Impact of a Single Hemodialysis Session on Oxidative Stress-Inducing and Oxidative Damage Biomarkers in End-Stage Kidney Disease Patients

Oxidative stress (OS) is elevated in patients with end-stage kidney disease undergoing maintenance dialysis and contributes to increased cardiovascular risk. While kidney dysfunction and dialysis can generate OS, the acute effects of a single dialysis session remain unclear due to variability in study design and the biomarkers used. In this observational study, blood samples from 68 hemodialysis patients were collected before and after a single session. Plasma levels of the reactive oxygen species marker superoxide (O2•−) and OS-damage marker lipid hydroperoxides (LOOHs), protein-bound malondialdehyde (PrMDA), protein-bound thiobarbituric acid reactive substances (PrTBARSs), and protein carbonyls (PrCOs) were measured. LOOHs increased significantly by 50% post-dialysis, whereas PrMDA and PrTBARSs decreased modestly by ~10%. No significant changes were observed in O2•− or PrCOs. Dialysis vintage correlated positively with LOOHs, PrMDA, and PrTBARSs, but not with O2•− or PrCOs. No significant associations were found between OS markers and comorbidities, medication or sex. The post-dialysis rise in LOOHs, an early-formed and least accumulating lipid peroxidation marker, may reflect acute changes in OS during a single HD session. The rising association of PrMDA and PrTBARSs with dialysis vintage may suggest cumulative OS over time.