Pomen določanja koncentracije mieloperoksidaze pri bolnikih s kronično ledvično boleznijo na dializnem zdravljenju

Dajčman, Lucija (author), Osredkar, Joško (mentor), Jerin, Aleš (comentor)

Kronična ledvična bolezen je pogosta bolezen, ki prizadene vsaj enega od desetih ljudi. Kronična ledvična bolezen predstavlja progresivno izgubo ledvične funkcije, ki lahko prizadene posameznike zaradi različnih vzrokov. Mieloperoksidaza je encim, ki se nahaja v belih krvnih celicah, še posebej v nevtrofilcih, monocitih in makrofagih. Njena ključna vloga je povezana z imunskim sistemom telesa in sodeluje pri obrabnih mehanizmih organizma, saj katalizira reakcije med vodikovim peroksidom in halidnimi ioni, tvorijo pa se mikrobicidne spojine, kot je hipoklorova kislina. Pri bolnikih s kronično ledvično boleznijo lahko prihaja do povečane aktivnosti mieloperoksidaze, kar vodi v prekomerno tvorbo hipohalogenih kislin, kar lahko povzroči oksidativno poškodbo celic in tkiv, s čimer se povečuje vnetni odziv v organizmu. Oksidativno modificirani lipidi in proteini, ki so posledica delovanja encima, lahko prispevajo k razvoju ateroskleroze in drugih srčno-žilnih zapletov pri bolnikih s kronično ledvično boleznijo. V okviru magistrske naloge smo se odločili za določanje koncentracije mieloperoksidaze pri bolnikih s kronično ledvično boleznijo na dializnem zdravljenju. Koncentracijo encima smo pri 32 bolnikih pomerili s pomočjo encimsko imunskega testa ELISA. Podatke smo ovrednotili in jih nato statistično primerjali med podskupinami. Imeli smo tri podskupine. Skupine smo primerjali z različnimi statističnimi testi. Pri podskupini z antikoagulatni (heparin in citrat) smo uporabili Freidmanov test in Wilcoxov predznakovni test za pare, pri podskupini z dializnimi membranami (Medium cut-off membrana in hemodiafiltracija) smo uporabili Mann-Whitney-ev U test in pri podskupini s posebno dieto in brez nje smo uporabili Wilcoxonov parni test . Rezultati so pokazali, da sprememba dializnega antikoagulanta vpliva na koncentracijo mieloperoksidaze. Pri tem je primernejša izbira citrat v primerjavi s heparinom. Različne dializne membrane ne vplivajo na koncentracijo mieloperoksidaze, saj je ta prevelika, da bi se učinkovito odstranjevala skozi pore membran. Prav tako so rezultati statistične analize pokazali, da je dieta z visoko vsebnostjo vlaknin in z dodatkom natrijevega propionata ustrezna za zmanjševanje vnetja in oksidativnega stresa, saj so bolniki na dieti imeli nižje koncentracije mieloperoksidaze.

• Language: Slovenian
• Keywords: mieloperoksidaza, kronična ledvična bolezen, ELISA, Freidmanov test, MCO
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2024
• PID: 20.500.12556/RUL-155912
• Publication date in RUL: 24.04.2024

DAJČMAN, Lucija, 2024, Pomen določanja koncentracije mieloperoksidaze pri bolnikih s kronično ledvično boleznijo na dializnem zdravljenju [online]. Master’s thesis. [Accessed 28 March 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=155912

Secondary language

• Language: English
• Title: Importance of mieloperoxidases determination in patients with chronic kidney disease on hemodialysis

Abstract

Chronic kidney disease is a common condition that affects at least one in ten people. Chronic kidney disease represents a progressive loss of kidney function, which can affect individuals due to various causes. Myeloperoxidase is an enzyme found in white blood cells, particularly in neutrophils, monocytes, and macrophages. Its key role is associated with the body's immune system and participates in the body's defense mechanisms by catalyzing reactions between hydrogen peroxide and halide ions, forming microbicidal compounds such as hypochlorous acid. In patients with chronic kidney disease, increased myeloperoxidase activity may lead to excessive formation of hypohalous acids, which can cause oxidative damage to cells and tissues, thereby increasing inflammatory response in the body. Oxidatively modified lipids and proteins resulting from enzyme activity may contribute to the development of atherosclerosis and other cardiovascular complications in patients with chronic kidney disease. As part of the master's thesis, we decided to determine the concentration of myeloperoxidase in patients with chronic kidney disease undergoing dialysis treatment. We measured the enzyme concentration in 32 patients using the enzyme-linked immunosorbent assay (ELISA). We evaluated the data and then statistically compared them among subgroups. We had three subgroups. We compared the groups using different statistical tests. In the subgroup with anticoagulants (heparin and citrate), we used the Friedman test and Wilcoxon signed-rank test for pairs; in the subgroup with dialysis membranes (medium cut-off membrane and hemodiafiltration), we used the Mann-Whitney U test; and in the subgroup with and without a special diet, we used the Wilcoxon signed-rank test. The results showed that changing the dialysis anticoagulant affects the concentration of myeloperoxidase, with citrate being a more suitable choice compared to heparin. Different dialysis membranes do not affect the concentration of myeloperoxidase, as it is too large to be effectively removed through membrane pores. Similarly, the results of the statistical analysis showed that a high-fiber diet with the addition of sodium propionate is suitable for reducing inflammation and oxidative stress, as patients on the diet had lower concentrations of myeloperoxidase.

• Keywords: myeloperoxidase, chronic kidney disease, ELISA, Freidman test, MCO