Serum oxidized albumin and cardiovascular mortality in normoalbuminemic hemodialysis patients: a cohort study.
BACKGROUND
Substantial evidence suggests that increased oxidative stress in hemodialysis (HD) patients may contribute to cardiovascular complications. Oxidative modifications of human serum albumin (HSA), the largest thiol pool in plasma, alter its biological properties and may affect its antioxidant potential in HD patients.


METHODS
We conducted a long-term follow-up study in a cohort of normoalbuminemic HD patients to examine the impact of redox state of serum albumin on patients' survival by measuring the human nonmercaptoalbumin (HNA) fraction of HSA.


RESULTS
After adjusting for potential demographic, anthropometric, and clinical confounders, a positive association of HNA level with the risk of death from cardiovascular disease (CVD) and all-cause mortality was observed in normoalbuminemic HD patients. Using stratified analysis, we found a stronger association between HNA level and the risk of death from CVD and all-cause mortality in patients with pre-existing CVD.


CONCLUSIONS
Serum HNA level is a positive predictor of mortality in normoalbuminemic HD patients, especially among those with pre-existing CVD. Increased oxidative stress resulting from biological changes in serum albumin levels could contribute to accelerated atherosclerosis and the development of cardiovascular disease in HD patients.
Division of Renal Medicine, Tungs' Taichung Metroharbour Hospital, Taichung, Taiwan.
Paik Seong
PS
Lim
Yachung
Y
Jeng
Ming Ying
MY
Wu
Mei-Ann
MA
Pai
Tsai-Kun
TK
Wu
Chia-San
CS
Liu
Chan Hsu
CH
Chen
Yuan-Chuan
YC
Kuo
Shiaw-Wen
SW
Chien
Hung Ping
HP
Chen
D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D018384:Oxidative Stress; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D055815:Young Adult
D012709:Serum Albumin