Zograbian R. O.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Chronic dysfunction is the leading cause of renal allograft loss and still presents a serious challenge for modern transplantology. To elucidate the role of peroxidation in the pathogenesis of this complication a comparative analysis of peroxidation indicators in 15 recipients with chronic renal allograft dysfunction (CRAD) and 10 recipients with stable allograft function was done. In patients with established CRAD activation of lipid peroxidation and decreased activity of antioxidant system were identified. These changes can lead to the accumulation of toxic secondary products of lipid peroxidation and cell damage. In patients without CRAD the state of these biochemical systems did not differ from the norm. These findings suggest the increased activity of peroxidation process to play an important role in the mechanism of CRAD development, and justifies application of antioxidants for slowing its progression. Purpose of the research. To study the state of free- radical oxidation processes and antioxidant (AO) system in recipients with Chronic Renal Allograft Dysfunction (CRAD), and to determine their role in CRAD pathogenesis. Object and methods of research. With the purpose of study the significance of lipid peroxidation (LPO) and AO processes in the mechanisms of CRAD development and progression, the intensity of these processes has been analyzed in 15 patients with CRAD, developed in 12-48 months after allotransplantation. The comparison group was constituted from 10 recipients with stably normal function of renal allograft during the follow-up period after transplantation as compared to similar one in the experimental group. 22 healthy donors have been involved into the control group. All patients underwent clinic-laboratory examination: evaluation of patients’ complaints, clinical common blood analysis and clinical common urine analysis, concentration of creatinine and urea in blood serum, glomerular filtration rate, arterial pressure level, diurnal dieresis. The activity of LPO processes has been estimated on the concentration of end product – malonic dialdehyde (MDA) in blood serum and erythrocytes. The state of AO system has been judged by the activity of the main enzymes of antiradical and antioxidant protection: superoxide dismutase (SOD), catalase (CT), general peroxidase activity (GPA) of erythrocytes. The RAG function has been estimated at the blood creatinine and glomerular filtration rate. The findings show that activation of free- radical oxidation processes may be crucial in the CRAD development. Reported experimental and clinical studied indicate in favor of prospective implementation of antioxidant therapy in cardio- and renoprotector aspect. However, there is no the reported conclusive clinical evidence as for their effectiveness in CRAD therapy. All this allow assuming the appropriateness of prescription antioxidant drugs to slow down the rates of progression of this complication. Conclusions. Increase of intensity of lipid peroxidation against the background of decrease of activity of free- radical oxidation processes is observed in the recipients with Chronic Renal Allograft Dysfunction. The increase of free- radical oxidation processes may be crucial in the mechanism of the development and progression of Chronic Renal Allograft Dysfunction. Positive effect of antioxidants on the clinical course of kidney disease, chronic renal failure, proved by the previous investigations, allows supposing the appropriateness of prescription antioxidant drugs to slow down the rates of progression of Chronic Renal Allograft Dysfunction.

chronic renal allograft dysfunction, lipid peroxidation, antioxidant system, antioxidants

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«Bulletin of problems biology and medicine» Issue 1 (106), 2014 year, 107-110 pages, index UDK 616. 61-002. 2-089-033. 3