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Nishikawa T, Ueyama J, Shimizu S, Shibata Y, Yamada S. Redox state of human serum albumin as a post-discharge prognostic marker in patients hospitalized for heart failure. Int J Cardiol 2024; 416:132497. [PMID: 39214476 DOI: 10.1016/j.ijcard.2024.132497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/17/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Heart failure (HF) is a global health concern, and oxidative stress has been implicated in its progression. The redox state of human serum albumin, a systemic oxidative biomarker, holds promise as a prognostic marker in HF. This study aimed to investigate the association between the fraction of human mercaptalbumin (fHMA), an indicator of human serum albumin's redox state, and adverse events in HF within a prospective single-hospital-based cohort. METHODS We enrolled patients hospitalized for HF and measured fHMA using high-performance liquid chromatography at discharge. The primary endpoint was the composite of HF rehospitalization and all-cause death within one year after discharge. RESULTS A total of 221 participants (median age:79 years; 35 % female) were included in the study. Over the course of one year, 26.1 % of the patients experienced HF readmission, while 13.1 % died. The low fHMA group divided by median of fHMA (<57.6 %) showed higher composite outcome rates (41.4 % for the low fHMA vs. 24.6 % for the high fHMA, p = 0.0114). Multivariate analysis, accounting for seven potential confounders, identified low fHMA (adjusted HR: 1.79 [1.03-3.11]) and lower hemoglobin as independent predictors of HF prognosis. CONCLUSIONS The findings in this study provide the first evidence that fHMA is a potential novel prognostic biomarker in patients with HF.
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Affiliation(s)
- Taiki Nishikawa
- Department of Biomolecular Sciences, Field of Omics Health Sciences, Nagoya University Graduate School, Nagoya, Japan; Department of Rehabilitation, Japan Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Jun Ueyama
- Department of Biomolecular Sciences, Field of Omics Health Sciences, Nagoya University Graduate School, Nagoya, Japan
| | - Shinya Shimizu
- Department of Cardiology, Kariya Toyota General Hospital, Kariya, Japan
| | - Yoshihisa Shibata
- Department of Cardiology, Japan Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Sumio Yamada
- Department of Cardiology, Aichi Medical University, Nagakute, Japan.
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2
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Mikami Y, Ogawa M, Hayasaka Y, Yamakami A, Hattori K, Fukazawa C, Ito T, Kanomata N, Terawaki H. Kidney damage relates to agonal bacteremia: a single-center retrospective study. Clin Exp Nephrol 2024; 28:773-783. [PMID: 38506981 DOI: 10.1007/s10157-024-02485-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Agonal bacteremia, diagnosed with postmortem positive blood culture results, is considered a possible contributing factor to death. We hypothesized that some premortem organ damage, such as kidney damage, can enhance agonal bacteremia. METHODS We performed a postmortem blood and alveolar fluid culture study in 30 cadavers and evaluated the relationship between blood culture results and clinical parameters, including organ damage (brain, heart, lung, kidney, liver and gastrointestinal tract). RESULTS A total of 23 cases (76.7%) were positive for blood culture; the number of cultured species was one in 12 cases, two in 7 cases, and three in 4 cases. The ratio of agonal bacteremia was significantly higher in patients with heart damage (100%, n = 13) and those with kidney damage (end-stage kidney damage, acute kidney injury, obstructive kidney failure, or metastatic kidney tumours) (100%, n = 13). The mean number of cultured species was 0.67 ± 0.98 in heart or kidney damage, 1.40 ± 0.55 in heart damage only, 1.40 ± 0.55 in kidney damage only, and 2.00 ± 0.93 in heart and kidney damage. As the number of damaged organs increased (0 organs, no heart/kidney damage; 1 organ, heart or kidney damage; and 2 organs, heart and kidney damage), the mean number of cultured species increased significantly (p for trend = 0.001964). CONCLUSION Premortem kidney damage relates to agonal bacteremia.
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Affiliation(s)
- Yumiko Mikami
- Clinical Laboratory Department, St. Luke's International University, 9-1 Akashi-Cho, Chuo-City, Tokyo, Japan
| | - Meiko Ogawa
- Department of Pathology, St. Luke's International Hospital, Tokyo, Japan
| | - Yuuki Hayasaka
- Clinical Laboratory Department, St. Luke's International University, 9-1 Akashi-Cho, Chuo-City, Tokyo, Japan
| | - Asuka Yamakami
- Clinical Laboratory Department, St. Luke's International University, 9-1 Akashi-Cho, Chuo-City, Tokyo, Japan
| | - Kanako Hattori
- Clinical Laboratory Department, St. Luke's International University, 9-1 Akashi-Cho, Chuo-City, Tokyo, Japan
| | - Chizumi Fukazawa
- Clinical Laboratory Department, St. Luke's International University, 9-1 Akashi-Cho, Chuo-City, Tokyo, Japan
| | - Takafumi Ito
- Department of Nephrology, Teikyo University Chiba Medical Hospital, Chiba, Japan
| | - Naoki Kanomata
- Department of Pathology, St. Luke's International Hospital, Tokyo, Japan
| | - Hiroyuki Terawaki
- Clinical Laboratory Department, St. Luke's International University, 9-1 Akashi-Cho, Chuo-City, Tokyo, Japan.
- Department of Nephrology, Teikyo University Chiba Medical Hospital, Chiba, Japan.
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Sastre-Oliva T, Corbacho-Alonso N, Rodriguez-Sanchez E, Mercado-García E, Perales-Sanchez I, Hernandez-Fernandez G, Juarez-Alia C, Tejerina T, López-Almodóvar LF, Padial LR, Sánchez PL, Martín-Núñez E, López-Andrés N, Ruiz-Hurtado G, Mourino-Alvarez L, Barderas MG. Albumin Redox Modifications Promote Cell Calcification Reflecting the Impact of Oxidative Status on Aortic Valve Disease and Atherosclerosis. Antioxidants (Basel) 2024; 13:108. [PMID: 38247532 PMCID: PMC10812654 DOI: 10.3390/antiox13010108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Calcific aortic valve disease (CAVD) and coronary artery disease (CAD) are related cardiovascular diseases in which common mechanisms lead to tissue calcification. Oxidative stress plays a key role in these diseases and there is also evidence that the redox state of serum albumin exerts a significant influence on these conditions. To further explore this issue, we used multimarker scores (OxyScore and AntioxyScore) to assess the global oxidative status in patients with CAVD, with and without CAD, also evaluating their plasma thiol levels. In addition, valvular interstitial cells were treated with reduced, oxidized, and native albumin to study how this protein and its modifications affect cell calcification. The differences we found suggest that oxidative status is distinct in CAVD and CAD, with differences in redox markers and thiol levels. Importantly, the in vitro interstitial cell model revealed that modified albumin affects cell calcification, accelerating this process. Hence, we show here the importance of the redox system in the development of CAVD, emphasizing the relevance of multimarker scores, while also offering evidence of how the redox state of albumin influences vascular calcification. These data highlight the relevance of understanding the overall redox processes involved in these diseases, opening the door to new studies on antioxidants as potential therapies for these patients.
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Affiliation(s)
- Tamara Sastre-Oliva
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45071 Toledo, Spain; (T.S.-O.); (N.C.-A.); (I.P.-S.); (G.H.-F.); (C.J.-A.); (L.M.-A.)
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Nerea Corbacho-Alonso
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45071 Toledo, Spain; (T.S.-O.); (N.C.-A.); (I.P.-S.); (G.H.-F.); (C.J.-A.); (L.M.-A.)
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Elena Rodriguez-Sanchez
- Cardiorenal Translational Laboratory, Instituto de Investigación Imas12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain (E.M.-G.); (G.R.-H.)
| | - Elisa Mercado-García
- Cardiorenal Translational Laboratory, Instituto de Investigación Imas12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain (E.M.-G.); (G.R.-H.)
| | - Ines Perales-Sanchez
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45071 Toledo, Spain; (T.S.-O.); (N.C.-A.); (I.P.-S.); (G.H.-F.); (C.J.-A.); (L.M.-A.)
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - German Hernandez-Fernandez
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45071 Toledo, Spain; (T.S.-O.); (N.C.-A.); (I.P.-S.); (G.H.-F.); (C.J.-A.); (L.M.-A.)
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Cristina Juarez-Alia
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45071 Toledo, Spain; (T.S.-O.); (N.C.-A.); (I.P.-S.); (G.H.-F.); (C.J.-A.); (L.M.-A.)
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Teresa Tejerina
- Department of Pharmacology, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Luis F. López-Almodóvar
- Cardiac Surgery, Hospital General Universitario de Toledo, Servicio de Salud de Castilla-La Mancha (SESCAM), 45007 Toledo, Spain;
| | - Luis R. Padial
- Department of Cardiology, Hospital General Universitario de Toledo, Servicio de Salud de Castilla-La Mancha (SESCAM), 45007 Toledo, Spain;
| | - Pedro L. Sánchez
- Department of Cardiology, Hospital Universitario de Salamanca-Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ernesto Martín-Núñez
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), 31008 Pamplona, Spain; (E.M.-N.); (N.L.-A.)
| | - Natalia López-Andrés
- Cardiovascular Translational Research, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), 31008 Pamplona, Spain; (E.M.-N.); (N.L.-A.)
| | - Gema Ruiz-Hurtado
- Cardiorenal Translational Laboratory, Instituto de Investigación Imas12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain (E.M.-G.); (G.R.-H.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Laura Mourino-Alvarez
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45071 Toledo, Spain; (T.S.-O.); (N.C.-A.); (I.P.-S.); (G.H.-F.); (C.J.-A.); (L.M.-A.)
