DO VITAMIN D DEFICIENCY AND HEPATITIS C VIRUS INFECTION PLAY A ROLE IN OXIDATIVE STRESS IN PATIENTS ON MAINTENANCE HEMODIALYSIS?

Background Elevated oxidant levels and low antioxidant levels in patients with end-stage renal disease (ESRD) play a significant role in the development of endothelial dysfunction, atherogenesis and cardiovascular disease (CVD). A deficiency in vitamin D (Vit.D) is also suggested to be responsible for the generation of oxidative stress (OS) and CVD. Among dialysis patients, conflicting data exist concerning the relationship between hepatitis C virus (HCV) infection and OS. We studied the relationship between 25Vit.D level, HCV infection, and plasma 8 iso-prostaglandin F2 alpha (8-ISO-PGF2 alpha) as an OS marker in an Egyptian hemodialysis (HD) cohort. Methods One hundred and twenty ESRD patients on HD were initially recruited to the study but only 88 patients have met the inclusion and none of the exclusion criteria. Midweek predialysis session blood samples were collected for the measurement of 25(OH) Vit.D, plasma 8-ISO-PGF2 alpha, high sensitivity C - reactive protein (hs-CRP), and intact parathyroid hormone (intact PTH). Patients were stratified into two groups according to the presence or absence of serum antibodies against HCV and their plasma 8-ISO-PGF2 alpha were compared. Results Vit.D deficiency was noted in 93% of the participants; the median 8-ISO-PGF2 alpha level was 382 pg/mL. No significant correlation between Vit.D and 8-ISO-PGF2 alpha levels was found. Thirty-two participants (36%) were HCV+ and their 8-ISO-PGF2 alpha levels were significantly lower relative to in the seronegative group (median 171 vs. 647 pg/mL; P < 0.006). Conclusion In this Egyptian HD cohort, Vit D deficiency was highly prevalent, yet failed to show any correlation with F2-isoprostanes. HCV+ HD patients might be shielded from OS.