with ESRD, and 49 healthy subjects. Plasma protein thiol oxidation was measured by spectrophotometry. Plasma protein carbonyl content and cytokine concentrations were measured by ELISA. Plasma protein thiol oxidation and carbonyl content were markedly different in ARF patients compared with healthy subjects, ESRD patients, and critically ill patients (P < 0.001 in all cases). There were significant but less marked differences in plasma protein oxidation between ESRD patients and critically ill patients compared with healthy subjects. Plasma protein thiol oxidation in ARF patients improved with dialysis (P < 0.001); however, there was significant plasma oxidant reaccumulation during the interdialytic period (P < 0.001) not due to rebound equilibration of compartmentalized solutes. Plasma proinflammatory cytokine levels were significantly higher (P < 0.05) in ARF patients and critically ill patients than in healthy subjects. Plasma protein oxidation is markedly increased in ARF patients compared with healthy subjects, ESRD patients, and critically ill patients. Increased oxidative stress may be an important target for nutritional and pharmacologic therapy in ARF patients.

This article has been cited by other articles:

				S. S. Waikar, K. D. Liu, and G. M. Chertow Diagnosis, Epidemiology and Outcomes of Acute Kidney Injury Clin. J. Am. Soc. Nephrol., May 1, 2008; 3(3): 844 - 861. [Abstract] [Full Text] [PDF]

				R. L. Mehta Glycemic Control and Critical Illness: Is the Kidney Involved? J. Am. Soc. Nephrol., October 1, 2007; 18(10): 2623 - 2627. [Abstract] [Full Text] [PDF]

				T. D. Nolin, K. Appiah, S. A. Kendrick, P. Le, E. McMonagle, and J. Himmelfarb Hemodialysis Acutely Improves Hepatic CYP3A4 Metabolic Activity J. Am. Soc. Nephrol., September 1, 2006; 17(9): 2363 - 2367. [Abstract] [Full Text] [PDF]

				P. Devarajan Update on Mechanisms of Ischemic Acute Kidney Injury J. Am. Soc. Nephrol., June 1, 2006; 17(6): 1503 - 1520. [Full Text] [PDF]

				N. Nitescu, S.-E. Ricksten, N. Marcussen, B. Haraldsson, U. Nilsson, S. Basu, and G. Guron N-acetylcysteine attenuates kidney injury in rats subjected to renal ischaemia-reperfusion Nephrol. Dial. Transplant., May 1, 2006; 21(5): 1240 - 1247. [Abstract] [Full Text] [PDF]

				S. Basi, L. B. Pupim, E. M. Simmons, M. T. Sezer, Y. Shyr, S. Freedman, G. M. Chertow, R. L. Mehta, E. Paganini, J. Himmelfarb, et al. Insulin resistance in critically ill patients with acute renal failure Am J Physiol Renal Physiol, August 1, 2005; 289(2): F259 - F264. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673