title: Genomic damage as an independent predictor marker of mortality in hemodialysis patients.
abstract: OBJECTIVE
  Hemodialysis (HD) patients present an enhanced mortality. Since oxidative DNA damage can be considered a biomarker of genomic instability our aim was to evaluate the influence of this genetic biomarker in all-cause mortality in a group of HD patients followed for 4 years.
  
  
  METHODS
  123 chronic HD patients were included. Overall genomic damage was analyzed using the Comet assay. Oxidative DNA damage was measured using the Comet assay complemented with the use of Endo-III and FPG enzymes. Follow-up was carried out from January 2007 to July 2011.
  
  
  RESULTS
  Selected HD patients had a mean age of 62 ± 15 years. During the follow-up 36% of patients died (48% due to cardiovascular disease) and 23% were transplanted. Older patients, with high CRP levels, low levels of cholesterol-HDL and albumin, and higher genetic damage at the beginning of the study showed an increased risk for mortality. Multivariate analysis showed that only genomic damage, age and CRP were independently associated with mortality.
  
  
  CONCLUSIONS
  Our study shows for the first time that, in HD patients, the presence of high levels of genomic damage is a strong predictor of all-cause mortality. This association remains significant after adjustment for relevant covariates.
authors.affiliation: Fundació Puigvert, 08025 Barcelona, Spain. ecoll@terra.com
authors.forename: Elisabet
authors.initials: E
authors.lastname: Coll
authors.forename: Elitsa
authors.initials: E
authors.lastname: Stoyanova
authors.forename: Lara
authors.initials: L
authors.lastname: Rodríguez-Ribera
authors.forename: Miriam
authors.initials: M
authors.lastname: Solozábal
authors.forename: Susana
authors.initials: S
authors.lastname: Pastor
authors.forename: Irene
authors.initials: I
authors.lastname: Silva
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Diaz
authors.forename: José
authors.initials: J
authors.lastname: Ballarin
authors.forename: Noel
authors.initials: N
authors.lastname: Xamena
authors.forename: Ricard
authors.initials: R
authors.lastname: Marcos
mesh_terms: D000368:Aged; D004249:DNA Damage; D005260:Female; D005500:Follow-Up Studies; D023281:Genomics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*