الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Oxidative stress is defined as the presence of an imbalance between oxidative products on one side and antioxidant defense mechanisms on the other side, with the former overwhelming the latter.
Oxidative molecules include RONS, whereas antioxidants can be endogenous or exogenously administrated molecules. Oxidative stress induces the oxidation and subsequent damage of several molecules, such as lipids, proteins, nucleic acids, and carbohydrates. Oxidative stress is implicated in the pathogenesis of several conditions, such as atherosclerosis, diabetes mellitus, inflammation, as well as progression of CKD to ESRD.
Hemodialysis patients are at high risk for CV and all-cause mortality. This is only partially explained by the traditional risk factors. In addition to these factors, OS and chronic inflammation are emerging as major and novel contributors to accelerated atherosclerosis and increased mortality. In these patients, OS is especially a promising therapeutic target.
Worldwide, chronic HCV infection constitutes a major public health problem, not only does it increase the risk of CKD but it also worsens the outcomes of patients at the different CKD stages, decreases the survival of maintenance HD patients, and increases the loss of allograft in kidney transplant recipients.
Egypt is considered the most affected nation by HCV. Both incidence and prevalence levels of HCV infection were high among all Egyptian populations. Genotype 4 accounted for 94.1% of infections. Two-thirds of Egyptians who are antibody-positive are chronically infected and need treatment. Despite the reported large-scale epidemic, current prevalence appears to be decreasing rapidly consistent with a contracting epidemic.
The aim of the present analysis was to assess the possible effect of HCV infection activity on OS indicators namely malonyldialdehyde (MDA) as a marker of lipid peroxidation and free radical activity as well as glutathione peroxidase (GSH-Px) as a marker of antioxidants among maintenance HD patients.
The current work was carried out on 45 maintenance HD patients (group I) from the Dialysis Unit, El-Mwasah Hospital, Alexandria Main University Hospitals and 15 healthy age- and sex-matched controls (group II). The maintenance HD patients were subdivided into 3 subgroups according to the HCV infection status: group Ia: included 15 maintenance HD patients who were both anti-HCV and HCV-RNA positive, group Ib: included 15 maintenance HD patients who were anti-HCV positive and HCV-RNA negative, and group Ic: included 15 maintenance HD patients who were both anti-HCV and HCV-RNA negative. The study protocol was carried out in compliance with the Helsinki Declaration and after approval of the Medical Ethics Committee of Alexandria Faculty of Medicine. All patients and controls were informed about the study and a written consent was obtained from each one. Maintenance HD patients were excluded from the study if they were younger than 18 years, on regular HD treatment for less than 6 months, had an episode of acute infection in the last 3 months before enrollment to the study, or if they had malignant neoplasms, concomitant HIV or chronic hepatitis B infection and/or used antioxidants, fish-oil or iron supplement in the previous month.