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Open Access Highly Accessed Research article

Paricalcitol reduces oxidative stress and inflammation in hemodialysis patients

María Jesús Izquierdo1*, Mónica Cavia25, Pilar Muñiz36, Angel LM de Francisco47, Manuel Arias47, Javier Santos18 and Pedro Abaigar18

Author Affiliations

1 Nephrology Service, Complejo Asistencial Universitario de Burgos, C/ Fuenteovejuna 138, Burgos, 09006, Spain

2 Research Unit. Complejo Asistencial Universitario de Burgos, Burgos, Spain

3 Área de Bioquímica y Biología molecular de la Universidad de Burgos, Burgos, Spain

4 Nephrology Service. Hospital Universitario Marques de Valdecilla, Santander, Spain

5 Unidad de Investigación. Hospital Universitario de Burgos, Burgos. Islas Baleares S/N, 09006, Burgos, Spain

6 Área de Bioquímica y Biología Molecular, Facultad de Ciencias. Universidad de Burgos, Plaza Misael Bañuelos s/n, Burgos, Spain

7 Servicio Nefrología. Hospital Universitario Marqués de Valdecilla, Avda. de Valdecilla, s/n, 39008, Santander, Cantabria, Spain

8 Servicio de Nefrología, Hospital Universitario de Burgos, Islas Baleares S/N, 09006, Burgos, Spain

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BMC Nephrology 2012, 13:159  doi:10.1186/1471-2369-13-159

Published: 27 November 2012

Abstract

Background

Treatment with selective vitamin D receptor activators such as paricalcitol have been shown to exert an anti-inflammatory effect in patients on hemodialysis, in addition to their action on mineral metabolism and independently of parathyroid hormone (PTH) levels. The objective of this study was to evaluate the additional antioxidant capacity of paricalcitol in a clinical setting.

Methods

The study included 19 patients with renal disease on hemodialysis, of whom peripheral blood was obtained for analysis at baseline and three months after starting intravenous paricalcitol treatment. The following oxidizing and inflammatory markers were quantified: malondialdehyde (MDA), nitrites and carbonyl groups, indoleamine 2,3-dioxygenase (IDO), tumor necrosis factor alfa (TNF-α), interleukin-6 (IL-6), interleukin-18 (IL-18) and C-reactive protein (CRP). Of the antioxidants and anti-inflammatory markers, superoxide dismutase (SOD), catalase, reduced glutathione (GSH), thioredoxin, and interleukin-10 (IL-10) levels were obtained.

Results

Baseline levels of oxidation markers MDA, nitric oxide and protein carbonyl groups significantly decreased after three months on paricalcitol treatment, while levels of GSH, thioredoxin, catalase and SOD activity significantly increased. After paricalcitol treatment, levels of the inflammatory markers CRP, TNF-α, IL-6 and IL-18 were significantly reduced in serum and the level of anti-inflammatory cytokine IL-10 was increased.

Conclusions

In renal patients undergoing hemodialysis, paricalcitol treatment significantly reduces oxidative stress and inflammation, two well known factors leading to cardiovascular damage.

Keywords:
Oxidative Stress; Immunomodulation; Receptors, Calcitriol; Paricalcitol; 19-nor-1alpha,25-dihydroxyvitamin D2