Study of homocysteine, total antioxidant capacity, lipoprotein (a) and minerals in steroid sensitive nephrotic syndrome

Several cardiovascular risk factors present in patients with nephrotic syndrome among which are systemic inflammation, hyperhomocysteinemia, increased oxidative stress are considered integral components of the inflammatory responses and also proposed as mediators of plasma homocysteine induced cell damage. We assessed dyslipidemia and its relative contribution in the abnormal oxidative stress, antioxidant status, hyperlipoproteinemia and hyperhomocysteinemia in nephrotic syndrome subjects and in remission stage of nephrotic syndrome. We studied 105 steroid sensitive nephrotic syndromes patients and 99 healthy age matched controls. The patients were observed and their blood samples were analyzed before (pre-treatment group) and after standard corticosteroid induction therapy for one month (post-treatment group).The blood samples were analyzed for quantification of malondialdehyde (an index of lipid per oxidation) homocysteine (a marker of inflammation), lipoprotein (a), lipid profile, total antioxidant capacity, Zinc and Copper. Significantly increased levels of serum total cholesterol, low density lipoprotein cholesterol, lipoprotein (a), malondialdehyde and homocysteine (p<0.001) were observed in pre-treatment group of nephrotic syndrome subjects. Significantly decreased levels of serum high density lipoprotein cholesterol, total antioxidant capacity, Zinc, Copper and albumin (p<0.001) were observed in pre-treatment group of nephrotic syndrome subjects as compared to normal healthy controls. Significant reduction in total cholesterol, triglyceride, lipoprotein (a), malondialdehyde (p<0.001) were observed in post-treatment group of nephrotic syndrome subjects but no significant reduction in Low density lipoprotein cholesterol (p<0.077) and homocysteine (p<0.942) were observed in post-treatment group of nephrotic syndrome subjects as compared to pre-treatment group of nephrotic syndrome subjects. Significant improvement in total antioxidant capacity, high density lipoprotein cholesterol, albumin, Zinc and Copper (p<0.001) were observed in post-treatment group of nephrotic syndrome subjects as compared to pre-treatment group of nephrotic syndrome subjects. Levels of serum Zinc, Copper, high density lipoprotein were occurred almost near to normal value in post-treatment group of nephrotic syndrome subjects. In conclusion the oxidative stress is enhanced, total antioxidant capacity is reduced due to dyslipidemia results in hyperhomocysteinemia, hyperlipoproteinemia and hypoalbuminemia in nephrotic syndrome subjects of both types.