Serum Thiol/Disulfide Homeostasis in Hemodialysis, Peritoneal Dialysis, and Renal Transplantation Patients

OBJECTIVE: We aimed to evaluate thiol/disulfide homeostasis as an oxidative stress parameter in end-stage renal disease patients receiving different substitutive therapies.

MATERIAL and METHODS: Twenty-four renal transplantation (46.2±8.1 years), 24 peritoneal dialysis (47.8±8.5 years), and 25 hemodialysis patients (45.7±16.0 years), and 24 healthy controls (47.6±8.1 years) were included. Serum native thiol, total thiol, and disulfide levels were measured for all subjects.

RESULTS: Serum total thiol and native thiol levels in the ESRD patients were significantly lower than those in the controls (P<0.001). Native and total thiol levels were significantly lower in PD (256 ± 45 μmol/L, and 287 ± 57 μmol/L) compared to HD (324 ± 44 μmol/L and 356 ± 46 μmol/L) group (p<0.01 and p=0.03). Disulfide/native thiol and disulfide/total thiol levels increased significantly in the PD and transplantation patients compared to control group (P<0.001). Positive correlation was observed between total thiols (r= 0.491 P<0.001), disulfide/native thiol ratio (r=0.383, P<0.001), and blood urea nitrogen; disulfide levels and blood urea nitrogen showed a negative correlation (-0.415, P<0.001). Disulfide levels and glomerular filtration rate showed a positive correlation (r=0.276, P=0.030).

CONCLUSION: Serum thiol/disulfide homeostasis can be an indicator of oxidative stress in end-stage renal disease and that thiol/disulfide homeostasis analysis should be included in the routine monitoring of end-stage renal disease patients.