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Open Access 01-12-2021 | Erythropoietin | Research article

The effects of vitamin E supplementation on malondialdehyde as a biomarker of oxidative stress in haemodialysis patients: a systematic review and meta-analysis

Authors: Peter Bergin, Aoife Leggett, Chris R. Cardwell, Jayne V. Woodside, Ammarin Thakkinstian, Alexander P. Maxwell, Gareth J. McKay

Published in: BMC Nephrology | Issue 1/2021

Abstract

Background

Haemodialysis (HD) patients tend to have higher levels of oxidative stress (OS), associated with increased morbidity and premature mortality, compared to the general population. Levels of malondialdehyde (MDA), a biomarker of OS, are reduced by the antioxidant properties of vitamin E (VE) but outcomes from randomised control trials of VE supplementation on MDA in HD patients have been inconsistent.

Methods

We undertook a systematic review and meta-analysis of adult HD patients from VE supplementation studies with measures of MDA. The following search criteria of MEDLINE and EMBASE were considered from inception to January 2020: ‘dialysis’ AND ‘Vitamin E OR tocopherol’ AND ‘malondialdehyde OR MDA’. Two reviewers independently extracted study data and assessed risk of bias. Mean MDA levels and standard deviation were determined before and after VE supplementation. Standardised mean difference (SMD) and standard error were calculated as the within person difference and units of measure were not consistently recorded across all studies. The SMD were pooled using random effects meta-analysis.

Results

The SMD of MDA levels from 18 comparisons was significantly lower in HD patients following VE supplementation (− 1.55; confidence interval: − 2.17 to − 0.94, P < 0.00001). There were significant levels of heterogeneity between studies (I² value = 91%; P < 0.00001) with evidence of potential publication bias toward smaller studies.

Conclusions

Our findings support the use of VE to reduce the effects of OS in HD patients although high levels of heterogeneity and variation in the methodological approaches used by some studies highlight the need for further investigation.

Sies H. On the history of oxidative stress: concept and some aspects of current development. Curr Opin Toxicol. 2018;7:122–6. https://doi.org/10.1016/j.cotox.2018.01.002.CrossRef

Sies H, Berndt C, Jones DP. Oxidative stress. Annu Rev Biochem. 2017;86(1):715–48. https://doi.org/10.1146/annurev-biochem-061516-045037.CrossRefPubMed

Birben E, Sahiner UM, Sackesen C, Erzurum S, Kalayci O. Oxidative stress and antioxidant defense. World Allergy Organ J. 2012;5(1):9–19. https://doi.org/10.1097/WOX.0b013e3182439613.CrossRefPubMedPubMedCentral

Wojtaszek E, Oldakowska-Jedynak U, Kwiatkowska M, Glogowski T, Malyszko J. Uremic toxins, oxidative stress, atherosclerosis in chronic kidney disease, and kidney transplantation. Oxidative Med Cell Longev. 2021;2021:6651367.

Wijnen MHWA, Coolen SAJ, Vader HL, Reijenga JC, Huf FA, Roumen RMH. Antioxidants reduce oxidative stress in claudicants. J Surg Res. 2001;96(2):183–7. https://doi.org/10.1006/jsre.2000.6078.CrossRefPubMed

Spiteller G. Peroxyl radicals: inductors of neurodegenerative and other inflammatory diseases. Their origin and how they transform cholesterol, phospholipids, plasmalogens, polyunsaturated fatty acids, sugars, and proteins into deleterious products. Free Radic Biol Med. 2006;41(3):362–87. https://doi.org/10.1016/j.freeradbiomed.2006.03.013.CrossRefPubMed

Fairus S, Nor RM, Cheng HM, Sundram K. Alpha-tocotrienol is the most abundant tocotrienol isomer circulated in plasma and lipoproteins after postprandial tocotrienol-rich vitamin E supplementation. Nutr J. 2012;11(1):5. https://doi.org/10.1186/1475-2891-11-5.CrossRefPubMedPubMedCentral

Traber MG, Vitamin E. Regulatory mechanisms. Annu Rev Nutr. 2007;27(1):347–62. https://doi.org/10.1146/annurev.nutr.27.061406.093819.CrossRefPubMed

Sen CK, Khanna S, Roy S. Tocotrienols: Vitamin E beyond tocopherols. Life Sci. 2006;78(18):2088–98. https://doi.org/10.1016/j.lfs.2005.12.001.CrossRefPubMedPubMedCentral

10.

