血液透析用從透析液供應抗氧化劑與鐵劑之調配與選擇

對於末期腎臟疾病(End-Stage Renal Disease)目前最常採用的治療方法為血液透析，利用擴散作用及超過濾作用來移除血中代謝廢物及多餘水分。在血液透析治療時，患者常會因為血液接觸到生物不相容性的透析器及透析管路導致體內氧化壓力升高，產生氧化傷害；以及因為腎臟疾病導致腎性貧血，這些對腎臟病人的健康造成很大的危害。為了改善病人氧化壓力升高及貧血，本研究探討在透析期間，從透析液補充抗氧化劑及鐵劑，使其持續且穩定地進入人體，研究中比較兩種抗氧化劑:EGCG及維他命C何種較適合做為此透析液的抗氧化添加物。實驗設計包括鐵螯合能力試驗、穩定度試驗、總抗氧化能力試驗、溶質累積總量理論計算，最後用豬血漿以燒杯模擬血液透析情況，檢測其總抗氧化能力(FRAP) 、血清鐵含量及總鐵結合能力(TIBC)。結果發現以豬血漿進行燒杯模擬透析，使用EGCG與鐵質透析液或維他命C與鐵質透析液皆能達到提升鐵含量的效果，且EGCG的鐵螯合能力較高，能穩定鐵質不被游離；EGCG及維他命C皆可以穩定的發揮抗氧化能力，其中EGCG之抗氧化能力大於維他命C。另外EGCG可以提升血中總鐵結合能力，提供更多鐵結合位置，與EGCG結合的鐵質可以在EGCG被人體代謝之後數小時持續釋放。因此在血液透析治療時，使用EGCG調配含抗氧化劑及鐵劑透析液，可以有效的降低氧化壓力，改善貧血情況，提升血液透析病人的透析品質。

關鍵字

抗氧化能力；血液透析；透析液；腎性貧血；氧化壓力

並列摘要

Hemodialysis is the most commonly used treatment for end-stage renal disease (ESRD) patients; it removes metabolize wastes and excessive water from blood stream by diffusion and convection. Hemodialysis patients may suffer oxidation damage due to higher oxidative stress, caused by direct contacts between blood and the bio-incompatible dialyzer and dialysis tubes. Patients also may suffer renal anemia due to kidney diseases. These are very harmful to the health of renal disease patients. In order to improve the anemia and high oxidative stress of patients, this research studies the addition of anti-oxidants and iron supplement through steady inflow of dialysate. In this study EGCG and vitamin C were selected to compare their effectiveness as antioxidant agent in dialysate. The experiments in this study include iron chelating analysis; stability test; total antioxidant capacity test, and theoretical calculation of cumulative solute amount. Finally, we used porcine plasma as test solution to simulated the hemodialysis process in beakers, to examine the total antioxidant capacity (FRAP), serum iron concentration, and total iron binding capacity. The result of this study show that when simulated in beakers by porcine plasma as test solution, both ECGC with iron, and vitamin C with iron in dialysate are able to increase the iron concentration of blood stream. EGCG has stronger iron chelating ability, which could stabilize free iron. Although both could provide stable antioxidant capacity, ECGC is however, a stronger antioxidant than vitamin C. EGCG also improves the total iron binding capacity in blood, offer more iron binding site, and the iron which bounds with EGCG could be gradually released in hours after the ECGC was metabolized in human body. So we can effectively reduce the oxidative pressure and anemia for hemodialysis patients by introducing EGCG formulated antioxidant and iron agent dialysate.

並列關鍵字

Antioxidant capability ； Oxidative stress ； Dialysate ； Hemodialysis ； Renal anemia

參考文獻

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血液透析用從透析液供應抗氧化劑與鐵劑之調配與選擇

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