Introduction. Chronic Renal Failure (CRF) patients are considered to show genomic instability and are associated with a high risk of both cardiovascular diseases and cancer. We explored DNA damage due to two dialysis treatments in 20 patients undergoing bicarbonate haemodialysis, 20 undergoing haemodiafiltration and 40 healthy subjects.
Methods. The cytokinesis-block micronucleus (MN) assay was performed on peripheral blood lymphocytes to evaluate genetic damage.
Results. A higher frequency of MN in the dialysis groups compared with controls was found. The results do not show a relationship between genetic instability and the type, frequency and duration of haemodialysis. The average BD and HDF treatment time was respectively 3.8Â±6.3 and 3.7Â±3.9 yrs. CAT and scintigraphy was independently correlated with high levels of MN.
Discussion. Overall, the frequency of MN in CRF patients undergoing dialysis therapy was observed to be higher. Further studies need to be performed on a larger number of patients and for a longer period.
Anderson S. Mechanisms of injury in progressive renal disease. Exp Nephrol 1996;4 (Suppl 1):34-40.
Weiner DE. Causes and consequences of chronic kidney disease: implications for managed health care. J Manag Care Pharm 2007;13(3 Suppl):S1-S9.
Sarnak MJ: Cardiovascular complications in chronic kidney disease. Am J Kidney Dis 2003;41(5 Suppl):11-7.
Di Angelantonio E, Chowdhury R, Sarwar N, Aspelund, T, Danesh J, Gudnason V. Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: Prospective population based cohort study. BMJ 2010;341:c4986.
Stengel B. Chronic kidney disease and cancer. A troubling connection. J Nephrol 2010;23:253-62.
Fragedaki E, Nebel M, Schupp N, et al. Genomic damage and circulating AGE levels in patients undergoing daily versus standard haemodialysis. Nephrol Dial Transplant 2005;20:1936-43.
Sandoval SB, Stoyanova E, Coll E, et al. Glomerular filtration rate index is associated with genetic damage in chronic renal failure patients. Mutagenesis 2010;25:603-8.
Stopper H, Meysen T, BÃ¶ckenfÃ¶rde A, Bahner U, Heidland A, Vamvakas S. Increased genomic damage in lymphocytes patients before and after long-term maintenance hemodialysis therapy. Am J Kidney Dis 1999;34:433-7.
Galle J. Oxidative stress in chronic renal failure. Nephrol Dial Transplant 2001;16:2135-7.
Vaziri ND. Oxidative stress in uremia: nature, mechanisms, and potential consequences. Semin Nephrol 2004;24:469-73.
Palleschi S, De Angelis S, Diana L, et al. Reliability of oxidative stress biomarkers in hemodialysis patients: a comparative study. Clin Chem Lab Med 2007;45:1211-8.
Stoyanova E, Sandoval SB, ZÃºÃ±iga LA, et al. Oxidative DNA damage in chronic renal failure patients. Nephrol Dial Transplant 2010;25:879-85.
Levy J, Brown E, Daley C, Lawrence A. Oxford Handbook of Dialysis, 3rd eds. Oxford: Oxford University Press 2009.
John S, Eckardt KU. Renal Replacement Strategies in the ICU. Chest 2007;132(4):1379-88.
Leber HW, Wizemann V, Goubeaud G, Rawer P, SchÃ¼tterle G. Hemodiafiltration: a new alternative to hemofiltration and conventional hemodialysis. Artif Organs 1978;2(2):150-3.
McDonald BR, Mehta RL. Transmembrane flux of IL-1B and TNF in patients undergoing continuous arteriovenous hemodialysis (CAVHD). J Am Soc Nephrol 1990;1:368.
Lameire N, Van Biesen W, Vanholder R, Colardijn F. The place of intermittent hemodialysis in the treatment of acute renal failure in the ICU patient. Kidney Int 1998;53:S110-9.
Stopper H, Boullay F, Heidland A, Vienken J, Bahnerm U. Comet assay analysis identifies genomic damage in lymphocytes of uremic patients. Am J Kidney Dis 2001;38:296-301.
Buemi M, Floccari F, Costa C, et al. Dialysis-related genotoxicity: sister chromatid exchanges and DNA lesions in T and B lymphocytes of uremic patients. Genomic damage in patients on hemodiafiltration. Blood Purif 2006;24(5-6):569-74.
