Metabolic, inflammatory and oxidative stress markers in the nitric oxide variation of hemodialysis subjects.

Introduction: Oxidative stress markers such as nitric oxide (NO) have been investigated in hemodialysis (HD).

Objective: Evaluate the association of NO variation with adiposity indicators, metabolic, inflammatory and oxidative stress markers in individuals to HD.

Methods: Cross-sectional study with 85 subjects on HD treatment (≥ 18 years). The clinical-nutritional status was evaluated through subjective global assessment modified (SGAm), anthropometric measurements and body composition. Dietary intake was evaluated using a food frequency questionnaire. Metabolic markers were obtained from medical records. Inflammatory markers (IL-6 and IL-10) and oxidative stress, (TACs), (SOD), (GST), (MDA) and NO were determined using standardized protocols.

Results: Those individuals with a high concentration of NO (> 4.32 μmol/L) had lower values for SGAm score (p = 0.012) and higher iron values (p = 0.050), Fe saturation (p = 0.037) and triacylglycerol (p = 0.003). The same subjects still had lower consumption of copper (p = 0.026), manganese (p = 0.035), vitamin E (p = 0.050), ω3 (p = 0.021) and ω6 (p = 0.020). In a multiple regression model, concentrations of ferritin, triacylglycerol, IL6 and SOD contributed to a 54.8% increase in NO concentrations, whereas triacylglycerol and SOD concentrations were independent factors for NO variation (p < 0.001). CONCLUSIONS: The clinical and nutritional status as well as intake of nutrients with antioxidant properties (Cu, Zn, Mn, vitamin C and ω3) appears to modulate the variation of NO in this population.