ABSTRACT
The role of oxidative stress in patients with chronic kidney disease (CKD) as a potential marker of morbidity and mortality remains poorly evaluated. The aim of the present study aims was thus: to determine plasma levels of malondialdehyde (MDA), end product of lipid peroxidation in patients at different CKD stages (predialysis and dialysis); to evaluate the association between plasma MDA levels and vascular disease or overall and cardiovascular mortality. Plasma MDA levels evaluated by HPLC, pulse wave velocity, aortic calcification score were evaluated in 94 CKD patients (67±13 years, 54% males, 29% at CKD stages 2-3, 32% at stages 4-5, 39% at stage 5D) prospectively followed for mortality. We observed that the plasma MDA levels were increased in patient with CKD and augmented progressively with CKD stages. However, we did not find any independent association between plasma levels of MDA and pulse wave velocity, aortic calcification score, or overall and cardiovascular mortality. Our results suggest that plasma MDA is not a useful biomarker in CKD patients.
Subject(s)
Kidney Failure, Chronic/mortality , Malondialdehyde/blood , Renal Dialysis/mortality , Adult , Aged , Aged, 80 and over , Algorithms , Biomarkers/blood , Chromatography, High Pressure Liquid , Disease Progression , Female , France/epidemiology , Humans , Kidney Failure, Chronic/blood , Kidney Failure, Chronic/complications , Male , Middle Aged , Oxidative Stress , Predictive Value of Tests , Retrospective Studies , Risk Factors , Sensitivity and Specificity , Survival RateABSTRACT
AIMS: To assess (a) plasma osteopontin (pOPN) in a cohort of chronic kidney disease (CKD) patients; (b) the relationship between pOPN and aortic calcification and stiffness, and (c) the association between pOPN and the overall and cardiovascular mortality risk. METHODS: pOPN, the abdominal aortic calcification score and pulse wave velocity (PWV) were determined in 94 CKD patients (68 ± 13 years; 60% males; 31% at CKD stages 2-3, 31% at stages 4-5, 38% at stage 5D), prospectively followed for mortality. RESULTS: pOPN was higher in CKD patients than in controls. Interleukin (IL)-6 (r(2) = 0.086; p = 0.004), CRP (r(2) = 0.046; p = 0.038), iPTH (r(2) = 0.065; p = 0.014), albumin (r(2) = 0.210; p < 0.0001) and statin use (r(2) = 0.038; p = 0.059) were associated with pOPN. There was no association between pOPN and the aortic calcification score or PWV. During follow-up (969 ± 405 days), 32 patients died. In crude analysis, pOPN >167 ng/ml predicted overall and cardiovascular mortality (p = 0.02 and 0.01, respectively), but this effect was lost after adjustment for albumin or IL-6. CONCLUSIONS: pOPN is elevated from the early stages of CKD onward. We found no associations between pOPN and the aortic calcification score or the PWV. The positive association between pOPN and clinical outcomes was dependent of the patients' inflammatory status.