Gaweł S, Wardas M, Niedworok E, Wardas P. Malondialdehyde (MDA) as a lipid peroxidation marker. Wiad Lek. 2004;57(9–10):453–5.PubMed

11.

Smith JB, Ingerman CM, Silver MJ. Malondialdehyde formation as an indicator of prostaglandin production by human platelets. J Lab Clin Med. 1976;88(1):167–72.PubMed

12.

Ayala A, Muñoz MF, Argüelles S. Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-Hydroxy-2-Nonenal. Oxidative Med Cell Longev. 2014;2014:1–31. https://doi.org/10.1155/2014/360438.CrossRef

13.

Cherian D, Peter T, Narayanan A, Madhavan SS, Achammada S, Vynat GP. Malondialdehyde as a marker of oxidative stress in periodontitis patients. J Pharm Bioallied Sci. 2019;11(6):297–300. https://doi.org/10.4103/JPBS.JPBS_17_19.CrossRef

14.

Hambali Z, Ahmad Z, Arab S, Khazaai H. Oxidative stress and its association with cardiovascular disease in chronic renal failure patients. Indian J Nephrol. 2011;21(1):21–5. https://doi.org/10.4103/0971-4065.75218.CrossRefPubMedPubMedCentral

15.

Himmelfarb J. Oxidative stress in hemodialysis. Contrib Nephrol. 2008;161:132–7. https://doi.org/10.1159/000130658.CrossRefPubMed

16.

Boudouris G, Verginadis II, Simos YV, Zouridakis A, Ragos V, Karkabounas SC, et al. Oxidative stress in patients treated with continuous ambulatory peritoneal dialysis (CAPD) and the significant role of vitamin C and e supplementation. Int Urol Nephrol. 2013;45(4):1137–44. https://doi.org/10.1007/s11255-012-0334-6.CrossRefPubMed

17.

Coombes JS, Fassett RG. Antioxidant therapy in hemodialysis patients: a systematic review. Kidney Int. 2012;81(3):233–46. https://doi.org/10.1038/ki.2011.341.CrossRefPubMed

18.

Agarwal R, Vasavada N, Sachs NG, Chase S. Oxidative stress and renal injury with intravenous iron-in patients with chronic kidney disease. Kidney Int. 2004;65(6):2279–89. https://doi.org/10.1111/j.1523-1755.2004.00648.x.CrossRefPubMed

19.

Rusu CC, Racasan S, Kacso IM, Moldovan D, Potra A, Patiu IM, et al. Malondialdehyde can predict survival in hemodialysis patients. Clujul Med. 2016;89(2):250–6. https://doi.org/10.15386/cjmed-537.CrossRefPubMedPubMedCentral

20.

Ito F, Sono Y, Ito T. Measurement and clinical significance of lipid peroxidation as a biomarker of oxidative stress: oxidative stress in diabetes, atherosclerosis, and chronic inflammation. Antioxidants. 2019;8(3):72. https://doi.org/10.3390/antiox8030072.CrossRefPubMedCentral

21.

Bayés B, Cruz Pastor M, Bonal J, et al. Homocysteine and lipid peroxidation in haemodialysis: role of folinic acid and vitamin E. Nephrol Dial Transplant. 2001;16(11):2172–5. https://doi.org/10.1093/ndt/16.11.2172.CrossRefPubMed

22.

Boaz M, Matas Z, Biro A, Katzir Z', Green M, Fainaru M, et al. Serum malondialdehyde and prevalent cardiovascular disease in hemodialysis. Kidney Int. 1999;56(3):1078–83. https://doi.org/10.1046/j.1523-1755.1999.00613.x.CrossRefPubMed

23.

Loughrey CM, Young IS, Lightbody JH, McMaster D, McNamee P, Trimble ER. Oxidative stress in haemodialysis. QJM. 1994;87(11):679–83.PubMed

24.

Lu L, Erhard P, Salomon RG, Weiss MF. Serum Vitamin E and oxidative protein modification in hemodialysis: a randomized clinical trial. Am J Kidney Dis. 2007;50(2):305–13. https://doi.org/10.1053/j.ajkd.2007.05.001.CrossRefPubMed

25.

