Differences in ischemia-modified albumin levels between end stage renal disease patients and the normal population.
BACKGROUND
Conventional biomarkers suffer from the drawback of being elevated in chronic renal failure even in the absence of myocardial ischemia. Ischemia-modified albumin (IMA) is a new biomarker proposed for the diagnosis of myocardial ischemia. This study was performed with the primary aim of determining IMA levels in patients with end stage renal disease (ESRD). The secondary aim of the study was to determine the impact of hemodialysis (HD), HD speed, and hemoglobin (Hb) levels on IMA levels.


METHODS
The study was conducted with 108 ESRD patients entering HD and 30 healthy volunteers. The serum IMA levels of ESRD patients were compared with the post-HD levels and also with healthy individuals. The interaction between Hb levels and HD treatment and the IMA levels were tested by using the Generalized Linear Model for repeated measurements.


RESULTS
The IMA levels of ESRD patients, both pre- and post-HD, were significantly higher than those of the control group. The baseline IMA levels of "low" and "high Hb groups" were not significantly different. Hb level modifies the effect of HD treatment on IMA concentration in ESRD patients. Furthermore, post-HD levels of IMA were increased at a lower dialysis speed.


CONCLUSIONS
Both pre- and post-dialysis IMA levels are higher in ESRD patients entering HD than in healthy individuals. Anemia is an effect-modifier for the effect of HD treatment on IMA levels in ESRD patients.
Turedi
Suleyman
S
Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon - Turkey. suleymanturedi@hotmail.com
Cinar
Orhan
O
Yavuz
Izzet
I
Mentese
Ahmet
A
Gunduz
Abdulkadir
A
Karahan
Suleyman Caner
SC
Topbas
Murat
M
Cevik
Erdem
E
Yildirim
Ali Osman
AO
Uzun
Ahmet
A
Kaldirim
Umit
U
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood*; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis*
D012709:Serum Albumin