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Abstract: FR-PO227

The Oxidized Form of Serum Albumin, Non-Mercaptalbumin Is Significantly Associated with Renal Function and Anemia in CKD Patients

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Nakatani, Shinya, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Ishimura, Eiji, Meijibashi Hospital, Matsubara-shi, OSAKA-FU, Japan
  • Yasukawa, Keiko, The University of Tokyo Hospital, Tokyo, Japan
  • Toi, Norikazu, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Uedono, Hideki, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Tsuda, Akihiro, Department of Nephrology, Endocrinology, Metabolism, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Yamada, Shinsuke, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Mori, Katsuhito, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Ikeda, Hitoshi, The University of Tokyo Hospital, Tokyo, Japan
  • Yatomi, Yutaka, The University of Tokyo Hospital, Tokyo, Japan
  • Inaba, Masaaki, Osaka City University Graduate School of Medicine, Osaka, Japan
Background

Human mercaptalbumin (HMA; reduced form of serum albumin) and non-mercaptalbumin (HNA; oxdized form of serum albumin) have been known to be an indicator for evaluating oxidative stress in the systemic circulation, including patients with end stage renal disease.

Methods

We investigated factors associated with fraction of HNA (f(HNA)) in 112 pre-dialysis CKD patients (age 63.6±14.0 years; 59 males and 53 females), using a newly established, anion-exchange column packed with a hydrophilic polyvinyl alcohol gel, along with high performance liquid chromatography.

Results

The means f(HNA) in CKD patients was 30.0 ±6.13%, whose value was higher than that reported in healthy subjects f(HNA) 25.1±3.0%. Age, estimated glomerular filtration rate (eGFR), blood urea nitrogen, hemoglobin, sodium-chloride, phosphate, intact parathyroid hormone (PTH), and fibroblast growth factor (FGF)-23 levels correlated significantly with plasma f(HNA) (ρ=0.302, p〈0.001;ρ=-0.436, p〈0.001; ρ=0.457, p〈0.001;ρ=-0.382, p〈0.001;ρ=-0.324, p〈0.001;ρ=0.265, p=0.001;ρ= 0.367, p=0.001;ρ= 0.419, p〈0.001;respectively). In multiple regression analyses, age (β=0.200, p=0.014), eGFR (β=-0.238, p=0.009), hemoglobin (β=- 0.346, p<0.001), and ferritin (β=0.200, p=0.019), were associated significantly and independently with f(HNA) (R2=0.356, p<0.001). In addition, concerning factors related to CKD-mineral and bone disorder(CKD-MBD), intact-PTH (β=0.218, p=0.049) and 1,25-dihydroxyvitamin D (1,25(OH)2D ) levels (β=-0.178,p<0.001) were significantly and independently associated with serum f(HNA) (R2=0.339, p<0.001), although fibroblast growth factor-23 were not.

Conclusion

We demonstrated that impaired renal function and renal anemia were strongly associated with oxidization of serum albumin. We also demonstrated that, intact PTH and 1,25(OH)2D are significant factors associated with the redox states of serum albumin. Our findings suggest the importance of management of hemoglobin and ferritin levels, and appropriate control of CKD-MBD factors in regard to better redox state of albumin in CKD patients.

Funding

  • Commercial Support