Abstract
BackgroundSubstantial evidence suggests that increased oxidative stress in hemodialysis (HD) patients may contribute to cardiovascular complications. Oxidative modifications of human serum albumin (HSA), the largest thiol pool in plasma, alter its biological properties and may affect its antioxidant potential in HD patients.MethodsWe conducted a long-term follow-up study in a cohort of normoalbuminemic HD patients to examine the impact of redox state of serum albumin on patients’ survival by measuring the human nonmercaptoalbumin (HNA) fraction of HSA.ResultsAfter adjusting for potential demographic, anthropometric, and clinical confounders, a positive association of HNA level with the risk of death from cardiovascular disease (CVD) and all-cause mortality was observed in normoalbuminemic HD patients. Using stratified analysis, we found a stronger association between HNA level and the risk of death from CVD and all-cause mortality in patients with pre-existing CVD.ConclusionsSerum HNA level is a positive predictor of mortality in normoalbuminemic HD patients, especially among those with pre-existing CVD. Increased oxidative stress resulting from biological changes in serum albumin levels could contribute to accelerated atherosclerosis and the development of cardiovascular disease in HD patients.
Highlights
It has been recognized for many years that the risk of cardiovascular disease (CVD) incidence and related mortality is far greater in end-stage renal disease patients than in the general population [1,2]
Several studies of the antioxidant activity of human serum albumin (HSA) in different clinical situations have focused on the importance of the single, free sulfhydryl group at amino acid position 34 (Cys-34, the position is measured from the N-terminus) [10,11]
Human serum albumin (HSA) can be further divided into at least three forms according to the redox state of Cys-34: unoxidized [human mercaptoalbumin (HMA)], reversibly oxidized [human nonmercaptoalbumin-1 (HNA-1)], and strongly oxidized [human nonmercaptoalbumin-2 (HNA-2)]
Summary
It has been recognized for many years that the risk of cardiovascular disease (CVD) incidence and related mortality is far greater in end-stage renal disease patients than in the general population [1,2]. Accumulating evidence suggests that albumin has significant antioxidant activity [5,6,7,8,9] These studies have suggested that albumin, which is the largest thiol pool in plasma, contributes to the protective mechanism for maintaining cellular and regulatory long-lived proteins. The human isoform of serum albumin is a 67-kD protein containing 585 amino acids, including 35 cysteine (Cys) residues. As the major plasma protein, albumin is predicted to be a target of modification during oxidative stress, and oxidative damage of albumin may impair its function. Oxidative modifications of human serum albumin (HSA), the largest thiol pool in plasma, alter its biological properties and may affect its antioxidant potential in HD patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
