title: Reactive oxygen metabolites (ROMs) are associated with cardiovascular disease in chronic hemodialysis patients.
abstract: BACKGROUND
  The aim of our study was to measure reactive oxygen metabolites (ROMs) in chronic hemodialysis (HD) patients and evaluate the possible association with cardiovascular disease (CVD) and mortality.
  
  
  METHODS
  We measured ROMs in 76 HD patients and correlated with CVD, cardiovascular (CV) events in the follow-up and all-cause and CVD-related mortality.
  
  
  RESULTS
  The levels of ROMs presented a median value of 270 (238.2-303.2) CARR U (interquartile range). We created a ROC curve (ROMs levels vs. CVD) and we identified a cut-off point of 273 CARR U. Patients with ROMs levels ≥273 CARR U were significantly older, had higher C-reactive protein levels and lower creatinine concentrations. The prevalence of CVD was higher in patients with ROMs levels ≥273 (87.1%) than in those with ROMs levels <273 CARR U (17.7%; p<0.0001). ROMs levels were significantly higher in patients with CVD (317±63.8) than in those without (242.7±49.1; p<0.0001). At multiple regression analysis, age, creatinine and C-reactive protein were independent factors associated with ROMs. At multiple logistic regression analysis the association between ROMs and CVD was independent (OR: 1.02, 95% CI: 1.00-1.05; p=0.03). Twenty six patients developed cardiovascular (CV) events during the follow-up. Of these, seven were in the group with ROMs levels <273 CARR U and 19 in the group with ROMs levels ≥273 CARR U. The logistic regression analysis showed that both age (OR: 1.06, 95% CI: 1.01-1.12; p=0.013) and ROMs levels (OR: 1.10, 95% CI: 1.00-1.02; p=0.045) were independently associated with CV events in the follow-up.
  
  
  CONCLUSIONS
  ROMs are independently associated with CVD and predict CV events in chronic HD patients.
authors.affiliation: Hemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy. maubosso@tin.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bossola
authors.forename: Carlo
authors.initials: C
authors.lastname: Vulpio
authors.forename: Luigi
authors.initials: L
authors.lastname: Colacicco
authors.forename: Donata
authors.initials: D
authors.lastname: Scribano
authors.forename: Cecilia
authors.initials: C
authors.lastname: Zuppi
authors.forename: Luigi
authors.initials: L
authors.lastname: Tazza
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism*; D006435:Renal Dialysis
chemical_list: D017382:Reactive Oxygen Species