Impact of a Single Hemodialysis Session on Oxidative Stress-Inducing and Oxidative Damage Biomarkers in End-Stage Kidney Disease Patients

Oxidative stress (OS) is elevated in patients with end-stage kidney disease undergoing maintenance dialysis and contributes to increased cardiovascular risk. While kidney dysfunction and dialysis can generate OS, the acute effects of a single dialysis session remain unclear due to variability in study design and biomarkers used. In this observational study, blood samples from 68 hemodialysis patients were collected before and after a single session. Plasma levels of the reactive oxygen species marker superoxide (O2•⁻) and OS-damage markers lipid hydroperoxides (LOOH), protein-bound malondialdehyde (PrMDA), protein-bound thiobarbituric acid reactive substances (PrTBARS), and protein carbonyls (PrCO) were measured. LOOH increased significantly by 50% post-dialysis, whereas PrMDA and PrTBARS decreased modestly by ~10%. No significant changes were observed in O2•⁻ or PrCO. Dialysis vintage correlated positively with LOOH, PrMDA, and PrTBARS, but not with O2•⁻ or PrCO. Patients undergoing low-flux hemodialysis exhibited a greater post-dialysis increase in LOOH than those treated with high-flux hemodialysis. No significant associations were found between OS markers and comorbidities or medication. The post-dialysis rise in LOOH, an early-formed and least accumulating lipid peroxidation marker, highlights its sensitivity to acute dialysis-related oxidative changes. The rising tendency of PrMDA and PrTBARS with dialysis vintage suggests cumulative OS over time.