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A lower level of reduced albumin induces serious cardiovascular incidence among peritoneal dialysis patients

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Abstract

Background

Human serum albumin is composed of human mercaptoalbumin (HMA) with cysteine residues having reducing powers and of oxidized human non-mercaptoalbumin. Previously, we reported that a lower HMA level is closely related to serious cardiovascular disease (CVD) incidence and mortality among hemodialysis patients. However, the relationship between HMA level and CVD incidence among peritoneal dialysis (PD) patients is unclear.

Methods

We measured the redox state of human serum albumin using high-performance liquid chromatography in 30 continuous ambulatory PD patients. The association between HMA and incidental CVD events was evaluated.

Results

Eight patients experienced symptomatic CVD events (5 patients died) at the 5-year follow-up. The concentration and fraction of HMA (cHMA and f(HMA), respectively) showed significantly lower values in patients with CVD than those without CVD (cHMA 1.58 ± 0.39 and 2.16 ± 0.43 g/dL, f(HMA) 48.9 ± 5.4 and 56.4 ± 8.6%, respectively). Multiple forward stepwise regression analysis using cHMA and f(HMA) as the criterion variables was performed, and C-reactive protein and hemoglobin were adopted as significant explanatory variables in the former equation, whereas urea nitrogen was adopted in the latter equation. Multiple logistic regression analysis revealed that cHMA is a statistically, and f(HMA) is a marginally significant explanatory variable of CVD incidence (p = 0.0369, R = −0.260 and p = 0.0580, R = −0.214, respectively).

Conclusions

Lower HMA level, which might be caused by chronic inflammation, anemia and accumulation of dialyzable uremic toxin(s), is closely related to serious CVD incidence among PD patients.

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References

  1. Nakai S, Suzuki K, Masakane I, Wada A, Itami N, Ogata S, et al. Overview of regular dialysis treatment in Japan (as of 31 December 2008). Ther Apher Dial. 2010;14:505–40.

    Article  PubMed  CAS  Google Scholar 

  2. Terawaki H, Takada Y, Era S, Funakoshi Y, Nakayama K, Nakayama M, et al. The redox state of albumin and serious cardiovascular incidence in hemodialysis patients. Ther Apher Dial. 2010;14:465–71.

    Article  PubMed  Google Scholar 

  3. Ogasawara Y, Namai T, Togawa T, Ishii K. Formation of albumin dimers induced by exposure to peroxides in human plasma: a possible biomarker for oxidative stress. Biochem Biophys Res Commun. 2005;340:353–8.

    Article  PubMed  Google Scholar 

  4. Terawaki H, Nakayama K, Matsuyama Y, Nakayama M, Sato T, Hosoya T, et al. Dialyzable uremic solutes contribute to enhanced oxidation of serum albumin in regular hemodialysis patients. Blood Purif. 2007;25:274–9.

    Article  PubMed  CAS  Google Scholar 

  5. Sogami M, Nagoka S, Era S, Honda M, Noguchi K. Resolution of mercapt- and nonmercaptalbumin by high-performance liquid chromatography. Int J Peptide Protein Res. 1984;24:96–103.

    Article  CAS  Google Scholar 

  6. Sogami M, Era S, Nagaoka S, Kuwata K, Kida K, Miura K, et al. HPLC-studies on nonmercapt–mercapt conversion of human serum albumin. Int J Peptide Protein Res. 1985;25:398–402.

    Article  CAS  Google Scholar 

  7. Era S, Hamaguchi T, Sogami M, Kuwata K, Suzuki E, Miura K, et al. Further studies on the resolution of human mercapt- and non-mercaptalbumin and on human serum albumin in the elderly by high-performance liquid chromatography. Int J Peptide Protein Res. 1988;31:435–42.

    Article  CAS  Google Scholar 

  8. Era S, Kuwata K, Imai I, Nakamura K, Hayashi T, Sogami M. Age-related change in redox state of human serum albumin. Biochim Biophys Acta. 1995;1247:12–6.

