Journal de néphrologie et thérapeutique

Acute Renal Failure and Thiol-Disulfide Homeostasis

Abstract

Yavuz Otal, Serkan Demircan, Alp Şener, Murat Alışık, Fatih Tanrıverdi, F Güllü Ercan Haydar, Ayhan Özhasenekler and Özcan Erel

Aims: Investigating the thiol-disulphide balance in the patients with acute renal failure and evaluating the potential of using tGFR (thiol based GFR) index as a new parameter, alternative to the parameter called estimated Glomerular Filtration Rate (eGFR).
Study design: The serum thiol-disulphide levels in the predialysis and postdialysis blood samples of 42 patients diagnosed with acute renal failure in the emergency department and hemodialyzed right after were measured through the novel method. Methods: The acute renal failure was detected through the clinical and laboratory findings, and a hemodialysis procedure was performed. The obtained results were statistically evaluated. While eGFR (ml/min/1.73 m2) values were being calculated, MDRD (Modification of Diet in Renal Disease) formula was used. To calculate tGFR as an alternative to eGFR, tGFR=(SH/creatinine) xk formula was used.
Results: Disulphides/native thiol and Disulphides/total thiol rates in the patient population were found to be significantly lower after the hemodialysis when compared with those before the hemodialysis process (p<0.001). A significantly negative relationship was found between the creatinine values and the native and total thiol values (r=-0.732; r=-0.739; p<0.001 respectively). There was also a significantly negative relationship between the urea values and the native and total thiol values (r=-0.722; r=-0.739; p<0.001 respectively). Quite a significant relationship was also found between eGFR values and tGFR values (r=0.98; p<0.001).
Conclusion: The thiol-disulphide balance in the patients with acute renal failure weakened, in addition to which the balance in question shifted towards the direction of disulphide. Native thiol and total thiol levels are associated with the severity of the disease. There is the potential of using tGFR index as an alternative to eGFR for the emergency department patients (ER-patients) whose age, gender and race cannot be identified.