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
| | - Maria G. Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Servicio de Salud de Castilla-La Mancha (SESCAM), 45071 Toledo, Spain; (T.S.-O.); (N.C.-A.); (I.P.-S.); (G.H.-F.); (C.J.-A.); (L.M.-A.)
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain
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Boss K, Paar M, Waterstradt K, Schnurr K, Ickerott P, Wieneke U, Spitthöver R, Oettl K, Kribben A. Albumin redox state of maintenance haemodialysis patients is positively altered after treatment. BMC Nephrol 2023; 24:273. [PMID: 37723426 PMCID: PMC10506191 DOI: 10.1186/s12882-023-03317-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND AND AIM Maintenance haemodialysis patients have increased morbidity and mortality which is mainly driven by an elevated inflammation level due to the uraemic milieu. A major part of this increased inflammation level is the degree of oxidative stress which can be assessed by albumin redox state (ARS). Aim of this study was to evaluate how the ARS is affected by a haemodialysis treatment and different dialyzer properties. METHODS ARS was determined before and after haemodialysis treatment by fractionating it into reduced human mercaptalbumin (HMA), reversibly oxidized human non-mercaptalbumin 1 (HNA-1), and irreversibly oxidized human non-mercaptalbumin 2 (HNA-2) by high-performance liquid chromatography. In healthy individuals, albumin circulates in the following proportions: HMA 70-80%, HNA-1 20-30% and HNA-2 2-5%. High flux (FX 100 [Fresenius Medical Care], BG 1.8 [Toray], Xevonta Hi 18 [B. Braun], CTA-2000 [Kawasumi]) and low flux FX10 [Fresenius Medical Care] dialyzers were used. RESULTS 58 patients (59% male, median age 68 years, median time on haemodialysis 32 month) were included in the study. Before haemodialysis treatment, HMA (median 55.9%, IQR 50.1-61.2%) was substantially lower than in healthy individuals. Accordingly, oxidized albumin fractions were above the level of healthy individuals (median HNA-1 38.5%, IQR 33.3-43.2%; median HNA-2 5.8%, IQR 5.1-6.7%). Before haemodialysis treatment HMA was significantly higher in patients usually treated with high flux membranes (p < 0.01). After haemodialysis treatment there was a significant increase of HMA and a decrease of HNA-1 and HNA-2 (p < 0.01). These effects were more pronounced in patients treated with high flux dialyzers (p < 0.01). There were no differences of ARS alteration with regard to the dialyzer´s sterilization mode or the presence of diabetes. CONCLUSION The study confirms that the ARS is positively altered by haemodialysis and shows for the first time that this effect depends on dialyzer properties.
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Affiliation(s)
- Kristina Boss
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany.
| | - Margret Paar
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | | | | | - Philipp Ickerott
- Gemeinschaftspraxis für Nieren- und Hochdruckkrankheiten Essen-Steele, Essen, Germany
| | | | | | - Karl Oettl
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany
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5
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Watanabe H. Oxidized Albumin: Evaluation of Oxidative Stress as a Marker for the Progression of Kidney Disease. Biol Pharm Bull 2022; 45:1728-1732. [DOI: 10.1248/bpb.b22-00586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Hiroshi Watanabe
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
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6
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Okada K, Tashiro M, Michiwaki H, Inoue T, Shima H, Minakuchi J, Kawashima S. Effects of high albumin leakage on survival between online hemodiafiltration and super high-flux hemodialysis: the HISTORY study. RENAL REPLACEMENT THERAPY 2022. [DOI: 10.1186/s41100-022-00440-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
All-cause mortality is lower with a high substitution volume in predilution (pre) and postdilution (post) online hemodiafiltration (OHDF) than with hemodialysis (HD), and mortality does not significantly differ between pre- and post-OHDF groups. Despite the improved survival with a high substitution volume, there may be limitations. On the other hand, either normoalbuminemia or high albumin leakage in HD can reduce mortality, and super high-flux (SHF) membrane dialyzers can reduce mortality compared with low-flux and high-flux membrane dialyzers. Here, we investigated the associations of serum albumin concentration (s-Alb), albumin leakage, and substitution volume with all-cause mortality in OHDF and SHF-HD.
Methods
In a 3-year retrospective observational study of patients receiving dialysis from April 1 to July 1, 2017, we developed a propensity score-matched model using 783 stable patients (SHF-HD, 355; OHDF, 428). We used the log-rank test to compare Kaplan–Meier survival curves and Cox regression analysis to calculate hazard ratio (HR). Cox regression analysis was also used to compare the effect of estimated albumin leakage (EAL) and substitution volume on 3-year all-cause mortality.
Results
All-cause mortality was significantly lower with high EAL than with low EAL (SHF-HD: P = 0.012, log-rank test; HR, 0.44; 95% confidence interval [CI] 0.23–0.85; OHDF: P = 0.027, log-rank test; HR, 0.41; 95% CI 0.18–0.93). The mortality of high EAL was not significantly different between high and low s-Alb in SHF-HD (3.5 ± 0.1 and 3.2 ± 0.2 g/dL) and OHDF (3.6 ± 0.2 and 3.2 ± 0.1 g/dL), despite significant differences in s-Alb. Mortality did not significantly differ between SHF-HD and OHDF with higher EAL ranges or a lower difference in EAL. Mortality in pre-OHDF was significantly correlated with EAL (P = 0.007, beta − 0.32) rather than substitution volume, and mortality in post-OHDF was not analyzed because of fewer deaths.
Conclusions
The results suggest that survival is improved more with high EAL than with low EAL in both OHDF and SHF-HD patients, that high EAL with mild-to-moderate hypoalbuminemia does not necessarily worsen survival in OHDF and SHF-HD patients, and that survival is equivalent between OHDF and SHF-HD patients with a similar level of EAL.
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Garavaglia ML, Giustarini D, Colombo G, Reggiani F, Finazzi S, Calatroni M, Landoni L, Portinaro NM, Milzani A, Badalamenti S, Rossi R, Dalle-Donne I. Blood Thiol Redox State in Chronic Kidney Disease. Int J Mol Sci 2022; 23:ijms23052853. [PMID: 35269995 PMCID: PMC8911004 DOI: 10.3390/ijms23052853] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 02/05/2023] Open
Abstract
Thiols (sulfhydryl groups) are effective antioxidants that can preserve the correct structure of proteins, and can protect cells and tissues from damage induced by oxidative stress. Abnormal levels of thiols have been measured in the blood of patients with moderate-to-severe chronic kidney disease (CKD) compared to healthy subjects, as well as in end-stage renal disease (ESRD) patients on haemodialysis or peritoneal dialysis. The levels of protein thiols (a measure of the endogenous antioxidant capacity inversely related to protein oxidation) and S-thiolated proteins (mixed disulphides of protein thiols and low molecular mass thiols), and the protein thiolation index (the molar ratio of the S-thiolated proteins to free protein thiols in plasma) have been investigated in the plasma or red blood cells of CKD and ESRD patients as possible biomarkers of oxidative stress. This type of minimally invasive analysis provides valuable information on the redox status of the less-easily accessible tissues and organs, and of the whole organism. This review provides an overview of reversible modifications in protein thiols in the setting of CKD and renal replacement therapy. The evidence suggests that protein thiols, S-thiolated proteins, and the protein thiolation index are promising biomarkers of reversible oxidative stress that could be included in the routine monitoring of CKD and ESRD patients.
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Affiliation(s)
- Maria Lisa Garavaglia
- Department of Biosciences (Department of Excellence 2018–2022), Università degli Studi di Milano, Via Celoria 26, 20133 Milan, Italy; (M.L.G.); (G.C.); (L.L.); (A.M.)
| | - Daniela Giustarini
- Department of Biotechnology, Chemistry and Pharmacy (Department of Excellence 2018–2022), University of Siena, Via A. Moro 2, 53100 Siena, Italy;
| | - Graziano Colombo
- Department of Biosciences (Department of Excellence 2018–2022), Università degli Studi di Milano, Via Celoria 26, 20133 Milan, Italy; (M.L.G.); (G.C.); (L.L.); (A.M.)
| | - Francesco Reggiani
- Nephrology and Dialysis Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy or (F.R.); (S.F.); or (M.C.); (S.B.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Silvia Finazzi
- Nephrology and Dialysis Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy or (F.R.); (S.F.); or (M.C.); (S.B.)
| | - Marta Calatroni
- Nephrology and Dialysis Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy or (F.R.); (S.F.); or (M.C.); (S.B.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
| | - Lucia Landoni
- Department of Biosciences (Department of Excellence 2018–2022), Università degli Studi di Milano, Via Celoria 26, 20133 Milan, Italy; (M.L.G.); (G.C.); (L.L.); (A.M.)
| | - Nicola Marcello Portinaro
- Department of Medical Biotechnologies and Translational Medicine, Università degli Studi di Milano, 20133 Milan, Italy;
| | - Aldo Milzani
- Department of Biosciences (Department of Excellence 2018–2022), Università degli Studi di Milano, Via Celoria 26, 20133 Milan, Italy; (M.L.G.); (G.C.); (L.L.); (A.M.)
| | - Salvatore Badalamenti
- Nephrology and Dialysis Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy or (F.R.); (S.F.); or (M.C.); (S.B.)
| | - Ranieri Rossi
- Department of Biotechnology, Chemistry and Pharmacy (Department of Excellence 2018–2022), University of Siena, Via A. Moro 2, 53100 Siena, Italy;
- Correspondence: (R.R.); (I.D.-D.)
| | - Isabella Dalle-Donne
- Department of Biosciences (Department of Excellence 2018–2022), Università degli Studi di Milano, Via Celoria 26, 20133 Milan, Italy; (M.L.G.); (G.C.); (L.L.); (A.M.)
