Kidney Week

Abstract: FR-PO227

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

Session Information

• CKD: Clinical, Outcomes, Trials - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

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

Authors

• Nakatani, Shinya, Osaka City University Graduate School of Medicine, Osaka, Japan

Shinya Nakatani,

• Ishimura, Eiji, Meijibashi Hospital, Matsubara-shi, OSAKA-FU, Japan

Eiji Ishimura,

• Yasukawa, Keiko, The University of Tokyo Hospital, Tokyo, Japan

Keiko Yasukawa,

• Toi, Norikazu, Osaka City University Graduate School of Medicine, Osaka, Japan

Norikazu Toi,

• Uedono, Hideki, Osaka City University Graduate School of Medicine, Osaka, Japan

Hideki Uedono,

• Tsuda, Akihiro, Department of Nephrology, Endocrinology, Metabolism, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan

Akihiro Tsuda,

• Yamada, Shinsuke, Osaka City University Graduate School of Medicine, Osaka, Japan

Shinsuke Yamada,

• Mori, Katsuhito, Osaka City University Graduate School of Medicine, Osaka, Japan

Katsuhito Mori,

• Ikeda, Hitoshi, The University of Tokyo Hospital, Tokyo, Japan

Hitoshi Ikeda,

• Yatomi, Yutaka, The University of Tokyo Hospital, Tokyo, Japan

Yutaka Yatomi,

• Inaba, Masaaki, Osaka City University Graduate School of Medicine, Osaka, Japan

Masaaki Inaba,

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 –