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- Title
Markers of Oxidative Stress and Endothelial Dysfunction Predict Haemodialysis Patients Survival.
- Authors
Suvakov, Sonja; Jerotic, Djurdja; Damjanovic, Tatjana; Milic, Natasa; Pekmezovic, Tatjana; Djukic, Tatjana; Jelic-Ivanovic, Zorana; Savic Radojevic, Ana; Pljesa-Ercegovac, Marija; Matic, Marija; McClements, Lana; Dimkovic, Nada; Garovic, Vesna D.; Albright, Robert C.; Simic, Tatjana; Savic Radojevic, Ana; Garovic, Vesna D; Albright, Robert C
- Abstract
<bold>Introduction: </bold>Overall survival of patients with end-stage renal disease (ESRD) remains poor. Oxidative stress is one of the major risk factors associated with mortality in this patient group. As glutathione S-transferases (GST) are well-established antioxidants, we hypothesized that a model including GST gene polymorphisms, oxidative damage byproducts and cell adhesion markers has a prognostic role in ESRD patient survival.<bold>Methods: </bold>A prospective study of 199 patients with ESRD on haemodialysis was conducted. GST genotype, oxidative stress byproducts and cell adhesion molecules were measured in plasma. Multivariate Cox regression and Kaplan-Meier survival analyses were performed to test the predictive ability of these parameters in the 8-year follow-up period.<bold>Results: </bold>GSTM1-null genotype was associated with significantly shorter overall (HR 1.6, p = 0.018) and cardiovascular-specific (HR 2.1, p = 0.010) survival. Oxidative stress byproducts (advanced oxidation protein products [AOPP], prooxidant-antioxidant balance [PAB], malondialdehyde [MDA]) and cell adhesion molecules (soluble vascular cell adhesion molecule-1 [sVCAM-1] and soluble intercellular adhesion molecule-1 [sICAM-1]) demonstrated a significant predictive role in terms of overall and cardiovascular survival. When 6 biomarkers (GSTM1 genotype, high AOPP/PAB/MDA/-sVCAM-1/sICAM-1) were combined into a scoring model, a significantly shorter overall and cardiovascular survival was observed for patients with the highest score (p < 0.001).<bold>Conclusion: </bold>We identified a novel panel of biomarkers that can be utilized in predicting survival in ESRD patients. This biomarker signature could enable better monitoring of patients and stratification into appropriate treatment groups.
- Subjects
OXIDATIVE stress
- Publication
American Journal of Nephrology, 2019, Vol 50, Issue 2, p115
- ISSN
0250-8095
- Publication type
journal article
- DOI
10.1159/000501300