- Correspondence: (R.R.); (I.D.-D.)
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Non-mercaptalbumin is significantly associated with the coronary plaque burden and the severity of coronary artery disease. Sci Rep 2021; 11:14242. [PMID: 34244579 PMCID: PMC8270939 DOI: 10.1038/s41598-021-93753-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/30/2021] [Indexed: 01/01/2023] Open
Abstract
Human non-mercaptalbumin (HNA), oxidized form of serum albumin, has been reported as a useful marker in oxidative stress-related diseases; however, few reports have examined the association between HNA and the severity of coronary artery disease (CAD). The present study evaluated whether the HNA fraction is correlated with coronary artery stenosis in 140 patients considered to have a high risk of CAD or who were suspected of having acute coronary syndrome. The severity of CAD was defined by the number of stenotic coronary vessels and a severity score system (the Gensini score). HNA measurements were performed using our newly established high-performance liquid chromatography methodology. The results had shown that HNA was significantly increased in patients with three-vessel disease, compared with those without CAD or with single-vessel disease (p = 0.025), and was positively correlated with the Gensini score (ρ = 0.421, p < 0.001). A multivariate analysis showed that the number of stenotic vessels was an independent and significant factor associated with HNA (ρ = 1.246, p = 0.012). A logistic regression analysis showed that HNA was a strong predictor of multivessel CAD (odds ratio, 1.12; 95% confidence interval, 1.020–1.229; p = 0.017). These findings indicate that the measurement of HNA could be clinically practical for predicting the severity of coronary artery stenosis.
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9
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Imafuku T, Tanaka M, Tokunaga K, Miyamura S, Kato H, Tanaka S, Nakano T, Hirata K, Kadowaki D, Maeda H, Matsushita K, Otagiri M, Komaba H, Fukagawa M, Watanabe H, Maruyama T. Effect of Cinacalcet on the Redox Status of Albumin in Secondary Hyperparathyroidism Patients Receiving Hemodialysis. Biol Pharm Bull 2021; 43:1583-1590. [PMID: 32999168 DOI: 10.1248/bpb.b20-00472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Chronic kidney disease (CKD) patients with secondary hyperparathyroidism (SHPT) have an increased risk of cardiovascular disease (CVD). Cinacalcet is a calcimimetic that permits impaired endothelial functions to be recovered via inhibiting parathyroid hormone (PTH) production in SHPT patients. However, the underlying mechanism for its action remains unknown. The purpose of this study was to examine the effect of cinacalcet on the redox state of human serum albumin (HSA), a reliable marker for assessing endothelial oxidative damage in SHPT patients who were receiving hemodialysis. Cinacalcet was administered to six SHPT patients for a period of 8 weeks. After 4 weeks of treatment, cinacalcet significantly decreased the oxidized albumin ratio which is a ratio of reduced and oxidized forms of HSA via increasing reduced form of HSA. Moreover, the radical scavenging abilities of HSA that was isolated from SHPT patients were increased by cinacalcet, suggesting the recovery of the impaired vascular anti-oxidant ability. Interestingly, the oxidized albumin ratio in SHPT patients was significantly higher than that in hemodialysis patients. In addition, the changes of intact PTH levels were significantly correlated with the oxidized albumin ratio. It therefore appears that PTH may induce oxidative stress in SHPT patients. In fact, an active analogue of PTH increased the production of reactive oxygen species in human endothelial cells. Thus, cinacalcet exhibits anti-oxidative activity through its pharmacological action. Additionally, cinacalcet itself showed radical scavenging activity. In conclusion, cinacalcet improves the redox status of HSA by inhibiting PTH production and partially by its radical scavenging action.
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Affiliation(s)
- Tadashi Imafuku
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | | | - Koki Tokunaga
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | | | - Hiromasa Kato
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | - Shoma Tanaka
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | - Takehiro Nakano
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | | | | | - Hitoshi Maeda
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | | | | | - Hirotaka Komaba
- Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine
| | - Masafumi Fukagawa
- Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine
| | - Hiroshi Watanabe
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
| | - Toru Maruyama
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University
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10
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Figueroa SM, Araos P, Reyes J, Gravez B, Barrera-Chimal J, Amador CA. Oxidized Albumin as a Mediator of Kidney Disease. Antioxidants (Basel) 2021; 10:antiox10030404. [PMID: 33800425 PMCID: PMC8000637 DOI: 10.3390/antiox10030404] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 12/19/2022] Open
Abstract
Renal diseases are a global health concern, and nearly 24% of kidney disease patients are overweight or obese. Particularly, increased body mass index has been correlated with oxidative stress and urinary albumin excretion in kidney disease patients, also contributing to increased cardiovascular risk. Albumin is the main plasma protein and is able to partially cross the glomerular filtration barrier, being reabsorbed mainly by the proximal tubule through different mechanisms. However, it has been demonstrated that albumin suffers different posttranslational modifications, including oxidation, which appears to be tightly linked to kidney damage progression and is increased in obese patients. Plasma-oxidized albumin levels correlate with a decrease in estimated glomerular filtration rate and an increase in blood urea nitrogen in patients with chronic kidney disease. Moreover, oxidized albumin in kidney disease patients is independently correlated with higher plasma levels of transforming growth factor beta (TGF-β1), tumor necrosis factor (TNF-α), and interleukin (IL)-1β and IL-6. In addition, oxidized albumin exerts a direct effect on neutrophils by augmenting the levels of neutrophil gelatinase-associated lipocalin, a well-accepted biomarker for renal damage in patients and in different experimental settings. Moreover, it has been suggested that albumin oxidation occurs at early stages of chronic kidney disease, accelerating the patient requirements for dialytic treatment during disease progression. In this review, we summarize the evidence supporting the role of overweight- and obesity-induced oxidative stress as a critical factor for the progression of renal disease and cardiovascular morbimortality through albumin oxidation.
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Affiliation(s)
- Stefanny M. Figueroa
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
| | - Patricio Araos
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
| | - Javier Reyes
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
| | - Basile Gravez
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
| | - Jonatan Barrera-Chimal
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
- Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | - Cristián A. Amador
- Laboratory of Renal Physiopathology, Institute of Biomedical Sciences, Universidad Autónoma de Chile, Santiago 8910060, Chile; (S.M.F.); (P.A.); (J.R.); (B.G.)
- Correspondence: ; Tel.: +56-22-303-6662
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11
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Plasma Protein Carbonyls as Biomarkers of Oxidative Stress in Chronic Kidney Disease, Dialysis, and Transplantation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:2975256. [PMID: 33299524 PMCID: PMC7707964 DOI: 10.1155/2020/2975256] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/03/2020] [Accepted: 10/13/2020] [Indexed: 02/07/2023]
Abstract
Accumulating evidence indicates that oxidative stress plays a role in the pathophysiology of chronic kidney disease (CKD) and its progression; during renal replacement therapy, oxidative stress-derived oxidative damage also contributes to the development of CKD systemic complications, such as cardiovascular disease, hypertension, atherosclerosis, inflammation, anaemia, and impaired host defence. The main mechanism underlying these events is the retention of uremic toxins, which act as a substrate for oxidative processes and elicit the activation of inflammatory pathways targeting endothelial and immune cells. Due to the growing worldwide spread of CKD, there is an overwhelming need to find oxidative damage biomarkers that are easy to measure in biological fluids of subjects with CKD and patients undergoing renal replacement therapy (haemodialysis, peritoneal dialysis, and kidney transplantation), in order to overcome limitations of invasive monitoring of CKD progression. Several studies investigated biomarkers of protein oxidative damage in CKD, including plasma protein carbonyls (PCO), the most frequently used biomarker of protein damage. This review provides an up-to-date overview on advances concerning the correlation between plasma protein carbonylation in CKD progression (from stage 1 to stage 5) and the possibility that haemodialysis, peritoneal dialysis, and kidney transplantation improve plasma PCO levels. Despite the fact that the role of plasma PCO in CKD is often underestimated in clinical practice, emerging evidence highlights that plasma PCO can serve as good biomarkers of oxidative stress in CKD and substitutive therapies. Whether plasma PCO levels merely serve as biomarkers of CKD-related oxidative stress or whether they are associated with the pathogenesis of CKD complications deserves further evaluation.
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12
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Amano H, Yoshimura K, Iijima R, Waki K, Matsumoto K, Ueda H, Ito Y, Akimoto K, Yokoo T, Inoue K, Terawaki H. A Slight Decrease in the Serum Albumin Level Is Associated with the Rapid Progression of Kidney Dysfunction, Even within the Normal Range. Intern Med 2020; 59:2679-2685. [PMID: 32669489 PMCID: PMC7691045 DOI: 10.2169/internalmedicine.4466-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objective A low-normal albumin level is associated with a high risk of cardiovascular disease and mortality in the general population. However, the relationship between the serum albumin level and the future decline in the kidney function is unclear. We evaluated the effect of the serum albumin level on the decline in the kidney function in the general population. Methods The data used were from 11,000 participants in a voluntary health checkup program conducted between 1998 and 2006 in Japan. The primary outcome for the kidney function was a difference in the estimated glomerular filtration rate (ΔeGFR) of≥3 mL/min/1.73 m2/year. The association of the risk of a decreased kidney function with the albumin level was determined using a logistic regression analysis. We fit separate multivariable logistic regressions for the serum albumin levels (g/dL) as a continuous variable and as categorical data, classified as ≤4.3 (n=2,530), 4.4-4.6 (n=5,427), and≥4.7 (n=3,043). Results Of the 11,000 participants, 346 had a ΔeGFR/year of≥3. Compared with the participants with albumin levels of≥4.7 g/dL, the risk of a decline in the kidney function was higher not only in those with albumin levels of ≤4.3 g/dL [adjusted odds ratio (OR) =2.10, 95% confidence interval (CI): 1.20-2.93] but also in those with levels of 4.4-4.6 g/dL (adjusted OR=1.53, 95% CI: 1.14-2.05). Conclusion A decreased albumin level is an independent risk factor for a rapid decline in the kidney function, even within the normal range.
