Malondialdehyde as a Biomarker for Oxidative Stress in Dialysis Patients: A Predictor of Complications and Treatment Efficacy
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Abstract
Background: Oxidative stress plays a crucial role in the complications associated with chronic kidney disease (CKD), particularly in individuals undergoing dialysis. Malondialdehyde (MDA), a key marker of lipid peroxidation, serves as an indicator of oxidative stress and has been associated with heightened cardiovascular risk, inflammation, and other adverse outcomes in dialysis patients. Objective: This study aimed to assess MDA’s role as a biomarker of oxidative stress in dialysis patients and its potential for predicting complications and evaluating treatment effectiveness. Methods: A cross-sectional study was conducted at Srinivas Institute of Medical Sciences and Research Centre, Mangalore, between December 2021 and September 2022. The study included 50 dialysis patients (subdivided into hemodialysis and peritoneal dialysis groups) and 30 healthy controls matched for age and sex. Plasma MDA levels were measured using the Thiobarbituric Acid Reactive Substances (TBARS) assay. Additional biochemical markers related to oxidative stress, inflammation, and renal function were also analyzed. Results: Dialysis patients exhibited significantly higher MDA levels (3.82 ± 0.73 nmol/L) compared to controls (2.07 ± 0.47 nmol/L, p < 0.0001), alongside reduced antioxidant enzyme activity. Elevated CRP levels indicated persistent inflammation. Renal function markers and lipid profile changes also suggested disease-related metabolic disturbances. MDA correlated positively with CRP (r = 0.68, p < 0.001) and negatively with antioxidant enzyme activity. Conclusion: These findings confirm that dialysis patients experience significant oxidative stress and inflammation, with MDA serving as a reliable biomarker. MDA may aid in monitoring oxidative stress levels, predicting complications, and guiding antioxidant therapies.
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Copyright (c) 2025 Dr. Jayesh Prabhakar Warade MD
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[1] Fonseca, I. (2016). Malondialdehyde as a Biomarker in Kidney Transplantation. In: Patel, V., Preedy, V. (eds) Biomarkers in Kidney Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7699-9_38
[2] Fonseca I, Reguengo H, Almeida M, Dias L, Martins LS, Pedroso S, Santos J, Lobato L, Henriques AC, Mendonça D. Oxidative stress in kidney transplantation: malondialdehyde is an early predictive marker of graft dysfunction. Transplantation. 2014 May 27;97(10):1058-65. doi: 10.1097/01.TP.0000438626.91095.50. PMID: 24406454.
[3] Bergin, P., Leggett, A., Cardwell, C.R. et al. The effects of vitamin E supplementation on malondialdehyde as a biomarker of oxidative stress in haemodialysis patients: a systematic review and meta-analysis. BMC Nephrol 22, 126 (2021). https://doi.org/10.1186/s12882-021-02328-8
[4] https://www.socscistatistics.com/tests/mannwhitney/ Accessed on Feb 2025.
[5] Maria J. Puchades, Guillermo Saez, M. Carmen Muñoz, Miguel Gonzalez, Isidro Torregrosa, Isabel Juan and Alfonso Miguel.Study of oxidative stress in patients with advanced renal disease and undergoing either hemodialysis or peritoneal dialysis. 2013; 80: 177-186. doi: 10.5414/CN107639.
[6] Vida C, Oliva C, Yuste C, Ceprián N, Caro PJ, Valera G, González de Pablos I, Morales E, Carracedo J. Oxidative Stress in Patients with Advanced CKD and Renal Replacement Therapy: The Key Role of Peripheral Blood Leukocytes. Antioxidants (Basel). 2021 Jul 20;10(7):1155. doi: 10.3390/antiox10071155. PMID: 34356387; PMCID: PMC8301096.
[7] Liakopoulos V, Roumeliotis S, Gorny X, Eleftheriadis T, Mertens PR. Oxidative Stress in Patients Undergoing Peritoneal Dialysis: A Current Review of the Literature. Oxid Med Cell Longev. 2017 Dec 27; 2017:3494867. doi: 10.1155/2017/3494867. PMID: 29750088; PMCID: PMC5892210.
[8] Rapa SF, Di Iorio BR, Campiglia P, Heidland A, Marzocco S. Inflammation and Oxidative Stress in Chronic Kidney Disease-Potential Therapeutic Role of Minerals, Vitamins and Plant-Derived Metabolites. Int J Mol Sci. 2019 Dec 30;21(1):263. doi: 10.3390/ijms21010263. PMID: 31906008; PMCID: PMC6981831.
[9] Mihai S, Codrici E, Popescu ID, Enciu AM, Albulescu L, Necula LG, Mambet C, Anton G, Tanase C. Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome. J Immunol Res. 2018 Sep 6; 2018:2180373. doi: 10.1155/2018/2180373. PMID: 30271792; PMCID: PMC6146775.
[10] Cobo G, Lindholm B, Stenvinkel P. Chronic inflammation in end-stage renal disease and dialysis. Nephrol Dial Transplant. 2018 Oct 1;33(suppl_3): iii35-iii40. doi: 10.1093/ndt/gfy175. PMID: 30281126; PMCID: PMC6168801.
[11] Swedko PJ, Clark HD, Paramsothy K, Akbari A. Serum creatinine is an inadequate screening test for renal failure in elderly patients. Arch Intern Med. 2003 Feb 10;163(3):356-60. doi: 10.1001/archinte.163.3.356. PMID: 12578517.
[12] Vaziri ND. Dyslipidemia of chronic renal failure: the nature, mechanisms, and potential consequences. Am J Physiol Renal Physiol. 2006 Feb;290(2): F262-72. doi: 10.1152/ajprenal.00099.2005. PMID: 16403839.