Serum protein acrolein adducts: utility in detecting oxidant stress in hemodialysis patients and reversal using a vitamin E-bonded hemodialyzer

Accumulating evidence indicates that protein modification by acrolein is one of the major hallmarks of atherosclerosis. The purpose of the present study was to evaluate the serum acrolein-modified protein adduct (Acr) level in end-stage renal disease (ESRD), and to elucidate the efficacy of vitamin E-bonded hemodialyzer in reducing Acr in a crossover trial. A significant increase in Acr was found in ESRD patients compared with healthy controls (p < .001). In ESRD, the Acr level of those patients with type 2 diabetes mellitus (DM) was significantly higher compared with the non-DM group (p < .05). Forty-one ESRD patients who exhibited Acr levels higher than the mean value in ESRD were treated by vitamin E-bonded hemodialyzer for 6 months. After 6 months of treatment, Acr levels were decreased to those found in healthy individuals (p < .001). When hemodialyzers were switched back from vitamin E bonded to the original regular ones, Acr levels increased to nearly their initial levels after 3 months (p < .001), compared with the 6 month time point. These results suggest the potential of Acr as an oxidative stress marker in ESRD, and that vitamin E-bonded hemodialyzer treatment is a reasonable approach to reduce oxidative stress in ESRD.