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Affiliation(s)
- Hoichi Amano
- Graduate School of Public Health, Teikyo University, Japan
- Division of Nephrology and Hypertension, The Jikei University School of Medicine, Japan
| | - Kazunobu Yoshimura
- Department of Internal Medicine, Nephrology, Teikyo University Chiba Medical Center, Japan
| | - Ryutaro Iijima
- Department of Internal Medicine, Nephrology, Teikyo University Chiba Medical Center, Japan
| | - Kaito Waki
- Department of Internal Medicine, Nephrology, Teikyo University Chiba Medical Center, Japan
| | - Keisei Matsumoto
- Department of Internal Medicine, Nephrology, Teikyo University Chiba Medical Center, Japan
| | - Hitomi Ueda
- Department of Internal Medicine, Nephrology, Teikyo University Chiba Medical Center, Japan
| | - Yasuko Ito
- Department of Internal Medicine, Nephrology, Teikyo University Chiba Medical Center, Japan
| | | | - Takashi Yokoo
- Division of Nephrology and Hypertension, The Jikei University School of Medicine, Japan
| | - Kazuo Inoue
- Department of Community Medicine, Teikyo University Chiba Medical Center, Japan
| | - Hiroyuki Terawaki
- Department of Internal Medicine, Nephrology, Teikyo University Chiba Medical Center, Japan
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13
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Weighted gene co-expression network analysis of chronic kidney disease and hemodialysis patients. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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14
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Tanaka R, Imafuku T, Suzuki Y, Nishida K, Matsusaka K, Shin T, Sato Y, Ishima Y, Watanabe H, Mimata H, Maruyama T, Itoh H. Changes in redox state of albumin before and after kidney transplantation in patients with end-stage renal disease. Clin Biochem 2020; 81:20-26. [PMID: 32380091 DOI: 10.1016/j.clinbiochem.2020.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/12/2020] [Accepted: 04/29/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Cardiovascular disease is one of the major causes of death in patients with end-stage kidney disease who have undergone kidney transplantation. Since the complication of cardiovascular disease in patients with chronic kidney disease is strongly linked to oxidative stress, understanding the oxidative stress condition after kidney transplantation would be of great importance for the prevention of cardiovascular disease. This study examined whether improvement of renal function after kidney transplantation has an impact on the redox state of the Cys34 residue of albumin that reflects the level of oxidative stress in blood. DESIGN & METHODS We enrolled 23 patients with end-stage renal failure who received kidney transplantation. All patients were followed for 180 days after transplantation. The fractions of albumin isoforms were determined by the electrospray ionization time-of-flight mass spectrometry (ESI-TOFMS) method. RESULTS Serum creatinine decreased significantly immediately after kidney transplantation, suggesting successful transplantations. The ESI-TOFMS method identified three albumin isoforms cysteinylated at the Cys34 residue (Cys-Cys34-albumin) and the three corresponding albumin isoforms without Cys34 cysteinylation. The fraction of total Cys-Cys34-albumin decreased transiently after kidney transplantation, and was followed by an elevation at day 7 and gradual decrease thereafter until day 180. Meanwhile, reduced albumin concentration did not change until day 14 after kidney transplantation, then showed a significant increase compared to pre-transplant level at day 30 and remained stably elevated until day 180. CONCLUSIONS Actual reduced albumin levels were found to exceed pre-transplant levels on or after day 30 following kidney transplantation unlike immediate restoration of renal function. Renal function was recovered immediately following kidney transplantation, but reduced albumen concentration increased above the pre-transplant levels only from day 30 after transplantation.
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Affiliation(s)
- Ryota Tanaka
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Hasama-machi, Oita 879-5593, Japan.
| | - Tadashi Imafuku
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan
| | - Yosuke Suzuki
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Hasama-machi, Oita 879-5593, Japan
| | - Kento Nishida
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan
| | - Kotaro Matsusaka
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan
| | - Toshitaka Shin
- Department of Urology, Faculty of Medicine, Oita University, Hasama-machi, Oita 879-5593, Japan
| | - Yuhki Sato
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Hasama-machi, Oita 879-5593, Japan
| | - Yu Ishima
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan; Center for Clinical Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan
| | - Hiroshi Watanabe
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan; Center for Clinical Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan
| | - Hiromitsu Mimata
- Department of Urology, Faculty of Medicine, Oita University, Hasama-machi, Oita 879-5593, Japan
| | - Toru Maruyama
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan; Center for Clinical Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan
| | - Hiroki Itoh
- Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Hasama-machi, Oita 879-5593, Japan
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15
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Ward RA, Beck W, Bernardo AA, Alves FC, Stenvinkel P, Lindholm B. Hypoalbuminemia: a price worth paying for improved dialytic removal of middle-molecular-weight uremic toxins? Nephrol Dial Transplant 2020; 34:901-907. [PMID: 30102329 DOI: 10.1093/ndt/gfy236] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Indexed: 01/17/2023] Open
Abstract
Hemodiafiltration (HDF) increases the removal of middle-molecular-weight uremic toxins and may improve outcomes in patients with end-stage kidney disease (ESKD), but it requires complex equipment and comes with risks associated with infusion of large volumes of substitution solution. New high-flux hemodialysis membranes with improved diffusive permeability profiles do not have these limitations and offer an attractive alternative to HDF. However, both strategies are associated with increased albumin loss into the dialysate, raising concerns about the potential for decreased serum albumin concentrations that have been associated with poor outcomes in ESKD. Many factors can contribute to hypoalbuminemia in ESKD, including protein energy wasting, inflammation, volume expansion, renal loss and loss into the dialysate; of these factors, loss into the dialysate is not necessarily the most important. Furthermore, recent studies suggest that mild hypoalbuminemia per se is not an independent predictor of increased mortality in dialysis patients, but in combination with inflammation it is a poor prognostic sign. Thus, whether hypoalbuminemia predisposes to increased morbidity and mortality may depend on the presence or absence of inflammation. In this review we summarize recent findings on the role of dialysate losses in hypoalbuminemia and the importance of concomitant inflammation on outcomes in patients with ESKD. Based on these findings, we discuss whether hypoalbuminemia may be a price worth paying for increased dialytic removal of middle-molecular-weight uremic toxins.
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Affiliation(s)
| | - Werner Beck
- R&D, Baxter International Inc., Hechingen, Germany
| | | | - Filipa C Alves
- Department of Nephrology, Hospital Espírito Santo, Évora, Portugal.,Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Lindholm
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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16
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Kurano M, Yasukawa K, Ikeda H, Aoki J, Yatomi Y. Redox state of albumin affects its lipid mediator binding characteristics. Free Radic Res 2019; 53:892-900. [DOI: 10.1080/10715762.2019.1641603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Makoto Kurano
- Department of Clinical Laboratory, Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiko Yasukawa
- Department of Clinical Laboratory, Medicine, The University of Tokyo, Tokyo, Japan
| | - Hitoshi Ikeda
- Department of Clinical Laboratory, Medicine, The University of Tokyo, Tokyo, Japan
| | - Junken Aoki
- Laboratory of Molecular and Cellular Biochemistry, Graduate School of Pharmaceutical Sciences, Tohoku University, Miyagi, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, Medicine, The University of Tokyo, Tokyo, Japan
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17
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Uremic Toxin Concentrations are Related to Residual Kidney Function in the Pediatric Hemodialysis Population. Toxins (Basel) 2019; 11:toxins11040235. [PMID: 31022857 PMCID: PMC6521157 DOI: 10.3390/toxins11040235] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 12/15/2022] Open
Abstract
Protein-bound uremic toxins (PBUTs) play a role in the multisystem disease that children on hemodialysis (HD) are facing, but little is known about their levels and protein binding (%PB). In this study, we evaluated the levels and %PB of six PBUTs cross-sectionally in a large pediatric HD cohort (n = 170) by comparing these with healthy and non-dialysis chronic kidney disease (CKD) stage 4-5 (n = 24) children. In parallel β2-microglobulin (β2M) and uric acid (UA) were evaluated. We then explored the impact of age and residual kidney function on uremic toxin levels and %PB using analysis of covariance and Spearman correlation coefficients (rs). We found higher levels of β2M, p-cresyl glucuronide (pCG), hippuric acid (HA), indole acetic acid (IAA), and indoxyl sulfate (IxS) in the HD compared to the CKD4-5 group. In the HD group, a positive correlation between age and pCG, HA, IxS, and pCS levels was shown. Residual urine volume was negatively correlated with levels of β2M, pCG, HA, IAA, IxS, and CMPF (rs -0.2 to -0.5). In addition, we found overall lower %PB of PBUTs in HD versus the CKD4-5 group, and showed an age-dependent increase in %PB of IAA, IxS, and pCS. Furhtermore, residual kidney function was overall positively correlated with %PB of PBUTs. In conclusion, residual kidney function and age contribute to PBUT levels and %PB in the pediatric HD population.
