Abstract

Abstract Background and Aims Haemodialysis (HD) is one of the life-saving procedures which prolonged life of chronic kidney disease stage 5, however, the long-termed complications such as cardiovascular disease (CVD), immune and endothelial dysfunction are commonly occurred. The high incidence of CVD in haemodialysis patient associated with traditional and non-traditional risk factors. The novel non-traditional risk factors such as p-cresol, Advance Glycosylation End Products (AGEs), Ankle-Brachial Index (ABI), Cardio-Ankle Vascular Index (CAVI). The ischemic modified albumin (IMA) is the new marker for cardiovascular disease in various populations including haemodialysis. We aimed to explored the factors associate with higher IMA in chronic haemodialysis patients. Method Cross sectional study 196 chronic haemodialysis patients were collected blood sample for Ischemic modified albumin (IMA), measured Ankle-Brachial Index (ABI), Cardio-Ankle Vascular Index (CAVI), and skin autofluorescence advanced glycosylation end products (SAF). Results 53% were female, 21% were smoker, 57% were diabetes, 93% were hypertension, 33% were coronary artery disease, 12% on HDF. Mean Age were 69.2±13.2 year, ABI 1.1±0.15, CAVI 9.3±1.5, SAF 3.1±0.8 arbitrary unit, IMA 37.5±15.2 U/ml, and serum albumin 3.7±0.4 g/dl. In multivariate adjustment showed factors associate with higher IMA were low ABI (B co-efficiency -13.4, P=0.049) and high serum albumin (B co-efficiency 1.68, P=0.000002). Conclusion Lower ABI and high serum albumin associate with higher IMA. The finding underlines the association between the atherosclerosis, vascular endothelial function and cardiac injury in haemodialysis. These results should be confirmed and explored in larger and longer clinical trials. Figure Regression analysis of factors associate with IMA accumulation.

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