    Article  PubMed  Google Scholar 

  9. Imai H, Hayashi T, Negawa T, Nakamura K, Tomida M, Koda K, et al. Strenuous exercise-induced change in redox state of human serum albumin during intensive kendo training. Jpn J Physiol. 2002;52:135–40.

    Article  PubMed  CAS  Google Scholar 

  10. Sogami M, Era S, Nagaoka S, Kuwata K, Kida K, Shigemi J, et al. High-performance liquid chromatographic studies on non-mercapt in equilibrium with mercapt conversion of human serum albumin. II. J Chromatogr. 1985;332:19–27.

    Article  PubMed  CAS  Google Scholar 

  11. Fukushima H, Miwa Y, Shiraki M, Gomi I, Toda K, Kuriyama S, et al. Oral branched-chain amino acid supplementation improves the oxidized/reduced albumin ratio in patients with liver cirrhosis. Hepatol Res. 2007;37:765–70.

    Article  PubMed  CAS  Google Scholar 

  12. Terawaki H, Yoshimura K, Hasegawa T, Matsuyama Y, Negawa T, Yamada K, et al. Oxidative stress is enhanced in correlation with renal dysfunction: examination with the redox state of albumin. Kidney Int. 2004;66:1988–93.

    Article  PubMed  CAS  Google Scholar 

  13. Terawaki H, Matsuyama Y, Era S, Matsuo N, Ikeda M, Ogura M, et al. Elevated oxidative stress measured as albumin redox state in continuous ambulatory peritoneal dialysis patients correlates with small uraemic solutes. Nephrol Dial Transpl. 2007;22:968.

    Article  Google Scholar 

  14. Matsuyama Y, Terawaki H, Terada T, Era S. Albumin thiol oxidation and serum protein carbonyl formation are progressively enhanced with advancing stages of chronic kidney disease. Clin Exp Nephrol. 2009;13:308–15.

    Article  PubMed  CAS  Google Scholar 

  15. Suzuki E, Yasuda K, Takeda N, Sakata S, Era S, Kuwata K, et al. Increased oxidized form of serum albumin in patients with diabetes mellitus. Diabetes Res Clin Pract. 1992;18:153–8.

    Article  PubMed  CAS  Google Scholar 

  16. Hayakawa A, Kuwata K, Era S, Sogami M, Shimonaka H, Yamamoto M, et al. Alteration of redox state of human serum albumin in patients under anesthesia and invasive surgery. J Chromatogr B. 1997;698:27–33.

    Article  CAS  Google Scholar 

  17. Kawai K, Yoh M, Hayashi T, Imai H, Negawa T, Tomida M, et al. Observation for redox state of human serum and aqueous humor albumin from patients with senile cataract. Tokai J Exp Clin Med. 2001;26:93–9.

    PubMed  CAS  Google Scholar 

  18. Tomida M, Ishimaru J, Murayama K, Kajimoto T, Kurachi M, Era S, et al. Intra-articular oxidative state correlated with the pathogenesis of disorders of the temporomandibular joint. Br J Oral Maxillofac Surg. 2004;42:405–9.

    Article  PubMed  CAS  Google Scholar 

  19. Ashfaq S, Abramson JL, Jones DP, Rhodes SD, Weintraub WS, Hooper WC, et al. The relationship between plasma levels of oxidized and reduced thiols and early athelosclerosis in healthy adults. J Am Coll Cardiol. 2006;47:1005–11.

    Article  PubMed  CAS  Google Scholar 

  20. Ashfaq S, Abramson JL, Jones DP, Rhodes SD, Weintraub WS, Hooper WC, et al. Endothelial function and aminothiol biomarkers of oxidative stress in healthy adults. Hypertension. 2008;52:80–5.

    Article  PubMed  CAS  Google Scholar 

  21. Gonçalves S, Pecoits-Filho R, Perreto S, Barberato SH, Stinghen AE, Lima EG, et al. Associations between renal function, volume status and endotoxaemia in chronic kidney disease patients. Nephrol Dial Transpl. 2006;21:2788–94.

