title: Protective role of extracellular superoxide dismutase in hemodialysis patients.
abstract: BACKGROUND
  The superoxide anion and other oxygen radicals have been implicated in the progression of chronic renal failure, and are removed by extracellular superoxide dismutase (EC-SOD) in the extracellular space on the surface of the endothelium. A single-base substitution of the EC-SOD gene which reduces the binding capability to endothelial cells resulting in an increased serum concentration, has been identified in healthy persons and hemodialysis patients.
  
  
  RESULTS
  The proportion of patients with this mutation among hemodialysis patients in each 20 months' duration after the initiation of hemodialysis was retrospectively studied. The percentage of substitution-positive patients declined 80 months after the start of hemodialysis in non-DM patients. In contrast, in DM patients, the rapid decrease was obvious as early as 40 months after the initiation of hemodialysis. By prospective study for 5 years, there were significant differences in the survival rate between patients with and without R213G in DM, but not in non-DM patients. Among those who died, the incidence of ischemic heart disease and cerebrovascular disease in cases with R213G was significantly higher than in cases without R213G.
  
  
  CONCLUSIONS
  These results suggest that the presence of a substitution in the EC-SOD gene at the heparin-binding domain could be a prognostic marker of dialysis patients.
authors.affiliation: First Department of Internal Medicine, Aichi Medical University, Yazako-Karimata, Nagakute, Aichi, Japan. harutaka@amugw.aichi-med-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Yamada
authors.forename: Y
authors.initials: Y
authors.lastname: Yamada
authors.forename: T
authors.initials: T
authors.lastname: Adachi
authors.forename: A
authors.initials: A
authors.lastname: Fukatsu
authors.forename: M
authors.initials: M
authors.lastname: Sakuma
authors.forename: A
authors.initials: A
authors.lastname: Futenma
authors.forename: S
authors.initials: S
authors.lastname: Kakumu
mesh_terms: D002423:Cause of Death; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000201:enzymology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D013482:Superoxide Dismutase / Q000097:blood* / Q000235:genetics
chemical_list: D013482:Superoxide Dismutase