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Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
Malondialdehyde can predict survival in hemodialysis patients
Crina Claudia Rusu1, Simona Racasan2, Ina Maria Kacso1
1Department of Nephrology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Insights
Bound malondialdehyde (bMDA) predicts survival in hemodialysis patients. This oxidative stress marker is linked to cardiovascular mortality but not cardiovascular events over 9 years.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Cardiovascular disease is the primary cause of death in hemodialysis patients.
- Oxidative stress is an emerging risk factor for cardiovascular disease in kidney disease.
- Limited data exists on oxidative stress markers predicting cardiovascular outcomes in hemodialysis patients.
Purpose of the Study:
- To investigate determinants of oxidative stress markers in hemodialysis patients.
- To evaluate the predictive role of oxidative stress markers on survival and cardiovascular events in hemodialysis patients over 108 months.
Main Methods:
- Prospective observational study of 44 hemodialysis patients.
- Collected baseline characteristics, oxidative stress markers, and tracked mortality and cardiovascular events for 108 months.
- Utilized descriptive statistics, Kaplan-Meier analysis, and Cox regression models.
Main Results:
- Bound malondialdehyde (bMDA) was the only oxidative stress marker significantly associated with survival (HR=3.29, p=0.01).
- bMDA showed a trend towards predicting cardiovascular mortality (HR=2.85, p=0.07).
- No significant association was found between measured oxidative stress markers and cardiovascular events.
Conclusions:
- Bound malondialdehyde (bMDA) is a strong predictor of long-term survival in hemodialysis patients.
- While correlated with cardiovascular mortality, bMDA does not predict cardiovascular events.
- Regular assessment of MDA and interventions to reduce oxidative stress may benefit hemodialysis patients.
Background And Aims:
Cardiovascular (CV) disease is the leading cause of morbidity and mortality in hemodialysis (HD) patients. Kidney disease is associated with increased oxidative stress (OS), a nontraditional CV risk factor. Few studies evaluate the effect of OS markers on CV events (CVE) and survival in HD patients. The aim of this study is to examine potential determinants of OS markers and their predictive role on survival and CV morbidity and mortality in HD patients during a long-term follow-up (108 months).
Methods:
We conducted an analytical cross-sectional prospective observational study, carried on a cohort of randomly selected HD patients. We registered in 44 HD patients baseline characteristics, OS markers, mortality and CVE over a period of 108 months and we used statistical analysis (descriptive, Kaplan-Meier, univariate and multivariate Cox model) for interpretation.
Results:
Bound malondialdehyde (bMDA) was positively correlated with serum calcium, protein carbonyls (PC) were inversely correlated with diastolic blood pressure (DBP) and directly correlated with ferritin, NOx was directly correlated with ceruloplasmin) and serum albumin. Of the measured OS markers only bMDA was related to survival (HR=3.29 95% CI (1.28-8.44), p=0.01), and approached statistical significance in the effect on CV mortality (HR=2.85 95% CI (0.88-9.22), p=0.07). None of the measured OS markers was associated with CVE.
Conclusions:
bMDA has a strong predictive value on survival in HD patients in a long-term follow-up (9 years). Its value is correlated with CV mortality but is not a predictor of CV events. Regular assessment of MDA in HD patients and the development of strategies aimed at reducing oxidative stress in these patients might be beneficial.
