Elevated plasma F2-isoprostanes in patients on long-term hemodialysis

Kidney Int. 2001 May;59(5):1960-6. doi: 10.1046/j.1523-1755.2001.0590051960.x.


Background: End-stage renal disease (ESRD) patients on long-term hemodialysis (HD) may be under increased oxidative stress, caused by either HD or renal failure. Plasma F2-isoprostanes have been established as an important indicator of in vivo oxidative stress.

Methods: Plasma esterified F2-isoprostanes were measured in 25 HD patients and 23 controls with normal renal function, employing gas chromatography-mass spectrometry with negative chemical ionization (GC-MS-NCI). C-reactive protein (CRP) was determined concurrently in patients and controls by enzyme-linked immunosorbent assay (ELISA). alpha-Tocopherol, retinol, albumin and creatinine were also determined.

Results: The average total esterified F2-isoprostanes in the ESRD patients was 1.62 +/- 0.73 vs. 0.27 +/- 0.10 ng/mL in controls (P < 0.001), with no overlap between patients and controls. Plasma F2-isoprostanes in diabetic ESRD patients were similar to F2-isoprostanes in patients with other causes for renal failure. In a subset of 10 of these ESRD patients evaluated eight months after the initial measurement, plasma-esterified F2-isoprostanes were not altered by an individual dialysis session. Average plasma CRP values were also higher in HD patients (P < 0.02), but some patients had CRP values that were similar to controls. In the HD patients, total plasma F2-isoprostanes and plasma CRP were correlated (r = 0.48, P = 0.015). Plasma alpha-tocopherol did not differ between patients and controls, but plasma retinol was higher in patients (3.15 +/- 1.71 micromol/L) than in controls (1.97 +/- 0.51 micromol/L, P < 0.05).

Conclusions: These results are consistent with the hypothesis that oxidative stress in ESRD patients contributes to increased values of esterified plasma F2-isoprostanes, with concurrent increases in plasma CRP levels in some patients. Impaired clearance of esterified F2-isoprostanes may contribute to the elevated levels in renal failure. Plasma esterified F2-isoprostanes may be a useful indicator to evaluate effectiveness of interventions to decrease oxidative stress and associated inflammation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • C-Reactive Protein / metabolism
  • Case-Control Studies
  • Dinoprost / analogs & derivatives
  • Dinoprost / blood*
  • Dinoprost / chemistry
  • Esterification
  • F2-Isoprostanes
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Oxidative Stress
  • Renal Dialysis / adverse effects*
  • Vitamin A / blood
  • Vitamin E / blood


  • F2-Isoprostanes
  • Vitamin A
  • Vitamin E
  • C-Reactive Protein
  • Dinoprost