Antunovic Tanja, Stefanovic Aleksandra, Gligorovic Barhanovic Najdana, Miljkovic Milica, Radunovic Danilo, Ivanisevic Jasmina, Prelevic Vladimir, Bulatovic Nebojsa, Ratkovic Marina, Stojanov Marina
a Centre for Clinical-Laboratory Diagnostics , Clinical Centre of Montenegro , Podgorica , Montenegro.
b Department of Medical Biochemistry , University of Belgrade , Faculty of Pharmacy , Belgrade , Serbia.
Ren Fail. 2017 Nov;39(1):491-499. doi: 10.1080/0886022X.2017.1323645.
Oxidative stress and inflammation are highly intertwined pathophysiological processes. We analyzed the markers of these processes and high-sensitive troponin I (hsTnI) for mortality prediction in patients on haemodialysis. This study enrolled a total of 62 patients on regular haemodialysis. The patients were monitored for two years, and the observed outcomes were all-cause and cardiovascular mortality. Blood samples were taken before one dialysis session for analysis of the baseline concentrations of prooxidant-antioxidant balance (PAB), total antioxidant status (TAS), total oxidative status (TOS), hsTnI, hsCRP and resistin. The overall all-cause mortality was 37.1% and CVD mortality 16.1%. By univariate and multivariate logistic regression, our findings suggest that good predictors of all-cause mortality include hsCRP and PAB (p < .05) and of CVD mortality hsCRP (p < .05) and hsTnI (p < .001). To evaluate the relationship between the combined parameter measurements and all-cause/CVD mortality risk, patients were divided into three groups according to their PAB, hsCRP and hsTnI concentrations. The cutoffs for hsCRP and hsTnI and the median for PAB were used. Kaplan-Meier survival curves pointed out that the highest mortality risk of all-cause mortality was in the group with hsCRP levels above the cutoff and PAB levels above the median (p < .001). The highest risk of CVD mortality was found in the group with hsCRP and hsTnI levels above the cutoff levels (p = .001). Our data suggest that hsCRP and PAB are very good predictors of all-cause mortality. For CVD complications and mortality prediction in HD patients, the most sensitive parameters appear to be hsTnI and hsCRP.
氧化应激和炎症是紧密交织的病理生理过程。我们分析了这些过程的标志物以及高敏肌钙蛋白I（hsTnI），以预测血液透析患者的死亡率。本研究共纳入62例规律血液透析患者。对患者进行了两年的监测，观察的结局为全因死亡率和心血管死亡率。在一次透析治疗前采集血样，分析促氧化剂-抗氧化剂平衡（PAB）、总抗氧化状态（TAS）、总氧化状态（TOS）、hsTnI、hsCRP和抵抗素的基线浓度。总体全因死亡率为37.1%，心血管疾病死亡率为16.1%。通过单因素和多因素逻辑回归分析，我们的研究结果表明，全因死亡率的良好预测指标包括hsCRP和PAB（p < 0.05），心血管疾病死亡率的预测指标为hsCRP（p < 0.05）和hsTnI（p < 0.001）。为了评估联合参数测量与全因/心血管疾病死亡风险之间的关系，根据患者的PAB、hsCRP和hsTnI浓度将其分为三组。使用hsCRP和hsTnI的截断值以及PAB的中位数。Kaplan-Meier生存曲线指出，全因死亡率最高的风险出现在hsCRP水平高于截断值且PAB水平高于中位数的组中（p < 0.001）。心血管疾病死亡率最高的风险出现在hsCRP和hsTnI水平高于截断值的组中（p = 0.001）。我们的数据表明，hsCRP和PAB是全因死亡率的良好预测指标。对于血液透析患者的心血管疾病并发症和死亡率预测，最敏感的参数似乎是hsTnI和hsCRP。