Domenici FA, Vannucchi MTI, Jordão AA, et al. DNA oxidative damage in patients with dialysis treatment. Ren Fail. 2005;27(6):689–94. https://doi.org/10.1080/08860220500242678.CrossRefPubMed

26.

Yusuf S, Dagenais G, Pogue J, et al. Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med. 2000;342(3):154–60. https://doi.org/10.1056/NEJM200001203420302.CrossRefPubMed

27.

Davi G, Ciabattoni G, Consoli A, Mezzetti A, Falco A, Santarone S, et al. In vivo formation of 8-iso-prostaglandin F2α and platelet activation in diabetes mellitus: effects of improved metabolic control and vitamin E supplementation. Circulation. 1999;99(2):224–9. https://doi.org/10.1161/01.CIR.99.2.224.CrossRefPubMed

28.

Giardini O, Taccone-Gallucci M, Lubrano R, Ricciardi-Tenore G, Bandino D, Silvi I, Paradisi C, Mannarino O, Citti G, Elli M. Effects of alphatocopherol administration on red blood cell membrane lipid peroxidation in hemodialysis patients. Clin Nephrol. 1984;21(3):174–7.

29.

Taccone-Gallucci M, Lubrano R, Mazzarella V, Bandino D, Meloni C, Morosetti M, Elli M, Giardini O, Boffo V, Tozzo C. Red blood cell membrane lipid peroxidation and chronic haemolysis in haemodialysis patients. Life Support Syst. 1985;3:41–4.

30.

Lubrano R, Taccone‐Gallucci M, Mazzarella V, Bandino D, Citti G, Elli M, Giardini O, Casciani CU. Relationship between red blood cell lipid peroxidation, plasma hemoglobin, and red blood cell osmotic resistance before and after vitamin E supplementation in hemodialysis patients. Artif Organs. 1986;10(3):245–8.

31.

Taccone-Gallucci M, Giardini O, Ausiello C, Piazza A, Spagnoli GC, Bandino D, et al. Vitamin E supplementation in hemodialysis patients: effects on peripheral blood mononuclear cells lipid peroxidation and immune response. Clin Nephrol. 1986;25(2):81–6.

32.

Taccone-Gallucci M, Lubrano R, Del Principe D, et al. Platelet lipid peroxidation in haemodialysis patients: effects of vitamin E supplementation. Nephrol Dial Transplant. 1989;4(11):975–8.

33.

Hassan MQ, Hussain SA, Zaki MA, Alsharif NZ, Stohs SJ. Protective Effects of Antioxidants Against Uraemia‐Induced Lipid Peroxidation and Glutathione Depletion in Humans. Pharmacol Toxicol. 1995;77(6):407–11.

34.

Yukawa S, Hibino A, Maeda T, Mimura K, Yukawa A, Maeda A, Kishino M, Sonobe M, Mune M, Yamada Y, Niside I. Effect of α-tocopherol on in vitro and in vivo metabolism of low-density lipoproteins in haemodialysis patients. Nephrol Dial Transplant. 1995;10(supp3):1-3.

35.

Cristol JP, Bosc JY, Badiou S, Leblanc M, Lorrho R, Descomps B, Canaud B. Erythropoietin and oxidative stress in haemodialysis: beneficial effects of vitamin E supplementation. Nephrol Dial Transplant. 1997;12(11):2312-7.

36.

Inal M, Kanbak G, Şen S, et al. Antioxidant status and lipid peroxidation in hemodialysis patients undergoing erythropoietin and erythropoietin-vitamin E combined therapy. Free Radic Res. 1999;31(3):211–6. https://doi.org/10.1080/10715769900300771.CrossRefPubMed

37.

Roob JM, Khoschsorur G, Tiran A, Horina JH, Holzer H, Winklhofer-Roob BM. Vitamin E attenuates oxidative stress induced by intravenous iron in patients on hemodialysis. J Am Soc Nephrol. 2000;11(3):539–49.

38.

Bayés B, Pastor MC, Bonal J, Junca J, Romero R. Homocysteine and lipid peroxidation in haemodialysis: role of folinic acid and vitamin E. Nephrol Dial Transplant. 2001;16(11):2172–5.

39.

Uzum A, Toprak O, Gumustas MK, Ciftci S, Sen S. Effect of vitamin E therapy on oxidative stress and erythrocyte osmotic fragility in patients on peritoneal dialysis and hemodialysis. J Nephrol. 2006;19(6):739–45.

