Serum Oxidized Albumin and Cardiovascular Mortality in Normoalbuminemic Hemodialysis Patients: A Cohort Study |
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| Authors: | Paik Seong Lim Yachung Jeng Ming Ying Wu Mei-Ann Pai Tsai-Kun Wu Chia-San Liu Chan Hsu Chen Yuan-Chuan Kuo Shiaw-Wen Chien Hung Ping Chen |
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| Affiliation: | 1. Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan.; 2. Department of Food and Nutrition, Providence University, Taichung, Taiwan.; 3. Division of Epidemiology and Biostatistics, Department of Medical Research, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan.; University of Florida, United States of America, |
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| Abstract: | BackgroundSubstantial evidence suggests that increased oxidative stress in hemodialysis (HD) patients may contribute to cardiovascular complications. Oxidative modifications of human serum albumin (HSA), the largest thiol pool in plasma, alter its biological properties and may affect its antioxidant potential in HD patients.MethodsWe conducted a long-term follow-up study in a cohort of normoalbuminemic HD patients to examine the impact of redox state of serum albumin on patients’ survival by measuring the human nonmercaptoalbumin (HNA) fraction of HSA.ResultsAfter adjusting for potential demographic, anthropometric, and clinical confounders, a positive association of HNA level with the risk of death from cardiovascular disease (CVD) and all-cause mortality was observed in normoalbuminemic HD patients. Using stratified analysis, we found a stronger association between HNA level and the risk of death from CVD and all-cause mortality in patients with pre-existing CVD.ConclusionsSerum HNA level is a positive predictor of mortality in normoalbuminemic HD patients, especially among those with pre-existing CVD. Increased oxidative stress resulting from biological changes in serum albumin levels could contribute to accelerated atherosclerosis and the development of cardiovascular disease in HD patients. |
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