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2016 ; 89
(2
): 250-6
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Malondialdehyde can predict survival in hemodialysis patients
#MMPMID27152077
Rusu CC
; Racasan S
; Kacso IM
; Moldovan D
; Potra A
; Patiu IM
; Vladutiu D
; Caprioara MG
Clujul Med
2016[]; 89
(2
): 250-6
PMID27152077
show ga
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.