Kidney Week

Abstract: SA-PO185

8-Hydroxy-2-Deoxyguanosine (8-OHdG), a Marker of Oxidative DNA Damage, Is Associated with Mortality Independent of Inflammation in CKD Patients

Session Information

• Nutrition, Inflammation, Metabolism: Clinical Trials, Biomarkers, Epidemiology
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Nutrition, Inflammation, and Metabolism

• 1401 Nutrition, Inflammation, Metabolism

Authors

• Lu, Dai, Karolinska Institutet, Stockholm, Sweden

Dai Lu,

• Qureshi, Abdul Rashid Tony, Karolinska Institutet, Stockholm, Sweden

Abdul Rashid Tony Qureshi,

• Mukai, Hideyuki, Karolinska Institutet, Stockholm, Sweden

Hideyuki Mukai,

• Machowska, Anna, Karolinska Institutet, Stockholm, Sweden

Anna Machowska,

• Heimburger, Olof, Karolinska Institutet, Stockholm, Sweden

Olof Heimburger,

• Barany, Peter F., Karolinska Institutet, Stockholm, Sweden

Peter F. Barany,

• Stenvinkel, Peter, Karolinska Institutet, Stockholm, Sweden

Peter Stenvinkel,

• Lindholm, Bengt, Karolinska Institutet, Stockholm, Sweden

Bengt Lindholm,

Background

Oxidative stress and inflammation are two common interlinked features of CKD that associate with poor outcomes. We tested the hypothesis that inflammation modifies the mortality predictive capacity of serum 8-OHdG in CKD patients.

Methods

In 376 clinically stable CKD stage 1-5 patients (63% male; median age 57 years) including 53 CKD stage 1-2, 60 CKD stage 3-4 and 263 CKD stage 5 non-dialysis patients, 8-OHdG, and high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF), were measured at recruitment. The effect of inflammatory markers on the association between baseline 8-OHdG and 5-year mortality risk was investigated using multivariable modeling strategies using cut-off levels of each marker as determined by ROC curve analysis.

Results

The crude mortality rate was markedly increased in patients with high 8-OHdG especially when combined with high hsCRP and IL-6 (Figure 1). In multivariable analysis, adjusting for age, sex, comorbidity, calendar year and eGFR, high 8-OHdG associated with increased relative risk ratio of death, 1.15 (1.07-1.25), 1.16 (1.07-1.25) and 1.17 (1.08-1.26) respectively, when adjusted also for hsCRP, IL-6 and TNF-α, respectively (Table 1).

Conclusion

All-cause mortality risk was increased - independent of inflammation - in CKD patients with elevated 8-OHdG.

Funding

• Commercial Support – Baxter Healthcare Corporation