关键词:  , 缺血修饰白蛋白   , 腹膜透析  , 主要不良心血管事件

Abstract:

ABSTRACT   Objective: To evaluate the predictive value of ischemia modified albumin (IMA) for major adverse cardiovascular events (MACE) in patients on peritoneal dialysis. Methodology: A total of one hundred twenty end stage renal disease patients on peritoneal dialysis over 3 months were enrolled. According to whether or not suffering MACE, they were divided into MACE group (n=38) and non-MACE group (n=82). The baseline characteristics, IMA levels and other laboratory measurements were collected and analyzed. Results They were 74 males and 46 females with an average age of 44.2±14.6 years old. Their original diseases were primary glomerulonephritis in 80, diabetic nephropathy in 15, hypertensive glomerulosclerosis in 11, urate nephropathy in 5, obstructive nephropathy in 5, lupus nephritis in 2, purpura nephritis in one and nephritis associated with hepatitis B in one case. The patients in MACE group had significantly higher IMA levels (90.1±12.9 KU/L vs.77.5±12.5 KU/L P<0.0001)), glucose levels, cardiac troponin T (cTnT) levels, and high sensitivity C-reactive protein (hs-CRP), while lower serum albumin level, total creatinine clearance, and residual GFR (rGFR). Multivariable logistic regression analysis showed that IMA and hs-CRP were independent risk factors for MACE, and KT/V was protective factor. From ROC (receiver operating characteristic) curve analysis, the optimal cut-off of IMA to predict MACE was 85.6 KU/L, with a sensitivity of 73.7% and a speci?city of 78.1% [area under the curve, 0.77 (95% confidence interval, 0.69~0.84); P<0.05]. The optimal cut-off of cTnT to predict MACE was 46.8pg/ml, with a sensitivity of 64.9% and a speci?city of 73.2% [area under the curve, 0.72 (95% con?dence interval, 0.63–0.79); P<0.05]. The difference of AUC between IMA and cTnT was not significant, Z=0.92，P=0.36. Conclusions: IMA is an independent risk factors for the occurrence of MACE in patients on peritoneal dialysis, and can be used as a predictor of peritoneal dialysis patients with MACE.

Key words: ischemia modified albumin   , peritoneal dialysis   , Major adverse cardiovascular events