The effect of superoxide dismutase supplementation on TNF-α and TGF-β levels in patients undergoing hemodialysis

OBJECTIVE: Chronic kidney disease stage 5 on dialysis (CKD-5D) remains a global health problem associated with an increased risk of morbidity and mortality owing to cardiovascular disease. This condition is associated with chronic inflammation, which is characterized by an increase in cytokines, including tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β). Superoxide dismutase (SOD) is a first-line endogenous enzymatic antioxidant capable of neutralizing the effects of inflammation and oxidative stress. Therefore, the main aim of this study was to determine the effect of SOD supplementation on serum TNF-α and TGF-β levels in patients undergoing hemodialysis (CKD-5D). PATIENTS AND METHODS: A quasi-experimental study with a pretest-posttest design was conducted from October to December 2021 in the Hemodialysis Unit of Dr. Hasan Sadikin Hospital, Bandung. Patients with CKD-5D who routinely underwent hemodialysis therapy twice a week were included in the study. All participants received SOD-gliadin 250 IU twice a day for 4 weeks. Serum TNF-α and TGF-β levels were assessed before and after the intervention, and statistical analyses were performed. RESULTS: This study enrolled 28 patients undergoing hemodialysis. The median age of the patients was 42 ± 11 years, with a male-to-female ratio of 1:1. The average duration of hemodialysis in the participants was 24 (5-72) months. A statistically significant decrease in serum TNF-α and TGF-β levels from 0.109 (0.087-0.223) to 0.099 (0.083-0.149) pg/mL (p=0.036) and 15.38 ± 3.64 to 13.47 ± 3.07 pg/mL (p=0.031), respectively, after SOD administration was noted. CONCLUSIONS: Exogenous SOD supplementation decreased serum TNF-α and TGF-β levels in patients with CKD-5D. Further randomized controlled trials are required to confirm these findings

Uptake of hepatitis C virus screening and treatment in persons under opioid substitution therapy between 2008 and 2013 in Belgium

Background : Hepatitis C is a viral infection caused by the hepatitis C virus (HCV) with people who inject drugs as the main group at risk worldwide.Aim : This study investigated the differences in uptake for HCV screening and treatment between persons in opioid substitution therapy (OST) and the other members of the Christian Health Insurance Fund in Belgium.Methods : Invoice data were retrospectively collected from the Christian Health Insurance Fund, representing 42% of the healthcare users. Information on demographics, screening, diagnostic tests, treatment and disease progression was obtained from 2008 till 2013. All people in this study were aged 20-65 year. Persons in the OST group were identified as having at least one prescription reimbursed for methadone. This group was compared to the other members of the Insurance Fund not on OST (NOST).Results : The Insurance Fund registered 8,409 unique OST and 3,525,190 members in the general group. HCV RNA screening rate was higher in the OST group after correction for age and gender (4.3% vs. 0.2%). Ribavirin reimbursement, did not differ between the OST and NOST group screened for HCV RNA (16.9% vs. 14.4%), though the probability of having ribavirin reimbursed was smaller for females than for males. Procedures concerning disease progression were reimbursed less frequently in the HCV RNA screened OST group compared to the NOST group (0.3% vs. 1.2%).Conclusion : People on OST were screened more often for HCV RNA. However, the general uptake for HRA screening and treatment in both populations remained suboptimal