Display options
Share it on

Clujul Med. 2016;89(2):250-6. doi: 10.15386/cjmed-537. Epub 2016 Apr 15.

Malondialdehyde can predict survival in hemodialysis patients.

Clujul medical (1957)

Crina Claudia Rusu, Simona Racasan, Ina Maria Kacso, Diana Moldovan, Alina Potra, Ioan Mihai Patiu, Dan Vladutiu, Mirela Gherman Caprioara

Affiliations

  1. Department of Nephrology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
  2. Department of Dialysis, Nefromed Dialysis Center, Cluj-Napoca, Romania.

PMID: 27152077 PMCID: PMC4849384 DOI: 10.15386/cjmed-537

Abstract

BACKGROUND AND AIMS: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in hemodialysis (HD) patients. Kidney disease is associated with increased oxidative stress (OS), a nontraditional CV risk factor. Few studies evaluate the effect of OS markers on CV events (CVE) and survival in HD patients. The aim of this study is to examine potential determinants of OS markers and their predictive role on survival and CV morbidity and mortality in HD patients during a long-term follow-up (108 months).

METHODS: We conducted an analytical cross-sectional prospective observational study, carried on a cohort of randomly selected HD patients. We registered in 44 HD patients baseline characteristics, OS markers, mortality and CVE over a period of 108 months and we used statistical analysis (descriptive, Kaplan-Meier, univariate and multivariate Cox model) for interpretation.

RESULTS: Bound malondialdehyde (bMDA) was positively correlated with serum calcium, protein carbonyls (PC) were inversely correlated with diastolic blood pressure (DBP) and directly correlated with ferritin, NOx was directly correlated with ceruloplasmin) and serum albumin. Of the measured OS markers only bMDA was related to survival (HR=3.29 95% CI (1.28-8.44), p=0.01), and approached statistical significance in the effect on CV mortality (HR=2.85 95% CI (0.88-9.22), p=0.07). None of the measured OS markers was associated with CVE.

CONCLUSIONS: bMDA has a strong predictive value on survival in HD patients in a long-term follow-up (9 years). Its value is correlated with CV mortality but is not a predictor of CV events. Regular assessment of MDA in HD patients and the development of strategies aimed at reducing oxidative stress in these patients might be beneficial.

Keywords: cardiovascular disease; hemodialysis; malondialdehyde; oxidative stress; survival

References

  1. Kidney Int. 1999 Sep;56(3):1078-83 - PubMed
  2. Free Radic Res. 1999 Sep;31(3):211-6 - PubMed
  3. Methods Mol Biol. 1998;100:83-91 - PubMed
  4. J Am Soc Nephrol. 1998 Dec;9(12 Suppl):S16-23 - PubMed
  5. Kidney Int. 2002 Nov;62(5):1524-38 - PubMed
  6. Kidney Int. 2003 Jun;63(6):2262-8 - PubMed
  7. Nephrol Dial Transplant. 2003 Jul;18(7):1272-80 - PubMed
  8. Clin Nephrol. 2003 Jun;59(6):441-6 - PubMed
  9. J Lab Clin Med. 1961 Jul;58:161-8 - PubMed
  10. J Am Soc Nephrol. 2004 Mar;15(3):538-48 - PubMed
  11. Semin Dial. 2004 May-Jun;17(3):224-8 - PubMed
  12. J Nephrol. 2004 Sep-Oct;17(5):715-20 - PubMed
  13. Semin Dial. 2004 Nov-Dec;17(6):449-54 - PubMed
  14. Nutr Metab Cardiovasc Dis. 2005 Aug;15(4):316-28 - PubMed
  15. Hemodial Int. 2005 Jan;9(1):37-46 - PubMed
  16. Kidney Int Suppl. 2008 Dec;(111):S4-9 - PubMed
  17. Nephrol Dial Transplant. 2009 Aug;24(8):2524-9 - PubMed
  18. Semin Dial. 2009 Nov-Dec;22(6):636-43 - PubMed
  19. Ther Apher Dial. 2010 Oct;14(5):465-71 - PubMed
  20. Indian J Nephrol. 2011 Jan;21(1):21-5 - PubMed
  21. Ther Apher Dial. 2012 Feb;16(1):68-74 - PubMed
  22. Methods Enzymol. 1990;186:407-21 - PubMed
  23. Int J Med Sci. 2012;9(9):808-15 - PubMed
  24. PLoS One. 2013 Jul 29;8(7):e70822 - PubMed
  25. Oxid Med Cell Longev. 2013;2013:301982 - PubMed
  26. Nephrol Dial Transplant. 2014 Feb;29(2):255-9 - PubMed
  27. Biochem Res Int. 2013;2013:358985 - PubMed
  28. ISRN Nephrol. 2012 Dec 19;2013:717849 - PubMed
  29. World J Emerg Med. 2014;5(2):91-5 - PubMed
  30. EJIFCC. 2011 Jul 20;22(2):45-51 - PubMed
  31. Clin Chim Acta. 1978 Nov 15;90(1):37-43 - PubMed
  32. Methods Enzymol. 1994;233:357-63 - PubMed
  33. Am J Kidney Dis. 1997 Nov;30(5):665-71 - PubMed

Publication Types