40.

Al Youzbaki WB, Mustafa KN, Al Hayali RY. Comparison between the antioxidant level of uremic patients before and after hemodialysis (Hd) and vitamin E therapy: prospective cohort study. Qatar Med J. 2010;2010(2):13.

41.

Ahmadi A, Mazooji N, Roozbeh J, Mazloom Z, Hasanzade J. Effect of alpha-lipoic acid and vitamin E supplementation on oxidative stress, inflammation, and malnutrition in haemodialysis patients. Iran J Kidney Dis. 2013;7(6):461–7.PubMed

42.

Daud Z, Khosla P, Tubie B, et al. Vitamin E tocotrienol supplementation improves lipid profiles in chronic hemodialysis patients. Vasc Health Risk Manag. 2013;747–61.

43.

Asemi Z, Soleimani A, Shakeri H, Mazroii N, Esmaillzadeh A. Effects of omega-3 fatty acid plus alpha-tocopherol supplementation on malnutrition-inflammation score, biomarkers of inflammation and oxidative stress in chronic hemodialysis patients. Int Urol Nephrol. 2016;48(11):1887–95. https://doi.org/10.1007/s11255-016-1399-4.CrossRefPubMed

44.

Cervantes Gracia K, Llanas-Cornejo D, Husi H. CVD and oxidative stress. J Clin Med. 2017;6(2):22. https://doi.org/10.3390/jcm6020022.CrossRefPubMedCentral

45.

Thomas SR, Neužil J, Stocker R. Cosupplementation with coenzyme Q prevents the Prooxidant effect of α-Tocopherol and increases the resistance of LDL to transition metal-dependent oxidation initiation. Arterioscler Thromb Vasc Biol. 1996;16(5):687–96. https://doi.org/10.1161/01.ATV.16.5.687.CrossRefPubMed

46.

Pearson P, Lewis SA, Britton J, Young IS, Fogarty A. The pro-oxidant activity of high-dose vitamin E supplements in vivo. BioDrugs. 2006;20(5):271–3. https://doi.org/10.2165/00063030-200620050-00002.CrossRefPubMed

47.

Miller ER, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med. 2005;142(1):37–46. https://doi.org/10.7326/0003-4819-142-1-200501040-00110.CrossRefPubMed

48.

Van Haaften RIM, Haenen GRMM, Van Bladeren PJ, et al. Inhibition of various glutathione S-transferase isoenzymes by RRR-α-tocopherol. Toxicol in Vitro. 2003;17(3):245–51. https://doi.org/10.1016/S0887-2333(03)00038-9.CrossRefPubMed

49.

Murphy BF. Hypervitaminosis E. JAMA. 1974;227(12):1381. https://doi.org/10.1001/jama.1974.03230250013007.CrossRefPubMed

50.

Janssen MJFM, Van Der Meulen J. The bleeding risk in chronic haemodialysis: preventive strategies in high-risk patients. Neth J Med. 1996;48(5):198–20. https://doi.org/10.1016/0300-2977(96)00005-8.CrossRefPubMed

51.

Jiang S, Pan Z, Li H, et al. Meta-analysis: low-dose intake of vitamin e combined with other vitamins or minerals may decrease all-cause mortality. J Nutr Sci Vitaminol. 2014;60(3):194–205. https://doi.org/10.3177/jnsv.60.194.CrossRefPubMed

52.

Zhang L, Virgous C, Si H. Synergistic anti-inflammatory effects and mechanisms of combined phytochemicals. J Nutr Biochem. 2019;69:19–30. https://doi.org/10.1016/j.jnutbio.2019.03.009.CrossRefPubMed

53.

Wooltorton E. Too much of a good thing? Toxic effects of vitamin and mineral supplements. CMAJ. 2003 Jul 8;169(1):47–8.PubMedPubMedCentral

54.

Ogunleye A, Akinbodewa AA, Adejumo OA, Oluwafemi TT, Akinfaderin DA. Changes in antioxidant status associated with haemodialysis in chronic kidney disease. Ghana Med J. 2018;52(1):29–33. https://doi.org/10.4314/gmj.v52i1.6.CrossRefPubMedPubMedCentral

55.