Vamvakas S, Bahner U, Becker P, Steinle A, GÃ¶tz R, Heidland A. Impairment of DNA repair in the course of long-term hemodialysis and under cyclosporine immunosuppression after renal transplantation. Transplant Proc 1996;8(6):3468-73.
Bonassi S, Znaor A, Ceppi M, et al. An increased micronucleus frequency in peripheral blood lymphocytes predicts the risk of cancer in humans. Carcinogenesis 2007;28:625-631.
Roth JM, Restani RG, Goncalves TT, et al. Genotoxicity evaluation in chronic renal patients undergoing hemodialysis and peritoneal dialysis, using the micronucleus test. Genet Mol Res 2008;7:433-443.
Natarajan AT, Obe G. Screening of human populations for mutations induced by environmental pollutants: use of human lymphocyte system. Ecotoxicol Environ Saf 1980;4(4):468-81.
Carrano AV, Natarajan AT. International Commission for Protection Against Environmental Mutagens and Carcinogens. ICPEMC publication n. 14. Considerations for population monitoring using cytogenetic techniques. Mutat Res 1988;204(3):379-406.
Bonassi S, Fenech M, Lando C, Lin YP, Ceppi M, Chang WP. Human MicroNucleus project: International database comparison for results with the cytokinesis-block micronucleus assay in human lymphocytes: I. Effect of laboratory protocol, scoring criteria, and host factors on the frequency of micronuclei. Environ Mol Mutagen 2001;37:31-45.
Fenech M. Cytokinesis-block micronucleus cytome assay. Nat Protoc 2007;2(5):1084-104.
Eastmond DA, Tucker JD. Identification of aneuploidyâinducing agents using cytokinesisâblocked human lymphocytes and an antikinetochore antibody. Environ Mol Mutagen 1989;13:34-43.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004;351(13):1296-305.
Durak I, KaÃ§maz M, ElgÃ¼n S, OztÃ¼rk HS. Oxidative stress in patients with chronic renal failure: effects of hemodialysis. Med Princ Pract 2004;13(2):84-7.
Rangel-LÃ³pez A, Paniagua-Medina ME, UrbÃ¡n-Reyes M, et al. Genetic damage in patients with chronic kidney disease, peritoneal dialysis and haemodialysis: a comparative study. Mutagenesis 2013;28(2):219-25.
Kobras K, Schupp N, Nehrlich K, et al. Relation between different treatment modalities and genomic damage of end-stage renal failure patients. Kidney Blood Press Res 2006;29:10-7.
Himmelfarb J. Uremic toxicity, oxidative stress, and hemodialysis as renal replacement therapy. Semin Dial 2009;22:636-43.
Schupp N, Heidland A, Stopper H. Genomic damage in end-stage renal disease-contribution of uremic toxins. Toxins 2010;2:2340-58.
Bagatini PB, Palazzo RP, Rodrigues MT, Costa CH, Maluf SW. Induction and removal of DNA damage in blood leukocytes of patients with type 2 diabetes mellitus undergoing hemodialysis. Mutat Res 2008;657(2): 111-5.
MÃ¼ller C, Eisenbrand G, Gradinger M, et al. Effects of hemodialysis, dialyser type and iron infusion on oxidative stress in uremic patients. Free Radic Res 2004;38(10):1093-100.
Mekki K, Taleb W, Bouzidi N, Kaddous A, Bouchenak M. Effect of hemodialysis and peritoneal dialysis on redox status in chronic renal failure patients: a comparative study. Lipids Health Dis 2010;9:93.
Botto N, Rizza A, Colombo MG, et al. Evidence for DNA damage in patients with coronary artery disease. Mutat Res 2001;493(1-2):23-30.
Schupp N, Stopper H, Rutkowski P, et al. Effect of different hemodialysis regimens on genomic damage in end-stage renal failure. Semin Nephrol 2006;26(1):28-32.
Kan E, Undeğer U, Bali M, Başaran N. Assessment of DNA strand breakage by the alkaline COMET assay in dialysis patients and the role of Vitamin E supplementation. Mutat Res 2002;520(1-2):151-9.