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18
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Fujii R, Ueyama J, Kanno T, Suzuki K, Hamajima N, Wakai K, Hasegawa Y, Kondo T. Human serum albumin redox state is associated with decreased renal function in a community-dwelling population. Am J Physiol Renal Physiol 2018; 316:F214-F218. [PMID: 30427221 DOI: 10.1152/ajprenal.00138.2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The redox state of human serum albumin (HSA) has attracted interest as a possible biomarker for oxidative stress (OS) in humans. Although previous studies on this topic have taken only clinical settings into consideration, evidence of its efficacy in nonclinical settings remains to be established. The present study aimed to examine and validate the relationship between HSA redox state and renal function in a rural Japanese population. We analyzed two independent data sets from health checkup programs conducted in 2013 and 2016: one for discovery ( n = 267) and the other for replication ( n = 367). The fraction of human mercaptalbumin (HMA) to total HSA [f(HMA)] was determined using our revised method of high-performance liquid chromatography with post-column bromocresol green. The estimated glomerular filtration rate (eGFR) was calculated based on each individual's serum creatinine value, sex, and age. Adjustment for potential confounders revealed positive associations of fraction of human mercaptalbumin [f(HMA)] with eGFR in the discovery and replication analyses ( P < 0.001 and P = 0.03, respectively). Multivariate logistic regression analyses demonstrated significant inverse associations between renal dysfunction (defined as eGFR < 60 ml·min-1·1.73 m-2) and f(HMA) by a factor of 0.50 and 0.65 (confidence intervals of 0.26-0.91 and 0.37-1.00), respectively, with a unit of 10% f(HMA). Our results indicate that HSA redox state is consistently associated with renal dysfunction in both clinical and nonclinical settings.
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Affiliation(s)
- Ryosuke Fujii
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Jun Ueyama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Takuya Kanno
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Koji Suzuki
- Faculty of Medical Technology, Fujita Health University School of Health Sciences, Toyoake, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Yukiharu Hasegawa
- Department of Rehabilitation, Kansai University of Welfare Sciences, Kashiwara, Japan
| | - Takaaki Kondo
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya , Japan
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19
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Non-mercaptalbumin, Oxidized Form of Serum Albumin, Significantly Associated with Renal Function and Anemia in Chronic Kidney Disease Patients. Sci Rep 2018; 8:16796. [PMID: 30429539 PMCID: PMC6235854 DOI: 10.1038/s41598-018-35177-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/30/2018] [Indexed: 12/11/2022] Open
Abstract
Oxidative stress plays a major role in development of cardiovascular disease in patients with chronic kidney disease (CKD). Human mercaptalbumin (HMA), a reduced form of serum albumin, and non-mercaptalbumin (HNA), an oxidized form of serum albumin, are known as indicators for evaluating oxidative stress in systemic circulation, including end-stage renal disease cases. We investigated factors associated with fraction of HNA [f(HNA)] in 112 pre-dialysis CKD patients (63.6 ± 14.0 years old; 59 males, 53 females) using a newly established anion-exchange column packed with hydrophilic polyvinyl alcohol gel as well as high performance liquid chromatography. Mean f(HNA) in our CKD patients was 30.0 ± 6.1%, higher than that previously reported for healthy subjects. In multiple regression analysis, age (β = 0.200, p = 0.014), eGFR (β = −0.238, p = 0.009), hemoglobin (β = −0.346, p < 0.001), and ferritin (β = 0.200, p = 0.019) were significantly and independently associated with f(HNA) (R2 = 0.356, p < 0.001). In addition, factors related to CKD-mineral and bone disorder (CKD-MBD), including intact-PTH (β = 0.218, p = 0.049) and 1,25-dihydroxyvitamin D (1,25(OH)2D) (β = −0.178, p = 0.040), were significantly and independently associated with serum f(HNA) (R2 = 0.339, p < 0.001), whereas fibroblast growth factor-23 was not. These findings indicate the importance of management of hemoglobin and ferritin levels, as well as appropriate control of CKD-MBD factors for a better redox state of serum albumin in CKD patients.
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20
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Bocedi A, Cattani G, Stella L, Massoud R, Ricci G. Thiol disulfide exchange reactions in human serum albumin: the apparent paradox of the redox transitions of Cys34. FEBS J 2018; 285:3225-3237. [DOI: 10.1111/febs.14609] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/05/2018] [Accepted: 07/18/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Alessio Bocedi
- Department of Chemical Sciences and Technologies University of Rome Tor Vergata Italy
| | - Giada Cattani
- Department of Chemical Sciences and Technologies University of Rome Tor Vergata Italy
| | - Lorenzo Stella
- Department of Chemical Sciences and Technologies University of Rome Tor Vergata Italy
| | - Renato Massoud
- Department of Experimental Medicine and Surgery University of Rome Tor Vergata Italy
| | - Giorgio Ricci
- Department of Chemical Sciences and Technologies University of Rome Tor Vergata Italy
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21
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Plasma Protein Carbonylation in Haemodialysed Patients: Focus on Diabetes and Gender. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:4149681. [PMID: 30057679 PMCID: PMC6051011 DOI: 10.1155/2018/4149681] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/30/2018] [Indexed: 12/14/2022]
Abstract
Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) experience oxidative/carbonyl stress, which is postulated to increase after the HD session. The influence of diabetes mellitus and sex on oxidation of plasma proteins in ESRD has not yet been clarified despite that diabetic nephropathy is the most common cause of ESRD in developed and developing countries and despite the increasingly emerging differences between males and females in epidemiology, pathophysiology, clinical manifestations, and outcomes for several diseases. Therefore, this study aimed to evaluate the possible effect of type 2 diabetes mellitus, gender, and dialysis filter on plasma level of protein carbonyls (PCO) in ESRD patients at the beginning and at the end of a single HD session. Results show that mean post-HD plasma PCO levels are significantly higher than mean pre-HD plasma PCO levels and that the type of dialysis filter and dialysis technique are unrelated to plasma PCO levels. The mean level of plasma PCO after a HD session increases slightly but significantly in nondiabetic ESRD patients compared to diabetic ones, whereas it increases more markedly in women than in men. These novel findings suggest that women with ESRD are more susceptible than men to oxidative/carbonyl stress induced by HD.
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22
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Duni A, Liakopoulos V, Rapsomanikis KP, Dounousi E. Chronic Kidney Disease and Disproportionally Increased Cardiovascular Damage: Does Oxidative Stress Explain the Burden? OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:9036450. [PMID: 29333213 PMCID: PMC5733207 DOI: 10.1155/2017/9036450] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/18/2017] [Indexed: 02/07/2023]
Abstract
Chronic kidney disease (CKD) patients are among the groups at the highest risk for cardiovascular disease and significantly shortened remaining lifespan. CKD enhances oxidative stress in the organism with ensuing cardiovascular damage. Oxidative stress in uremia is the consequence of higher reactive oxygen species (ROS) production, whereas attenuated clearance of pro-oxidant substances and impaired antioxidant defenses play a complementary role. The pathophysiological mechanism underlying the increased ROS production in CKD is at least partly mediated by upregulation of the intrarenal angiotensin system. Enhanced oxidative stress in the setting of the uremic milieu promotes enzymatic modification of circulating lipids and lipoproteins, protein carbamylation, endothelial dysfunction via disruption of nitric oxide (NO) pathways, and activation of inflammation, thus accelerating atherosclerosis. Left ventricular hypertrophy (LVH) and heart failure are hallmarks of CKD. NADPH oxidase activation, xanthine oxidase, mitochondrial dysfunction, and NO-ROS are the main oxidative pathways leading to LVH and the cardiorenal syndrome. Finally, a subset of antioxidant enzymes, the paraoxonases (PON), deserves special attention due to abundant clinical evidence accumulated regarding reduced serum PON1 activity in CKD as a contributor to the increased burden of cardiovascular disease. Future, meticulously designed studies are needed to assess the effects of antioxidant therapy on patients with CKD.
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Affiliation(s)
- Anila Duni
- Department of Nephrology, Medical School of the University of Ioannina, Ioannina, Greece
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Evangelia Dounousi
- Department of Nephrology, Medical School of the University of Ioannina, Ioannina, Greece
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Nagai K, Tsuchida K, Ishihara N, Minagawa N, Ichien G, Yamada S, Hirose D, Michiwaki H, Kanayama HO, Doi T, Minakuchi J. Implications of Albumin Leakage for Survival in Maintenance Hemodialysis Patients: A 7-year Observational Study. Ther Apher Dial 2017; 21:378-386. [PMID: 28452109 DOI: 10.1111/1744-9987.12526] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 12/17/2016] [Accepted: 12/26/2016] [Indexed: 11/27/2022]
Abstract
Albumin leakage during hemodialysis (HD) presents a clinical dilemma. However, protein-binding uremic toxins are suggested to be responsible for increased mortality. No one has investigated the relationship between albumin leakage and mortality. Therefore, the purpose of this observational study was to analyze the association of albumin leakage with mortality in 690 HD patients who survived one year after enrollment. They were divided to three groups who received HD with large (3 g or more per HD session), middle (1 to 3 g) or small (less than 1 g) amount of albumin leakage, respectively. A propensity score analysis minimizing indication bias was performed. Consequently, in a 7-year observation period, 212 patients died. Albumin leakage 3 g or more per HD session provided better prognosis than albumin leakage less than 3 g per HD session. In conclusion, clinically acceptable large albumin leakage provides beneficial effects on mortality in maintenance HD patients.