Standage B, Schuman E, Ackerman D, et al. Does the use of erythropoietin in hemodialysis patients increase dialysis graft thrombosis rates? Am J Surg. 1993;165(5):650–4. https://doi.org/10.1016/S0002-9610(05)80454-4.CrossRefPubMed

56.

Sommerburg O. Does long-term treatment of renal anaemia with recombinant erythropoietin influence oxidative stress in haemodialysed patients? Nephrol Dial Transplant. 1998;13(10):2583–7. https://doi.org/10.1093/ndt/13.10.2583.CrossRefPubMed

57.

Katavetin P, Tungsanga K, Eiam-Ong S, et al. Antioxidative effects of erythropoietin. Kidney Int. 2007;72:10–5.CrossRef

58.

Hodkova M, Dusilova-Sulkova S, Skalicka A, Kalousova M, Zima T, Bartunkova J. Influence of parenteral Iron therapy and Oral Vitamin E supplementation on neutrophil respiratory burst in chronic hemodialysis patients. Ren Fail. 2005;27(2):135–41. https://doi.org/10.1081/JDI-48245.CrossRefPubMed

59.

Rusu A, Rusu F, Zalutchi D, Muresan A, Gherman Caprioara M, Kacso I. The influence of vitamin E supplementation on erythropoietin responsiveness in chronic hemodialysis patients with low levels of erythrocyte superoxide dismutase. Int Urol Nephrol. 2012;45(2):495–501. https://doi.org/10.1007/s11255-012-0175-3.CrossRefPubMed

60.

Harris P, Quaife M, Swanson W. Vitamin E content of foods. J Nutr. 1950;40(3):367–81. https://doi.org/10.1093/jn/40.3.367.CrossRef

61.

Handelman G, Machlin L, Fitch K, et al. Oral α-Tocopherol supplements decrease plasma γ-Tocopherol levels in humans. J Nutr. 1985;115(6):807–13. https://doi.org/10.1093/jn/115.6.807.CrossRefPubMed

62.

McCarty M. Gamma-tocopherol may promote effective no synthase function by protecting tetrahydrobiopterin from peroxynitrite. Med Hypotheses. 2007;69(6):1367–70. https://doi.org/10.1016/j.mehy.2004.11.050.CrossRefPubMed

63.

Fan Y, Liu ML, Qi YY, Ren ZW. Effect of different isoforms of tocopherols on expression of intercellular adhesion molecule-1 in human umbilical vein endothelial cells. Beijing Da Xue Xue Bao. 2004;36(1):70–4.PubMed

64.

McBurney M, Yu E, Ciappio E, et al. Suboptimal serum α-Tocopherol concentrations observed among younger adults and those depending exclusively upon food sources. NHANES. PLoS One. 2015;10(8):e0135510. https://doi.org/10.1371/journal.pone.0135510.CrossRefPubMedPubMedCentral

65.

Muntwyler J, Hennekens C, Manson J, et al. Vitamin supplement use in a low-risk population of US male physicians and subsequent cardiovascular mortality. Arch Intern Med. 2002;162(13):1472–6. https://doi.org/10.1001/archinte.162.13.1472.CrossRefPubMed

66.

Devaraj S, Adams-Huet B, Fuller C, et al. Dose-response comparison of RRR -α-Tocopherol and all-racemic α-Tocopherol on LDL oxidation. Arterioscler Thromb Vasc Biol. 1997;17(10):2273–9. https://doi.org/10.1161/01.ATV.17.10.2273.CrossRefPubMed

67.

Heitzer T, Herttuala S, Wild E, Luoma J, Drexler H. Effect of vitamin E on endothelial vasodilator function in patients with hypercholesterolemia, chronic smoking or both. J Am Coll Cardiol. 1999;33(2):499–505. https://doi.org/10.1016/S0735-1097(98)00584-1.CrossRefPubMed

68.

Himmelfarb J, Kane J, Mcmonagle E, Zaltas E, Bobzin S, Boddupalli S, et al. Alpha and gamma tocopherol metabolism in healthy subjects and patients with end-stage renal disease. Kidney Int. 2003;64(3):978–91. https://doi.org/10.1046/j.1523-1755.2003.00151.x.

69.

Mokhber-Dezfouli M, Rahimikia E, Asadi F, et al. The role of route of Vitamin E administration on the plasma antioxidant activity and lipid peroxidation in newborn calves. Basic Clin Pharmacol Toxicol. 2008;103(5):414–8. https://doi.org/10.1111/j.1742-7843.2008.00308.x.CrossRefPubMed

70.

