Evaluation of possible genotoxic damage in patients with end-stage renal failure

Chronic kidney disease is a common progressive disease characterized by the permanent loss of functional nephrons. End-stage renal failure (ESRD) is known to be an irreversible disease. There is some debate as whether the initiation of regular dialysis in general increases oxidative stress. Increased oxidative stress increases mortality in dialysis patients. Inflammation increased oxidative stress and concomitant DNA damage are expected to develop in the course of chronic disease in ESRD. Many factors, including heavy metals, can further exacerbate the damage. It is also important to reveal the relationship between these factors in ESRD patients. Studies showing how oxidative stress-related genotoxic events affect ESRD patients do not exist in our country and are very limited in the world. Within the scope of this study, genotoxic damage was determined by the Comet method and 8-hydroxy-2 deoxyguanosine (8-OHdG) levels in patients with ESRD who were undergoing hemodialysis or not. The relationship between genotoxic changes were evaluated by measuring the biochemical changes, the levels of heavy metals (aluminum, arsenic, cadmium, lead, and mercury) in the blood, the oxidative biomarkers including superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde (MDA) levels. Genotoxicity, oxidative stress, and heavy metal levels increased significantly in all patients. DNA damage, 8OHdG and MDA significantly increased, whereas Glutathione significantly decreased in the patients undergoing dialysis compared to those not undergoing dialysis. The duration of disease was strong positively correlated with increased Al levels and moderate positively correlated with increased DNA damage and cadmium levels. In conclusion, although further studies are needed, the approaches to reduce oxidative stress-related DNA damage and heavy metal load in ESRD patients are recommended.