    Article  Google Scholar 

  22. Terawaki H, Yokoyama K, Yamada Y, Maruyama Y, Iida R, Hanaoka K, et al. Low-grade endotoxemia is contributing to chronic inflammation in hemodialysis patients: examination with the novel LPS detection method (ESP method). Ther Apher Dial. 2010;14:477–82.

    Article  PubMed  Google Scholar 

  23. Szeto CC, Kwan BCH, Chow KM, Lai KB, Chung KY, Leung CB, et al. Endotoxemia is related to systemic inflammation and atherosclerosis in peritoneal dialysis patients. Clin J Am Soc Nephrol. 2008;3:431–6.

    Article  PubMed  CAS  Google Scholar 

  24. Sommerburg O, Grune T, Hampl H, Riedel E, van Kuijk FJ, Ehrich JH, et al. Does long-term treatment of renal anemia with recombinant erythropoietin influence oxidative stress in haemodialysed patients? Nephrol Dial Transpl. 1998;13:2583–7.

    Article  CAS  Google Scholar 

  25. Sela S, Shurtz-Swirski R, Cohen-Mazor M, Mazor R, Chezar J, Shapiro G, et al. Primed peripheral polymorphonuclear leukocyte: a culprit underlying chronic low-grade inflammation and systemic oxidative stress in chronic kidney disease. J Am Soc Nephrol. 2005;16:2431–8.

    Article  PubMed  CAS  Google Scholar 

  26. Anraku M, Kragh-Hansen U, Kawai K, Mariyama T, Yamasaki Y, Takakura Y, et al. Validation of the chloramine-T induced oxidation of human serum albumin as a model for oxidative damage in vivo. Pharm Res. 2003;20:684–92.

    Article  PubMed  CAS  Google Scholar 

  27. Matsuyama Y, Hayashi T, Terawaki H, Negawa T, Terada T, Okano Y, et al. Human astrocytes and aortic endothelial cells actively convert the oxidized form of albumin to the reduced form: reduced albumin might participate in redox regulation of nerve and blood vessel systems. J Physiol Sci. 2009;59:207–15.

    Article  PubMed  CAS  Google Scholar 

  28. Terawaki H, Era S, Nakayama M, Hosoya T. Decrease in reduced-form albumin among chronic kidney disease patients: new insights in cardiovascular complications. Ther Apher Dial. 2011;15:156–60.

    Article  PubMed  CAS  Google Scholar 

  29. Nakayama K, Nakayama M, Iwabuchi M, Terawaki H, Sato T, Kohno M, et al. Plasma α-oxoaldehyde levels in diabetic and nondiabetic chronic kidney disease. Am J Nephrol. 2008;28:1871–8.

    Article  Google Scholar 

  30. Tanaka M, Tokunaga K, Komaba H, Itoh K, Matsushita K, Watanabe H, et al. Vitamin D receptor activator reduces oxidative stress in hemodialysis patients with secondary hyperparathyroidism. Ther Apher Dial. 2011;15:161–8.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Kidney and Hypertension, The Jikei University School of Medicine, Tokyo, Japan

    Hiroyuki Terawaki, Nanae Matsuo, Makoto Ogura, Jun Mitome, Akihiko Hamaguchi & Tatsuo Hosoya

  2. Division of Physiology and Biophysics, Gifu University Graduate School of Medicine, Gifu, Japan

    Yukie Matsuyama, Tomoyoshi Terada & Seiichi Era

  3. Division of Kidney and Hypertension, The Jikei University Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba, 277-8567, Japan

    Hiroyuki Terawaki

Authors
  1. Hiroyuki Terawaki
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  2. Yukie Matsuyama
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  3. Nanae Matsuo
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  4. Makoto Ogura
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  8. Seiichi Era
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  9. Tatsuo Hosoya
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Correspondence to Hiroyuki Terawaki.

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Terawaki, H., Matsuyama, Y., Matsuo, N. et al. A lower level of reduced albumin induces serious cardiovascular incidence among peritoneal dialysis patients. Clin Exp Nephrol 16, 629–635 (2012). https://doi.org/10.1007/s10157-012-0610-x

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  • DOI: https://doi.org/10.1007/s10157-012-0610-x

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