Accumulation of circulating advanced oxidation protein products is an independent risk factor for ischaemic heart disease in maintenance haemodialysis patients.
OBJECTIVE
Whether the burden of advanced oxidation protein products (AOPP) accumulation, a marker of oxidative stress, is affected by dialysis modality remains unclear. We compared the serum levels of AOPP in patients on haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) and tested the hypothesis that an accumulation of AOPP was an independent risk factor for cardiovascular disease.


METHODS
This was a cross-section study. A total of 2095 patients (1539 HD, 556 CAPD) were recruited from the nine largest dialysis centres in China. Persons in medical centres for disease screening were selected as controls. Patients maintained on HD were dialyzed twice or thrice weekly. CAPD patients used lactate-buffered, glucose-containing solutions. The patients' data were abstracted from the medical record. The serum levels of AOPP were determined by spectrophotometric detection.


RESULTS
The levels of AOPP were significantly elevated in both HD and CAPD patients compared to healthy controls. Accumulation of AOPP was more significant in HD compared to CAPD population. Meanwhile, AOPP accumulation was associated with the presence of ischaemic heart disease (IHD) only in HD, but not CAPD patients. A higher proportion of IHD was found in the HD population among those with higher levels of AOPP in each category of age and irrespective of the presence or absence of high triglyceride. Multivariate regression analysis indicated that accumulation of AOPP was an independent risk factor for IHD in HD population.


CONCLUSIONS
Accumulation of AOPP was more significant in HD compared to CAPD patients. The level of AOPP was independently associated with IHD only in HD patients.
Key Lab for Organ Failure Research, Ministry of Education, Division of Nephrology, Nanfang Hospital, Guangzhou, China.
Qiugen
Q
Zhou
Shengjie
S
Wu
Jianping
J
Jiang
Jianwei
J
Tian
Jianghua
J
Chen
Xueqing
X
Yu
Pingyan
P
Chen
Changlin
C
Mei
Fei
F
Xiong
Wei
W
Shi
Wei
W
Zhou
Xusheng
X
Liu
Shiren
S
Sun
D I
DI
Xie
Jun
J
Liu
Xin
X
Xu
Min
M
Liang
Fanfan
F
Hou
D000328:Adult; D062107:Advanced Oxidation Protein Products / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D016017:Odds Ratio; D018384:Oxidative Stress; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D013053:Spectrophotometry; D015854:Up-Regulation
D062107:Advanced Oxidation Protein Products; D015415:Biomarkers; D008315:Malondialdehyde