Baker H, Frank O, Jaslow S. Oral versus intramuscular Vitamin supplementation for Hypovitaminosis in the elderly. J Am Geriatr Soc. 1980;28(1):42–5. https://doi.org/10.1111/j.1532-5415.1980.tb00123.x.CrossRefPubMed

71.

Dasselaar J, Lub-de Hooge M, Pruim J, et al. Relative blood volume changes underestimate Total blood volume changes during hemodialysis. Clin J Am Soc Nephrol. 2007;2(4):669–74. https://doi.org/10.2215/CJN.00880207.CrossRefPubMed

72.

Ioannidis J. Comparison of evidence of treatment effects in randomized and nonrandomized studies. JAMA. 2001;286(7):821–30. https://doi.org/10.1001/jama.286.7.821.CrossRefPubMed

73.

Moher D, Pham B, Jones A, et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet. 1998;352(9128):609–13. https://doi.org/10.1016/S0140-6736(98)01085-X.CrossRefPubMed

74.

Gehr BT, Weiss C, Porzsolt F. The fading of reported effectiveness. A meta-analysis of randomised controlled trials. BMC Med Res Methodol. 2006;6(1):25. https://doi.org/10.1186/1471-2288-6-25.CrossRefPubMedPubMedCentral

75.

Janero D, Burghardt B. Analysis of cardiac membrane phospholipid peroxidation kinetics as malondialdehyde: nonspecificity of thiobarbituric acid-reactivity. Lipids. 1988;23(5):452–8. https://doi.org/10.1007/BF02535519.CrossRefPubMed

76.

Kikugawa K, Kojima T, Yamaki S, Kosugi H. Interpretation of the thiobarbituric acid reactivity of rat liver and brain homogenates in the presence of ferric ion and ethylenediaminetetraacetic acid. Anal Biochem. 1992;202(2):249–55. https://doi.org/10.1016/0003-2697(92)90102-D.CrossRefPubMed

77.

Domijan AM, Ralić J, Radić Brkanac S, Rumora L, Žanić-Grubišić T. Quantification of malondialdehyde by HPLC-FL - application to various biological samples. Biomed Chromatogr. 2015;29(1):41–6. https://doi.org/10.1002/bmc.3361.CrossRefPubMed

78.

Khoubnasabjafari M, Ansarin K, Jouyban A. Reliability of malondialdehyde as a biomarker of oxidative stress in psychological disorders. Bioimpacts. 2015;5(3):123–7. https://doi.org/10.15171/bi.2015.20.CrossRefPubMedPubMedCentral

79.

Siu GM, Draper HH. Metabolism of malonaldehyde in vivo and in vitro. Lipids. 1982;17(5):349–55. https://doi.org/10.1007/BF02535193.CrossRefPubMed

80.

Strobel NA, Fassett RG, Marsh SA, Coombes JS. Oxidative stress biomarkers as predictors of cardiovascular disease. Int J Cardiol. 2011;147(2):191–201. https://doi.org/10.1016/j.ijcard.2010.08.008.CrossRefPubMed

81.

Lykkesfeldt J. Malondialdehyde as biomarker of oxidative damage to lipids caused by smoking. Clin Chim Acta. 2007;380(1–2):50–8. https://doi.org/10.1016/j.cca.2007.01.028.CrossRefPubMed

82.

Joshi U, Subedi R, Poudel P, Ghimire PR, Panta S, Sigdel MR. Assessment of quality of life in patients undergoing hemodialysis using WHOQOL-BREF questionnaire: a multicenter study. Int J Nephrol Renov Dis. 2017;10:195–203. https://doi.org/10.2147/IJNRD.S136522.CrossRef

Title: The effects of vitamin E supplementation on malondialdehyde as a biomarker of oxidative stress in haemodialysis patients: a systematic review and meta-analysis
Authors: Peter Bergin
Aoife Leggett
Chris R. Cardwell
Jayne V. Woodside
Ammarin Thakkinstian
Alexander P. Maxwell
Gareth J. McKay
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Erythropoietin
Erythropoietin
Biomarkers
Epoetin alfa
Published in: BMC Nephrology / Issue 1/2021
Electronic ISSN: 1471-2369
DOI: https://doi.org/10.1186/s12882-021-02328-8

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Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage