Increased plasma S-nitrosothiol levels in chronic haemodialysis patients

Background. An impairment of nitric oxide (NO) bioavailability and/or metabolism may contribute to the excessive incidence of atherosclerotic complications observed in haemodialysis (HD) patients. Recent evidence indicates that NO metabolism involves a family of NO-related molecules that have not yet been explored in such patients. The aim of our study was to determine the plasma levels of S-nitrosothiol and nitrotyrosine in chronic HD patients, and to evaluate potential factors influencing their levels. Methods. Plasma levels of S-nitrosothiols and nitrotyrosine were determined in 22 non-smoking HD patients and 12 healthy control subjects, together with albumin, homocysteine, haemoglobin, highly sensitive C-reactive protein (hsCRP) and various components of the oxidant-antioxidant system at the plasma and erythrocyte levels. Results. While plasma nitrosothiol levels were significantly higher in HD patients than in controls (2.25 +/- 1.17 vs 0.45 +/- 0.45 mumol/l, respectively, P < 0.0001), nitrotyrosine levels were not different. HD patients also exhibited a marked deficit of ascorbate and low plasma glutathione peroxidase activity. An inverse relationship was found between plasma S-nitrosothiol and blood haemoglobin in HD patients (P < 0.005). No direct relationship was observed between plasma S-nitrosothiol levels and any of the oxidative stress markers, or hsCRP levels. Conclusion. This study demonstrates high plasma S-nitrosothiol levels in HD patients, which are partially related to low blood haemoglobin concentrations. The pathophysiological significance of this elevation remains to be elucidated. A possible protective role against nitrosative stress is suggested in presence of normal plasma nitrotyrosine levels in such patients.