The role of oxidative stress in the development of protein-energy wasting and sarcopenia in patients with stage 5D chronic kidney disease

Objective. To study the features of oxidative stress, as well as to assess its contribution to the formation of protein-energy wasting and sarcopenia in patients with stage 5D CKD. Material and methods. The study included 40 patients with stage 5D CKD (mean age 58.8±13.2 years). Statistical analysis was performed using Statistica 10.0 software. Results: The prevalence of PEW in the group was 82.5%. At the same time, PEW was less common in men (80.9% of cases): 1st stage - 50%, 2nd stage - 27.3%, 3rd stage - 13.6%. In the cohort of women, this indicator was 84.4%: 1st stage - 44.4%, 2nd stage - 38.9%, 3rd stage - 11.1%. The SARC-F score for the likelihood of sarcopenia averaged 2.9±0.4 points (men 3±0.6, women 2.6±0.4), with 4 or more points, which constitute a criterion for a high probability of sarcopenia, recruited 36.4% of men and 33.4% of women. The average SOD level in the blood of the patients of the study group was 24.1±6.1 (14.8-56.7) ng/ ml, ADMA - 46.5±8.8 (25.8-64.8) ng/ml, MDA - 6.0±8.3 (1.8-11.2) nmol/ml. The presence of a relationship between the studied parameters was shown (correlation between SOD and ADMA - 0.26 (p=0.018), between MDA and SOD - 0.27 (p=0.02), between MDA and ADMA 0.46 (p=0.001). A statistically significant relationship was obtained between the test characterizing muscle performance and changes in the severity of oxidative stress. Thus, the number of meters traveled by the patients in the 6-minute walk test and the speed with which they covered this distance decreased, accompanied by an increase in the level of MDA in the blood. The increase in the severity of PEW was accompanied by a statistically significant increase in the level of MDA, and, accordingly, the activity of oxidative stress.

malondialdehyde, superoxide dismutase, asymmetric dimethylarginine, oxidative stress, chronic kidney disease