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

R. Supriyadi, E. Rakhmawati Kurniaatmaja, I. Huang, L. Sukesi, A. Makmun

Division of Nephrology and Hypertension, Department of Internal Medicine, Universitas Padjajaran, Bandung, Indonesia. rudi.supriyadi@unpad.ac.id

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• Nephrology

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.

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