The aim of the research was to determine the changes of lipid peroxidation processes in blood plasma, the state of antioxidant system and interrelations between the content of L-arginine, nitric oxide and arginase activity in patients with chronic renal insufficiency before and after dialysis.

18 patients with renal insufficiency of 5th stage (glomerulonephritis), receiving treatment of substitutive renal therapy by the method of hemodialysis were examined clinically and biochemically. Among them were 6 males, 10 females, and the average age of patients made 56 years. The comparative group included 20 donors; the average age was 48 years. Before and after hemodialysis the content of thiobarbituric acid products (TBA-active products), superoxide dismutase activity (SOD) and concentration of antioxidant vitamin C (total and oxidized form), content of L-arginine, nitric oxide, arginase activity and creatinine and urea concentration were measured. Statistical analysis of the experimental data was performed with the use of the program ANOVA “Statistika”.

In patients with chronic renal insufficiency the concentration of creatinine and urea increased 7.7-fold and 9.6-fold (р<0,01) respectively. After hemodialysis the creatinine concentration in blood plasma decreased by 41% (р<0,05), urea – by 42% (р<0,05). In patients with chronic renal insufficiency L-arginine concentration decreased by 28% (р<0,05), the tendency to decrease of nitrite anion content was noted and arginase activity in blood plasma increased. After hemodialysis L-arginine concentration decreased by 29% (р<0,05), nitrite anion content and arginase activity had tendency to decrease compared to the relevant indices before dialysis.

In plasma of patients with chronic renal insufficiency the increase of TBA-active products content by 34% (р<0,05) was noted. Simultaneously the decrease of vitamin C concentration was observed, the total form – by 41% (р>0,05), oxidized form – by 22%. After hemodialysis the TBA-active products content decreased by 16% (р<0,05). Vitamin C concentration also decreased, total form by 23%, oxidized form – by 22% compared to indices before dialysis.

Thus, acute decrease of vitamin C and L-arginine concentration on the background of glycemia and increase of oxidative processes in patients with chronic renal insufficiency, who receive supportive therapy with hemodialysis, shows the necessity of regular supplementation of vitamin C and L-arginine.

Conclusions. In blood plasma of patients with chronic renal insufficiency on the background of the significant rise of creatinine and urea concentration (7.7-fold and 9.6-fold relevantly) the increase of TBA-active products content and arginase activity are noted, whereas L-arginine and vitamin C content decreased. After hemodialysis, in blood plasma creatinine concentration decreased by 41% (р<0,05) and urea by 42% (р<0,05) compared to indices before hemodialysis, that was accompanied by the decrease of L-arginine and vitamin C concentration and tendency to decrease of TBA-active products, nitrite anion, arginase activity.

Ключові слова: hemodialysis, chronic renal insufficiency, oxidative stress, L-arginine, vitamin C, arginase

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