Blood extracellular superoxide dismutase levels in hemodialysis patients pre- and post-hemodialysis and its association with lipoprotein lipase mass and free fatty acid

Background: Hemodialysis (HD) is a method of chronic therapy for patients with renal failure. Diabetic nephropathy is the most common underlying disease among HD patients in Japan. A characteristic problem associated with this condition is endothelial cell damage. We have been using extracellular superoxide dismutase (EC-SOD) attached to the heparan sulfate on the endothelial cell surface as a marker of vascular damage. Methods: This study examined the pre- and post-HD levels of lipoprotein lipase (LPL). The increase in free fatty acid (FFA) is affected by a type of cytokine-like substances, which induces insulin resistance and causes abnormal lipid metabolism. Results: Pre-HD blood samples showed highly significant correlations between EC-SOD and LPL mass (r = 0.792) and between EC-SOD and FFA (r = 0.675) (p < 0.0001). EC-SOD, LPL mass, and FFA were remarkably high among the patients who had been placed on HD treatment for over 20 years. Conclusion: Because EC-SOD and LPL mass represent heparin-binding proteins, these results were considered to reflect severe vascular damage. (C) 2002 Elsevier Science B.V. All rights reserved.