Avaliação da Genotoxicidade Através do Teste de Micronúcleos em Pacientes Renais Crônicos

Abstract

Patients with renal chronic disease have an increased incidence of cancer. It is well known that long periods of hemodialysis treatment are linked to DNA damage due to the oxidative stress. This genotoxic effect may cause loss of chromosome fragments, or even entire chromosomes, which form micronucleus (MN) after cell division, and can be detected by the micronucleus test. In the present case-control study we evaluated the genotoxic effect of hemodialysis treatment in 20 patients undergoing hemodialysis (HD), and 20 subjected to peritoneal dialysis (DP), matched for sex and age with 40 controls. Genetic damage was assessed by examining the frequency of micronuclei in 2,000 exfoliated buccal cells per individual. Our results revealed that patients undergoing hemodialysis treatment have a significantly higher frequency of micronucleated cells (5.60±5.31 MNC) compared to control subjects (1.50±2.01 MNC, p<0.01). Interestingly, the same was not observed for the peritoneal dialysis patients, who presented no significant differences in MNC (2.85±2.96) frequency compared to control individuals (3.25±3.85). In addition, we evaluated the possible association between creatine levels, smoking, alcoholic intake, age, time of treatment, incomes of the individuals (separately analyzed according to their gender) and the frequency of micronuclei. The results reported here indicate that the period of treatment is the only factor associated with increased MNC frequency among HD patients (Spearman coefficient 0.414, p=0.01). The number of MN cells found in individuals under six years or less of treatment was significantly lower (2.91±2.74 MN) compared to patients under seven or more years of treatment (8.89±5.96 MN, p<0.05). Overall, peritoneal dialysis may be a safer choice of treatment, but further studies need to be performed to investigate the risks and benefits of both treatments.