Oxidative stress is enhanced in correlation with renal dysfunction: examination with the redox state of albumin.
BACKGROUND
Cardiovascular disease is known to be the most important complication among patients with renal failure, and oxidative stress has been proposed to play a major role as the source of such complications. Human serum albumin (HSA) is composed of human mercaptoalbumin (HMA) with cysteine residues having reducing powers, of reversibly oxidized human non-mercaptoalbumin-1 (HNA-1), and strongly oxidized human non-mercaptoalbumin-2 (HNA-2).


METHODS
We used the "redox state of HSA" as a marker to investigate the current status of oxidative stress in predialysis patients with renal failure. The subjects were 55 nondialysis patients (31 males and 24 females) with chronic renal diseases, and having various degrees of renal function. The subjects' redox state of HSA was determined by a high-performance liquid chromatographic (HPLC) procedure, and the results presented in terms of the ratios between HNA-total(HNA-1 + HNA-2) and HNA-2.


RESULTS
The values for each fraction of HNA-total (f(HNA-total)) and f(HNA-2) were increased with a decrease of renal functions, and a significant positive correlation with serum creatinine (R= 0.529, P < 0.0001 and R= 0.618, P < 0.0001) was detected. Multiple (forward stepwise) regression analysis using f(HNA-total) and f(HNA-2) as the criterion variables was performed, and creatinine was adopted as significant explanatory variable in both equations.


CONCLUSIONS
We found that even before dialysis, oxidative stress was enhanced in correlation with the level of renal dysfunction among patients with chronic renal failure. In the future, antioxidant strategies should become part of treatment for predialysis renal failure.
Terawaki
Hiroyuki
H
Department of Nephrology and Hypertension, Tokyo Jikei University School of Medicine, Tokyo, Japan. terawaki@jikei.ac.jp
Yoshimura
Kazunobu
K
Hasegawa
Toshio
T
Matsuyama
Yukie
Y
Negawa
Tsuneo
T
Yamada
Kenichi
K
Matsushima
Masato
M
Nakayama
Masaaki
M
Hosoya
Tatsuo
T
Era
Seiichi
S
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D018384:Oxidative Stress; D020033:Protein Isoforms / Q000097:blood; D051437:Renal Insufficiency / Q000097:blood / Q000378:metabolism*; D012709:Serum Albumin / Q000378:metabolism*; D000075462:Serum Albumin, Human
D015415:Biomarkers; D020033:Protein Isoforms; D012709:Serum Albumin; C079732:nonmercaptalbumin; D003404:Creatinine; D000075462:Serum Albumin, Human