Ischemia-Modified Albumin Is Associated with Arterial Stiffness in Hemodialysis Patients

Abstract

Increased arterial stiffness is strongly associated with cardiovascular morbidity and mortality in dialysis patients. Ischemia-modified albumin (IMA) is a useful biomarker of cardiac ischemia. This study was aimed to explore the association between IMA and arterial stiffness in hemodialysis patients. An observational study was conducted with 120 hemodialysis patients. Clinical data and laboratory characteristics were collected. Arterial stiffness was evaluated by brachial-ankle pulse wave velocity (baPWV). Hemodialysis patients had extensive arterial stiffness and high levels of IMA. Comparing to hemodialysis patients with normal baPWV, those with high baPWV had significantly higher levels of IMA (93.7 ± 8.6 versus 73.1 ± 10.7 Ku/L, P = 0.027). The multiple linear regression analysis showed that IMA was significantly associated with arterial stiffness in hemodialysis patients (β = 0.43, P < 0.001). Moreover, IMA, with a threshold value of 90.4 Ku/L, provided 77.4% sensitivity and 86.6% specificity for predicting arterial stiffness. Hemodialysis patients with arterial stiffness had high levels of IMA. IMA was a good predictive marker of arterial stiffness for hemodialysis patients.

Biomarkers of Uremic Cardiotoxicity

“…In ESRD patients, Sharma et al found that high IMA levels were correlated with a significantly larger left ventricular size, decreased left ventricular systolic function, and increased mortality [ 18 , 19 , 20 ]. Recently, it has been shown that high IMA is associated with vascular oxidative stress and inflammation [ 38 , 39 ], and some novel data pointed out that IMA is a good predictive marker of arterial stiffness in hemodialysis patients [ 40 ]. Increased arterial stiffness is a frequent finding in hemodialysis patients and is involved in high CV morbidity [ 41 ].…”

Changing Perspectives from Oxidative Stress to Redox Signaling—Extracellular Redox Control in Translational Medicine

“…Specific posttranslational modifications of proteins in human studies and potentially as a diagnostic method are technically evolving [149]. In the case of oxidation, a few clinically relevant oxidized proteins are known: One important protein in which redox modification has been associated with poor prognosis in several diseases is albumin [150,151]. When ROS increases in the circulation, redox changes in the metal and fatty acid-binding sites of albumin decrease, increasing the oxidative potential of these free molecules.…”

Novel insights about albumin in cardiovascular diseases: Focus on heart failure

“…Of note, continuous ventilation led to lower levels of IMA 24 h after CBP suggesting that lung ventilation during the operation could reduce ischemia and lung damage reducing the drop of blood flow (Ozgunay et al, 2019). In a recent paper, IMA has been described, in hemodialysis patients as a good predictor of arterial stiffness, which is strongly associated with cardiovascular risk in this type of patients (Jiao et al, 2020).…”