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Affiliation(s)
- Kojiro Nagai
- Department of Nephrology, Tokushima University Graduate School, Tokushima, Japan
| | - Kenji Tsuchida
- Department of Kidney Disease (Dialysis & Transplantation), Kawashima Hospital, Tokushima, Japan
| | - Noriyuki Ishihara
- Department of Kidney Disease (Dialysis & Transplantation), Kawashima Hospital, Tokushima, Japan
| | | | | | - Satoshi Yamada
- Department of Kidney Disease (Dialysis & Transplantation), Kawashima Hospital, Tokushima, Japan
| | - Daisuke Hirose
- Department of Kidney Disease (Dialysis & Transplantation), Kawashima Hospital, Tokushima, Japan
| | - Hiroyuki Michiwaki
- Department of Kidney Disease (Dialysis & Transplantation), Kawashima Hospital, Tokushima, Japan
| | - Hiro-Omi Kanayama
- Urology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Toshio Doi
- Department of Nephrology, Tokushima University Graduate School, Tokushima, Japan
| | - Jun Minakuchi
- Department of Kidney Disease (Dialysis & Transplantation), Kawashima Hospital, Tokushima, Japan
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Naldi M, Baldassarre M, Domenicali M, Bartolini M, Caraceni P. Structural and functional integrity of human serum albumin: Analytical approaches and clinical relevance in patients with liver cirrhosis. J Pharm Biomed Anal 2017; 144:138-153. [PMID: 28465079 DOI: 10.1016/j.jpba.2017.04.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/04/2017] [Accepted: 04/15/2017] [Indexed: 02/08/2023]
Abstract
Human serum albumin (HSA) is the most abundant circulating plasma protein. Besides a significant contribution to the osmotic pressure, it is also involved in the fine regulation of many other physiological processes, including the balance of the redox state, the inflammatory and/or immunological responses, and the pharmacokinetic and pharmacodynamics of many drugs. Growing evidence suggests that HSA undergoes structural and functional damage in diseases characterized by an enhanced systemic inflammatory response and oxidative stress, as it occurs in chronic liver disease. Based on their clinical relevance, this review provides a summary of the most common post-translational modifications affecting HSA structural integrity and functions and their clinical relevance in the field of liver disease. The review also provides a critical description of the analytical approaches employed for the investigation of conformational alterations and the identification/quantitation of specific post-translational modifications affecting HSA. Finally, the analytical methods available for the assessment of two of the most clinically relevant non-oncotic properties of HSA, namely the binding capacity and the antioxidant activity, are critically reviewed. Among the available techniques particular attention is given to those proposed for the in vitro and in vivo investigation of structurally modified albumin.
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Affiliation(s)
- Marina Naldi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, Via Belmeloro 6, 40126, Italy; Center for Applied Biomedical Research (C.R.B.A.), S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
| | - Maurizio Baldassarre
- Center for Applied Biomedical Research (C.R.B.A.), S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Italy
| | - Marco Domenicali
- Center for Applied Biomedical Research (C.R.B.A.), S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Italy
| | - Manuela Bartolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, Via Belmeloro 6, 40126, Italy
| | - Paolo Caraceni
- Center for Applied Biomedical Research (C.R.B.A.), S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Italy.
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Watanabe H, Imafuku T, Otagiri M, Maruyama T. Clinical Implications Associated With the Posttranslational Modification-Induced Functional Impairment of Albumin in Oxidative Stress-Related Diseases. J Pharm Sci 2017; 106:2195-2203. [PMID: 28302542 DOI: 10.1016/j.xphs.2017.03.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 02/08/2023]
Abstract
Recent research findings indicate that the posttranslational modification of human serum albumin (HSA) such as oxidation, glycation, truncation, dimerization, and carbamylation is related to certain types of diseases. We report herein on a simple and rapid analytical method, using an electrospray ionization time-of-flight mass spectrometry technique, that allows posttranslational modifications of HSA to be quantitatively and qualitatively evaluated with a high degree of sensitivity. In patients with chronic liver disease, chronic renal disease, and diabetes mellitus, an increase in the level of oxidized cysteine-34 (Cys-34) of HSA accompanied by a decrease in the level of reduced Cys-34 was observed. The redox status of Cys-34 was correlated with ligand binding and the antioxidative functions of HSA. Available evidence indicates that monitoring the redox state of Cys-34 not only could be a useful marker for evaluating the progression of disease and its complications but also would permit therapeutic efficacy to be predicted. The redox state of Cys-34 was also used as an index of the quality of HSA preparations. These data suggest that monitoring the posttranslational modifications of HSA can be important, because the function of HSA is related not only to its serum concentration but also to the preservation of its structural integrity under disease conditions.
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Affiliation(s)
- Hiroshi Watanabe
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, Kumamoto 862-0973, Japan; Center for Clinical Pharmaceutical Sciences, School of Pharmacy, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, Kumamoto 862-0973, Japan
| | - Tadashi Imafuku
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, Kumamoto 862-0973, Japan
| | - Masaki Otagiri
- Faculty of Pharmaceutical Sciences, Sojo University, 4-22-1 Ikeda, Nishi-ku, Kumamoto 860-0822, Japan; DDS Research Institute, Sojo University, 4-22-1 Ikeda, Nishi-ku, Kumamoto 860-0822, Japan
| | - Toru Maruyama
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, Kumamoto 862-0973, Japan; Center for Clinical Pharmaceutical Sciences, School of Pharmacy, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, Kumamoto 862-0973, Japan.
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Maeda K, Yoshizaki S, Iida T, Terada T, Era S, Sakashita K, Arikawa H. Improvement of the fraction of human mercaptalbumin on hemodialysis treatment using hydrogen-dissolved hemodialysis fluid: a prospective observational study. RENAL REPLACEMENT THERAPY 2016. [DOI: 10.1186/s41100-016-0054-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Nakayama M, Kabayama S, Ito S. The hydrogen molecule as antioxidant therapy: clinical application in hemodialysis and perspectives. RENAL REPLACEMENT THERAPY 2016. [DOI: 10.1186/s41100-016-0036-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Nagai K, Tsuchida K, Hirose D, Michiwaki H, Hann M, Kanayama HO, Doi T, Minakuchi J. The effect of albumin leakage in hemodialysis patients on redox status of serum albumin. J Artif Organs 2016; 19:310-4. [PMID: 27086124 DOI: 10.1007/s10047-016-0900-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/30/2016] [Indexed: 11/26/2022]
Abstract
Human mercaptoalbumin (HMA) is a reduced form of albumin that is associated with cardiovascular disease in dialysis patients. Albumin-leaky hemodialysis (HD) is increasingly recognized as a gold standard therapy because it is correlated with better prognosis compared to conventional HD. However, albumin-leaky HD induces low serum albumin concentration because of albumin leakage, which is a classical risk factor for mortality. The aim of this study was to explain the preferable prognosis in patients undergoing albumin-leaky HD with low serum albumin concentration. Ten HD patients were enrolled. They were preconditioned with albumin-non-leaky HD (mean albumin leakage: 1.0 g) for 2 months. Subsequently, albumin-leaky HD (9.1 g) was performed for 6 months, followed by relatively non-leaky HD (within 3.0 g). The ratio and level of HMA were evaluated. The amount of albumin leakage was related to the ratio of HMA, and inversely correlated with serum albumin concentration. The level of HMA was maintained regardless of albumin leakage. Regarding HMA level, a moderate amount of albumin leakage was acceptable. A stably maintained HMA level in albumin-leaky HD patients can contribute to preferable prognosis even if they have low serum albumin concentration.
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Affiliation(s)
- Kojiro Nagai
- Department of Nephrology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan.
| | - Kenji Tsuchida
- Department of Kidney Disease (Dialysis and Transplantation), Kawashima Hospital, 1-39, Kitasakoichiban-cho, Tokushima, 770-0011, Japan
| | - Daisuke Hirose
- Department of Kidney Disease (Dialysis and Transplantation), Kawashima Hospital, 1-39, Kitasakoichiban-cho, Tokushima, 770-0011, Japan
| | - Hiroyuki Michiwaki
- Department of Kidney Disease (Dialysis and Transplantation), Kawashima Hospital, 1-39, Kitasakoichiban-cho, Tokushima, 770-0011, Japan
| | - Michael Hann
- Department of Graduate Medical Education, Naval Medical Center San Diego, San Diego, CA, USA
| | - Hiro-Omi Kanayama
- Department of Urology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Toshio Doi
- Department of Nephrology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Jun Minakuchi
- Department of Kidney Disease (Dialysis and Transplantation), Kawashima Hospital, 1-39, Kitasakoichiban-cho, Tokushima, 770-0011, Japan
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Rusu CC, Racasan S, Kacso IM, Moldovan D, Potra A, Patiu IM, Vladutiu D, Caprioara MG. Malondialdehyde can predict survival in hemodialysis patients. ACTA ACUST UNITED AC 2016; 89:250-6. [PMID: 27152077 PMCID: PMC4849384 DOI: 10.15386/cjmed-537] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 09/08/2015] [Accepted: 09/22/2015] [Indexed: 01/11/2023]
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.
