Serum levels of protein carbonyl, a marker of oxidative stress, are associated with overhydration, sarcopenia and mortality in hemodialysis patients

Abstract

Background: Increased oxidative stress in end-stage renal disease is regarded as one of the important mechanisms in the atherosclerosis and muscle wasting. However, studies examining the clinical significance of oxidative stress by direct measurement of these markers and its association with volume status and sarcopenia are limited. Methods: A follow-up cross-sectional study was performed in stable hemodialysis (HD) patients and serum protein carbonyl levels were measured as a biomarker of oxidative stress. Additionally, multi-frequency body composition analysis, handgrip strength (HGS) and nutritional assessments were performed at baseline. Results: Eighty-eight patients undergoing HD were included and 30 (34.1%) patients died during a mean follow-up of 5.2 years. The mean patient age was 60.6 ± 13.5 years, and the mean HD duration was 50.8 ± 41.3 months. In total, 16 patients (18.2%) were overhydrated, 49 (55.7%) had low HGS and 36 (40.9%) had low muscle mass. Serum protein carbonyl levels were associated with serum levels of albumin, prealbumin and transferrin, hydration status and low HGS. Overhydration (odds ratio [OR] 7.01, 95% CI 1.77-27.79, p = 0.006), prealbumin (OR 0.91, 95% CI 0.83-0.99, p = 0.030), subjective global assessment (OR 3.52, 95% CI 1.08-11.46, p = 0.037) and sarcopenia (OR 3.41, 95% CI 1.02-11.32, p = 0.046) were significantly related to increased serum protein carbonyl levels. Multivariate analysis showed that the serum levels of protein carbonyl (Hazard ratio [HR] 2.37, 95% CI 1.02-5.55, p = 0.036), albumin (HR 0.17, 95% CI 0.06-0.46, p = 0.003), prealbumin (HR 0.86, 95% CI 0.80-0.92, p = 0.001), overhydration (HR 2.31, 95% CI 1.26-8.71, p = 0.015) and sarcopenia (HR 2.72, 95% CI 1.11-6.63, p = 0.028) were independent determinants of allcause mortality. Conclusions: Serum protein carbonyl was significantly associated with overhydration, nutritional status and sarcopenia, and could be a new predictor of mortality in patients undergoing HD.

Late stage 3 chronic kidney disease is an independent risk factor for sarcopenia, but not proteinuria

“…It is a big advantage that it can be repeatedly measured in bed-side non-invasively, very easily and quickly. Based on various information measured by BCM, we have previously conducted a study in dialysis patients and reported the results 11 , 14 , 40 – 43 . As such, this study was conducted as an extension of the study conducted on dialysis patients.…”

The Implication of Reactive Oxygen Species and Antioxidants in Knee Osteoarthritis

“…The serum concentration of carbonylated proteins correlates negatively with albumin levels, an extracellular molecule known as positive acute-phase protein. Such correlation reflects the fact that a low level of serum albumin signals the presence of inflammation and oxidative stress [ 142 ]. Elevated carbonyl protein levels have been detected in multiple pathologies, such as DM [ 143 ], rheumatoid arthritis [ 144 ], chronic renal failure, or sepsis [ 145 ].…”

Posttranslational Modifications Pattern in Clear Cell Renal Cell Carcinoma

“…It is a major product of peroxynitrite attack on proteins with an addition of a nitro group to the orthoposition of tyrosine. 3-NT has been used as a biomarker of nitrative damage in vivo [ 21 ]. The presence of 3-NT was previously reported in some carcinomas [ 22 ], in ccRCC through immunohistochemically staining, in contrast nephropathy [ 23 ], as a biomarker for vascular involvement in Fabry disease [ 24 ], and in preeclampsia [ 25 ].…”