Serum malondialdehyde and coronary artery disease in hemodialysis patients.
OBJECTIVE
It has been suggested that enhanced oxidative stress participates in the acceleration of coronary artery disease (CAD) in patients with end-stage renal disease (ESRD). The aim of this study was to investigate the relationship between the level of malondialdehyde (MDA), which is a marker of lipid peroxidation, and the severity of CAD in ESRD patients.


METHODS
We conducted a study of 39 hemodialysis patients (median age 58 years; 27 males and 12 females; diabetics 44%). In these patients, the predialysis serum concentrations of MDA and C-reactive protein (CRP) were measured. We performed multirow spiral computed tomography to derive coronary artery calcification (CAC) scores, as a marker of CAD severity.


RESULTS
Eleven of the 39 patients had minimal CAC (28%, CAC score <10), 10 patients had mild to moderate CAC (26%, 10-400), and 18 patients had severe CAC (46%, >400). The MDA levels increased (p < 0.05) with increasing CAC category and were correlated (r = 0.35, p < 0.05) with the CAC scores. The levels of MDA also correlated with the serum concentrations of CRP and albumin (r = 0.34, p < 0.05 and r = -0.32, p < 0.05, respectively). Patients in the highest tertile of MDA compared with the other patients were over four times as likely to have severe CAC, and the highest tertile of MDA was an independent predictor of severe CAC, along with a previous cardiovascular event.


CONCLUSIONS
An increased level of MDA, which was associated with inflammatory markers, was a predictive factor for severe CAC in ESRD patients.
Jung
Hae Hyuk
HH
Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Kangwon-do, Republic of Korea. haehyuk@kangwon.ac.kr
Choi
Dae Hee
DH
Lee
Sang Hyun
SH
D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood* / Q000209:etiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008315:Malondialdehyde / Q000097:blood*; D008875:Middle Aged; D006435:Renal Dialysis; D012720:Severity of Illness Index; D013997:Time Factors
D008315:Malondialdehyde