Xanthine Oxidoreductase Activity in Plateletpoor And Rich Plasma As A Oxidative Stress Indicator in Patients Required Renal Replacement Therapy Ⅱ

Results

The activity of xanthine oxidoreductase in poor and platelet‑rich plasma 

Signifcant diferences were found in XOR activity in platelet-poor plasma and in platelets within the groups studied (Fig. 1A, B): the highest mean activity of oxidoreductase was seen in the control group (also in PPP and in PRP), lower before hemodialysis (HD A), and the weakest after kidney transplantation (TE A) (PPP) and in patients treated conservatively (PRP).

HOW LONG DOES IT TAKE FOR CISTANCHE TO WORK FOR KIDNEY DISEASE?

Diferences in the activity of the XD isoform in the PPP between studied groups were also observed (Table  3). The lowest XD activity was observed in the group of kidney transplant patients, and the highest in the control group (Fig. 2A).

There was a statistically signifcant correlation between the measured XDO activities in the platelet-poor plasma in the groups (Table  3). The lowest activity of the intermediate isoform was demonstrated in patients after renal transplantation (TE A), and the highest in the group of patients treated conservatively (CT) (Fig. 2B).

The relationship between the activity of the XO oxidase isoform oxidase (XO) between the groups in platelet-poor plasma (PPP) (Table 3) approached significance: the lowest XO activity was observed in the group of patients after kidney transplantation and the highest before hemodialysis (Fig. 2C). Other relationships between particular groups are shown in Table 4.

Fig. 1 A, B. The xanthine oxidoreductase isoforms activity: A in platelet-rich plasma. B in platelet-poor plasma. C- control group CKD - treated conservatively; HD B - before hemodialysis; HD A - after hemodialysis; PD - peritoneal dialysis; TE B- before kidney transplantation: TE A - after kidney transplantation

A statistically signifcant difference was found between the activities of XD, XDO, and XO isoforms in the platelet-poor plasma between the examined groups (Fig. 2A, B, C). There was a statistically signifcant difference in the activity of the XD dehydrogenase isoform in the platelet-rich plasma between groups (Table  5): the lowest XD activity was found in patients treated conservatively, and the highest in patients prior to hemodialysis (Fig. 3A). 

Tere was a statistically signifcant difference in the activity of the oxidase isoform (XO) in platelet-rich plasma between the study groups (Table  5): the lowest XO activity was found in patients treated conservatively, and the highest in patients before renal transplantation (Fig. 3C; Table 5). Other relationships between the activity of all XOR isoforms and the type of renal replacement therapy are included in Table 6. Additionally, a statistically significant difference was found between the activities of XD, XDO, and XO isoforms in the platelet-rich plasma between the test groups (Table 6).

Table 3 Activity of XOR isoforms in the platelet-poor plasma, in patients treated conservatively (CKD), hemodialysis patients (before and after - HD B, HD A), peritoneal dialysis (PD), conservative treatment (CKD), before and after kidney transplantation (TE B, TE A) and in the control group (C) (mean±SD, median – lower and upper quartile)

Tere was also a negative correlation between the activity of XD and XO in PPP and the concentration of uric acid. And also a positive correlation between the activity of a) XD in PPP and XO in PPP, b) XO in PPP, and XD in PRP. A negative correlation was demonstrated between XD activity in PPP and XO activity in PRP. These correlations confirm the physiological importance of oxidoreductase (Table 7). There was no correlation between diabetes, BMI, and XOR activity. Dyslipidemia statistically significantly influences the activity of XD in PPP (p =0,038) and XO in PRP (p =0,001). The activity of these enzymes was higher in people with dyslipidemia. However, this proves the compensation of oxidative stress and, in our opinion, confirms that dyslipidemia did not have a significant effect on XOR activity

The activity of xanthine oxidoreductase isoforms according to gender, duration of dialysis, patient age, cause, and severity of CKD

There was no statistically signifcant difference in XOR isoform activity between women and men except for the XDO isoform in platelets (Table 8): in men, the activity of this isoform was significantly higher than in women.

A relationship was observed between the activity of all oxidoreductase isoforms in PPP and PRP plasma, the type of renal replacement therapy, and the duration of dialysis. There were also statistically signifcant differences between the activity of all tested parameters, the type of renal replacement therapy, and the age of patients (Table  8). The cause of chronic kidney disease was also reflected in diferences in XD and XO activity in PPP.

There was also a correlation between the activity of XD and XDO isoforms in PPP and the stage of chronic kidney disease (Table 8): XD activity was lowest in Stage 3 disease, and highest in Stage 1 disease. The activity of the XDO isoform varied differently: lowest in Stage 3 and highest in Stage 4.