الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
Free radicals are atoms or molecules which contain unpaired electrons in the outermost shell. Any
free radical involving oxygen can be referred as reactive oxygen species. Oxidants are reactive
oxygen species. The antioxidants are category of components to counter the effects of reactive
oxygen species. Oxidative stress is a profound imbalance between oxidants and antioxidants.
The aim of our study is to evaluate the oxidative stress in CRF by estimation a number of oxidative
stress markers : LP, GSH - PX, SOD and vitamin E, in CRF. In addition to study the correlation
between these markers and each of inflammation, anaemia and CVS complication.
The study was carried out in pediatric dialysis unit and outpatient clinic of Kasar Alani children
hospital. It included forty five patients and twenty healthy children taken as control. The
patients are classified into 2 groups [group A] for HD patients, [group B) for conservative
treatment patients and [group C) represented the healthy children.
All patients and controls were subjected to full history taking and clinical examination in
addition to the investigations which included routine .laboratory investigation: HB, HCV, Urea,
Creatinine, Creatinine Clearance, Albumin and CRP. Also there were the investigations of the
research including LP, GSH-PX, SOD and vitamin E.
The study revealed that the LP which is a product of the lipid peroxidation is increased
while the antioxidants are decreased in patient compared the controls and this is attributed to the
increased free radicals with a consequent consumption of the antioxidants reflecting
the increased oxidative stress. The increased LP and decreased antioxidants
occur more m HD group than conservative treatment group and this denotes that the
dialysis exacerbates the oxidative stress.
The oxidative stress has a strong relationship with inflammation and this was shown in our study
because the LP was increased while the antioxidants were decreased in CRP + ve patients than in CRP
-ve ones and the same occurred in hypoalbuminic patients than in normo albuminic ones. Increased
CRP and decreased Albumin are markers of inflammation.
The study cleared the connection between the oxidative stress and anaemia because the LP increased
and the antioxidants decreased in anaemic patients than in normal ones. The correction of anaemia
decreases the oxidative stress and prevention of the oxidative stress participates in treatment of
anaemia.
The lipids are affected with the oxidative stress and this was revealed from our research as we
have found the LP has a positive correlation. while the antioxidants have negative correlation with
each cholesterol and triglycerides. The oxidative stress alters the lipoprotein metabolism and
composition.
The progression of the CRF from early stage till the end one is associated with the occurrence and
increasing the oxidative stress as the LP is increased and the antioxidats are decreased with
increasing of both urea & creatinine and decreasing of creatinine clearance. This observation may
serve to establish a simple protocol for the evaluation of the renal function in CRF.
from our study and the studies by others, it was found that the lipid peroxide (L.P) cell content
is the most important oxidative stress markers.
We have studied the relation between the oxidative stress and CVS complications. It was found that
the development of atherosclerosis and the occun·ence of coronary heart disease in children with
advanced CRF need many factors other than oxidative stress such as obesity, dyslipedemia, genetic
component, and prescence of diabetes mellitus. These factors act with the oxidative stress in
synergism to cause CVS complications especially the atherosclerosis.
In conclusion, it is suggested that the increased LP and decreased the antioxidants : GSH - PX, SOD
and vitamin E can be used as markers of the oxidative stress. These is a strong relation between
oxidative stress and each of inflammation, anaemia and dyslipedemia. The oxidative stress alone has
not great role in developing CVS complications.