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Affiliation(s)
- Crina Claudia Rusu
- Department of Nephrology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simona Racasan
- Department of Dialysis, Nefromed Dialysis Center, Cluj-Napoca, Romania
| | - Ina Maria Kacso
- Department of Nephrology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Moldovan
- Department of Nephrology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alina Potra
- Department of Nephrology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Mihai Patiu
- Department of Dialysis, Nefromed Dialysis Center, Cluj-Napoca, Romania
| | - Dan Vladutiu
- Department of Nephrology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mirela Gherman Caprioara
- Department of Nephrology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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30
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Terawaki H, Yamagishi SI, Funakoshi Y, Matsuyama Y, Terada T, Nakayama K, Ogura M, Hosoya T, Ito S, Era S, Nakayama M. Pigment epithelium-derived factor as a new predictor of mortality among chronic kidney disease patients treated with hemodialysis. Ther Apher Dial 2013; 17:625-30. [PMID: 24330558 DOI: 10.1111/1744-9987.12020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pigment epithelium-derived factor (PEDF) plays a protective role against atherosclerosis. Although serum PEDF level is increased in patients undergoing regular hemodialysis (HD), the pathophysiological role of PEDF in HD patients is unknown. We measured serum PEDF levels in 74 HD patients, and the association between serum PEDF and adverse events such as all-cause death and cardiovascular accident was evaluated prospectively. During the follow up of 45.4 ± 25.1 months, 24 patients (32.4%) experienced cardiovascular accident and 18 (24.3%) died. Significantly higher incidences of all-cause mortality and cardiovascular accident were observed in the lower PEDF group than in the higher PEDF group. After adjusting for propensity score calculated from multiple confounding factors (age, gender, systolic blood pressure, history of previous cardiovascular disease, level of carbonyl content, albumin, hemoglobin, total cholesterol, creatinine, C-reactive protein, dialysis vintage, Kt/V-urea and history of diabetes), lower predialytic PEDF was a significant risk factor for all-cause mortality (relative hazard = 6.060, standard error = 0.68467, P = 0.0085). Lower levels of predialytic PEDF was associated with an increased risk of mortality.
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Affiliation(s)
- Hiroyuki Terawaki
- Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan
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31
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Terawaki H, Zhu WJ, Matsuyama Y, Terada T, Takahashi Y, Sakurai K, Kabayama S, Miyazaki M, Itami N, Nakazawa R, Ito S, Era S, Nakayama M. Effect of a hydrogen (H2)-enriched solution on the albumin redox of hemodialysis patients. Hemodial Int 2013; 18:459-66. [PMID: 24274030 DOI: 10.1111/hdi.12112] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Elevated oxidative stress (OS) is associated with severe cardiovascular disease and premature death among patients treated with hemodialysis (HD). Oxidative stress is enhanced by contact between blood and dialysis membranes during HD sessions. This study aimed to clarify whether hydrogen (H2), which is a known antioxidant, is capable of suppressing increased OS induced during HD sessions. Eight patients on regular HD treatment were studied. Two HD sessions were performed in a cross-over design trial using standard and hydrogen-enriched solutions (mean of 50 p.p.b. H2; H2-HD). Blood samples were obtained from the inlet and outlet of the dialyzer during HD to determine changes in plasma levels of glutathione, hydrogen peroxide, and albumin redox state as a marker of OS. Comparison of inlet and outlet blood revealed significant decreases in total glutathione and reduced glutathione, as well as significant increases in hydrogen peroxide in both HD treatments. However, the mean proportion of reversibly oxidized albumin in outlet serum was significantly lower than that in inlet serum following the H2-HD session, whereas no significant changes were found in the standard solution session, suggesting that "intra-dialyzer" OS is reduced by H2 -HD. In conclusion, the application of H2-enriched solutions could ameliorate OS during HD.
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Turell L, Botti H, Bonilla L, Torres MJ, Schopfer F, Freeman BA, Armas L, Ricciardi A, Alvarez B, Radi R. HPLC separation of human serum albumin isoforms based on their isoelectric points. J Chromatogr B Analyt Technol Biomed Life Sci 2013; 944:144-151. [PMID: 24316526 DOI: 10.1016/j.jchromb.2013.11.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 11/05/2013] [Accepted: 11/09/2013] [Indexed: 12/31/2022]
Abstract
Human serum albumin (HSA) is the most abundant protein in plasma. Cys34, the only free Cys residue, is the predominant plasma thiol and a relevant sacrificial antioxidant. Both in vivo circulating HSA and pharmaceutical preparations are heterogeneous with respect to the oxidation state of Cys34. In this work, we developed an external pH gradient chromatofocusing procedure that allows the analysis of the oxidation status of HSA in human plasma and biopharmaceutical products based on the different apparent isoelectric points and chemical properties of the redox isoforms. Specifically, reduced-mercury blocked HSA (HSA-SHg(+)), HSA with Cys34 oxidized to sulfenic acid (HSA-SOH) and HSA oxidized to sulfinate anion (HSA-SO2(-)) can be separated with resolutions of 1.4 and 3.1 (first and last pair) and hence quantified and purified. In addition, an N-terminally degraded isoform (HSA3-585) in different redox states can be resolved as well. Confirmation of the identity of the chromatofocusing isolated isoforms was achieved by high resolution whole protein MS. It is proposed that the chromatofocusing procedure can be used to produce more exact and complete descriptions of the redox status of HSA in vivo and in vitro. Finally, the scalability capabilities of the chromatofocusing procedure allow for the preparation of highly pure standards of several redox isoforms of HSA.
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Affiliation(s)
- Lucía Turell
- Laboratorio de Enzimología, Facultad de Ciencias, Universidad de la República, Montevideo, 11400, Uruguay.,Laboratorio de Fisicoquímica Biológica, Facultad de Ciencias, Universidad de la República, Montevideo, 11400, Uruguay.,Center for Free Radical and Biomedical Research, Universidad de la República, Montevideo, 11800, Uruguay
| | - Horacio Botti
- Center for Free Radical and Biomedical Research, Universidad de la República, Montevideo, 11800, Uruguay.,Unidad de Cristalografía de Proteínas, Institut Pasteur de Montevideo, Montevideo, 11400, Uruguay
| | - Lucía Bonilla
- Center for Free Radical and Biomedical Research, Universidad de la República, Montevideo, 11800, Uruguay.,Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Montevideo, 11800, Uruguay
| | - María José Torres
- Laboratorio de Enzimología, Facultad de Ciencias, Universidad de la República, Montevideo, 11400, Uruguay.,Center for Free Radical and Biomedical Research, Universidad de la República, Montevideo, 11800, Uruguay
| | - Francisco Schopfer
- Department of Pharmacology and Chemical Biology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Bruce A Freeman
- Department of Pharmacology and Chemical Biology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Larissa Armas
- Laboratorio de Biofármacos: Control de Calidad y Desarrollo, Institut Pasteur de Montevideo, Montevideo, 11400, Uruguay
| | - Alejandro Ricciardi
- Laboratorio de Biofármacos: Control de Calidad y Desarrollo, Institut Pasteur de Montevideo, Montevideo, 11400, Uruguay
| | - Beatriz Alvarez
- Laboratorio de Enzimología, Facultad de Ciencias, Universidad de la República, Montevideo, 11400, Uruguay.,Center for Free Radical and Biomedical Research, Universidad de la República, Montevideo, 11800, Uruguay
| | - Rafael Radi
- Center for Free Radical and Biomedical Research, Universidad de la República, Montevideo, 11800, Uruguay.,Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Montevideo, 11800, Uruguay
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Sridhar NR, Josyula S. Hypoalbuminemia in hemodialyzed end stage renal disease patients: risk factors and relationships--a 2 year single center study. BMC Nephrol 2013; 14:242. [PMID: 24499139 PMCID: PMC4029609 DOI: 10.1186/1471-2369-14-242] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 10/23/2013] [Indexed: 11/24/2022] Open
Abstract
Background Malnutrition affects 1/3 of hemodialysis patients and associates with a higher risk of morbidity and mortality. Serum albumin is a marker of nutrition and inflammation, and predicts mortality, particularly when <3.8 g/dL. This study was performed to identify risk factors for hypoalbuminemia (<3.8 g/dL) and the particular temporal relationship and strength of association between protein intake (nPCR) and serum albumin when confounding variables are taken into account. Methods Demographic, clinical, and dialysis-related data of 57 ESRD patients on hemodialysis over 24 months in 6 temporal segments were analyzed with serum albumin as a continuous, and categorical outcome (with 3.8 g/dl as cut-off) variable , against 13 potential independent variables [4 demographic factors, 3 nutrition-related, and 5 morbidity-related parameters, and % urea reduction ratio (URR)]. The temporal relationships between albumin and nPCR were analyzed for the concurrent & 3 subsequent months in each temporal segment. Results The impact of nPCR on serum albumin (p < 0.05) was significant but with no discernible temporal relationship. Advancing age, longer vintage, female gender, diabetes mellitus, nPCR, serum phosphate and ferritin had significant correlation with albumin <3.8 g/dl (p < 0.05). Serum phosphate levels correlated positively, and fever, bacteremia, hospital stay and weight loss negatively, with mean serum albumin but did not negate the effect of nPCR. Regression analysis showed that mean albumin associated with nPCR, fever, hospital stay, bacteremia, dialysis vintage, age, sex, and diabetes mellitus; and that an albumin level of <3.8 g/dl associated with age, female sex, diabetes, lower nPCR, and higher ferritin. Conclusion Suggested target albumin levels were not met in elderly, female, and diabetic patients. The association of nPCR with albumin was not nullified by confounding demographic or morbidity-related factors. nPCR had no demonstrable temporal relationship with albumin.
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Affiliation(s)
- Nagaraja Rao Sridhar
- Department of Internal Medicine (Nephrology), Buffalo General Hospital, University at Buffalo, and Buffalo Medical Group, 85 High Street, Buffalo, New York, USA.
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Lim PS, Jeng Y, Wu MY, Pai MA, Wu TK, Liu CS, Chen CH, Kuo YC, Chien SW, Chen HP. Serum oxidized albumin and cardiovascular mortality in normoalbuminemic hemodialysis patients: a cohort study. PLoS One 2013; 8:e70822. [PMID: 23923025 PMCID: PMC3726598 DOI: 10.1371/journal.pone.0070822] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 06/24/2013] [Indexed: 11/26/2022] Open
Abstract
Background Substantial 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. Methods We 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. Results After 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. Conclusions Serum 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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Affiliation(s)
- Paik Seong Lim
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
- Department of Food and Nutrition, Providence University, Taichung, Taiwan
| | - Yachung Jeng
- Division of Epidemiology and Biostatistics, Department of Medical Research, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
- * E-mail:
| | - Ming Ying Wu
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
| | - Mei-Ann Pai
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
| | - Tsai-Kun Wu
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
| | - Chia-San Liu
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
| | - Chan Hsu Chen
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
| | - Yuan-Chuan Kuo
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
| | - Shiaw-Wen Chien
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
| | - Hung Ping Chen
- Division of Renal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung, Taiwan
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Terawaki H, Hayashi Y, Zhu WJ, Matsuyama Y, Terada T, Kabayama S, Watanabe T, Era S, Sato B, Nakayama M. Transperitoneal administration of dissolved hydrogen for peritoneal dialysis patients: a novel approach to suppress oxidative stress in the peritoneal cavity. Med Gas Res 2013; 3:14. [PMID: 23816239 PMCID: PMC3734057 DOI: 10.1186/2045-9912-3-14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 06/12/2013] [Indexed: 12/25/2022] Open
Abstract
Background Oxidative stress (OS) related to glucose degradation products such as methylglyoxal is reportedly associated with peritoneal deterioration in patients treated with peritoneal dialysis (PD). However, the use of general antioxidant agents is limited due to their harmful effects. This study aimed to clarify the influence of the novel antioxidant molecular hydrogen (H2) on peritoneal OS using albumin redox state as a marker. Methods Effluent and blood samples of 6 regular PD patients were obtained during the peritoneal equilibrium test using standard dialysate and hydrogen-enriched dialysate. The redox state of albumin in effluent and blood was determined using high-performance liquid chromatography. Results Mean proportion of reduced albumin (ƒ(HMA)) in effluent was significantly higher in H2-enriched dialysate (62.31 ± 11.10%) than in standard dialysate (54.70 ± 13.08%). Likewise, serum ƒ(HMA) after administration of hydrogen-enriched dialysate (65.75 ± 7.52%) was significantly higher than that after standard dialysate (62.44 ± 7.66%). Conclusions Trans-peritoneal administration of H2 reduces peritoneal and systemic OS.
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Colombo G, Clerici M, Giustarini D, Rossi R, Milzani A, Dalle-Donne I. Redox albuminomics: oxidized albumin in human diseases. Antioxid Redox Signal 2012; 17:1515-27. [PMID: 22587567 DOI: 10.1089/ars.2012.4702] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
SIGNIFICANCE Albumin is the major contributor to colloid oncotic pressure and also serves as an important carrier protein of many endogenous and exogenous molecules throughout the body. In blood and extravascular fluids, albumin is susceptible to different oxidative modifications, especially thiol oxidation and carbonylation. Because of its metal-binding properties and the redox properties of its Cys34 thiol, albumin displays an important antioxidant activity. As albumin is the predominant protein in most body fluids, its Cys34 represents the largest fraction of free thiols within body fluids. RECENT ADVANCES Evidence that albumin oxidation takes place in vivo has been reported only recently. Different redox proteomic, mass spectrometric, and chromatographic techniques have shown albumin redox modifications in various human pathophysiological conditions. As a whole, most data here presented demonstrate that massive albumin oxidation occurs in vivo in different biological fluids and, to some extent, that this process is correlated to organ dysfunction. CRITICAL ISSUES Recent reports suggest that the albumin redox state may serve as a global biomarker for the redox state in the body in various human diseases. However, further study is required to elucidate the exact relationship between albumin oxidation and pathology. In addition, it is unknown if some albumin oxidized forms may also have diagnostic uses. FUTURE DIRECTIONS Application of specific redox proteomics techniques for the characterization of oxidized albumin forms in screening studies is required. A further challenge will be to analyze how these oxidative albumin modifications are related to real impact to the body.
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Effect of allopurinol on cardiovascular incidence among hypertensive nephropathy patients: the Gonryo study. Clin Exp Nephrol 2012. [PMID: 23192770 DOI: 10.1007/s10157-012-0742-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The present study aimed to clarify the beneficial effect of allopurinol on cardiovascular morbidity and mortality in a cohort of hypertensive nephropathy patients with impaired kidney function. METHODS One hundred and seventy-eight patients diagnosed with hypertensive nephropathy and presenting with impaired kidney function (estimated glomerular filtration rate <45 mL/min/1.73 m(2)) were recruited from nephrology clinics. Oral allopurinol was prescribed in 67 of these patients. The effects of allopurinol use on the development of cardiovascular disease (i.e. ischemic heart disease, congestive heart failure, and stroke) and all-cause death was analyzed using the Cox proportional hazard model. RESULTS During the follow-up of 18.4 months (mean), 28 primary events occurred. Basal use of allopurinol was a significant beneficial factor (hazard ratio = 0.342, p = 0.0434, standard error = 0.53058) after adjusting for confounding factors. CONCLUSION The use of allopurinol in hypertensive subjects with impaired kidney function appears to be beneficial in preventing cardiovascular morbidity and all-cause mortality, indicating that this xanthine oxidase inhibitor protects the vascular system, at least in this specific group.
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Otsuki J, Nagai Y, Matsuyama Y, Terada T, Era S. The influence of the redox state of follicular fluid albumin on the viability of aspirated human oocytes. Syst Biol Reprod Med 2012; 58:149-53. [DOI: 10.3109/19396368.2012.675004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Terawaki H, Matsuyama Y, Matsuo N, Ogura M, Mitome J, Hamaguchi A, Terada T, Era S, Hosoya T. A lower level of reduced albumin induces serious cardiovascular incidence among peritoneal dialysis patients. Clin Exp Nephrol 2012; 16:629-35. [PMID: 22358613 DOI: 10.1007/s10157-012-0610-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Accepted: 01/30/2012] [Indexed: 01/08/2023]
Abstract
BACKGROUND Human serum albumin is composed of human mercaptoalbumin (HMA) with cysteine residues having reducing powers and of oxidized human non-mercaptoalbumin. Previously, we reported that a lower HMA level is closely related to serious cardiovascular disease (CVD) incidence and mortality among hemodialysis patients. However, the relationship between HMA level and CVD incidence among peritoneal dialysis (PD) patients is unclear. METHODS We measured the redox state of human serum albumin using high-performance liquid chromatography in 30 continuous ambulatory PD patients. The association between HMA and incidental CVD events was evaluated. RESULTS Eight patients experienced symptomatic CVD events (5 patients died) at the 5-year follow-up. The concentration and fraction of HMA (cHMA and f(HMA), respectively) showed significantly lower values in patients with CVD than those without CVD (cHMA 1.58 ± 0.39 and 2.16 ± 0.43 g/dL, f(HMA) 48.9 ± 5.4 and 56.4 ± 8.6%, respectively). Multiple forward stepwise regression analysis using cHMA and f(HMA) as the criterion variables was performed, and C-reactive protein and hemoglobin were adopted as significant explanatory variables in the former equation, whereas urea nitrogen was adopted in the latter equation. Multiple logistic regression analysis revealed that cHMA is a statistically, and f(HMA) is a marginally significant explanatory variable of CVD incidence (p = 0.0369, R = -0.260 and p = 0.0580, R = -0.214, respectively). CONCLUSIONS Lower HMA level, which might be caused by chronic inflammation, anemia and accumulation of dialyzable uremic toxin(s), is closely related to serious CVD incidence among PD patients.
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Affiliation(s)
- Hiroyuki Terawaki
- Division of Kidney and Hypertension, The Jikei University School of Medicine, Tokyo, Japan.
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Albarello K, dos Santos GA, Bochi GV, Sangoi MB, Almeida TC, Paz da Silva JE, Garcia SC, Moresco RN. Ischemia modified albumin and carbonyl protein as potential biomarkers of protein oxidation in hemodialysis. Clin Biochem 2012; 45:450-4. [PMID: 22342921 DOI: 10.1016/j.clinbiochem.2012.01.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 01/20/2012] [Accepted: 01/28/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of HD on ischemia modified albumin (IMA) and protein carbonyl groups in order to investigate the role of IMA as a marker of protein oxidation. DESIGN AND METHODS This study was conducted with 23 chronic hemodialysis patients. The serum IMA levels and protein carbonyl groups were measured immediately before hemodialysis (pre-HD) and after the end of hemodialysis (post-HD). RESULTS IMA concentrations were significantly higher in post-HD than those of the pre-HD and carbonyl protein concentrations were higher in post-HD in comparison with pre-HD. A significant correlation was observed between IMA and carbonyl protein levels. CONCLUSIONS The increase of IMA levels and protein carbonyl groups post-HD could be attributed to the increase of oxidative stress associated with HD, and IMA appears to be an important biomarker for assessing protein oxidation after HD.
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Affiliation(s)
- Kassiano Albarello
- Programa de Pós-Graduação em Hematologia e Hemoterapia, Centro de Ciências Biológicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
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Terawaki H, Era S, Nakayama M, Hosoya T. Decrease in Reduced-Form Albumin Among Chronic Kidney Disease Patients: New Insights in Cardiovascular Complications. Ther Apher Dial 2011; 15:156-60. [DOI: 10.1111/j.1744-9987.2010.00889.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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