Background: Albumin, the most abundant protein in the extracellular fluid, displays an important antioxidant activity. Increased levels of oxidized albumin levels (high human non-mercaptoalbumin (HNA) level) have been reported in the serum of patients with end-stage renal disease. In this study, we attempted to identify the albumin redox status in the serum of patients on peritoneal dialysis (PD) and examined the relationship between these proteins and the transport type of the peritoneal membrane and other clinical and laboratory variables. Methods: We performed a cross-sectional study of a cohort of 80 patients with end-stage renal disease receiving PD. Peritoneal transport characteristics were identified and after peritoneal equilibration test patients were grouped as high (high(H)/high-average (HA) group, n = 31) or low (low (L)/low-average (LA) group, n = 49) transporters. The redox state of human serum albumin was measured using high-performance liquid chromatography. Results: The fraction of human mercaptoalbumin (HMA) showed significantly higher values in patients with high transport status than those with low transport status (f(HMA) 64.0 ± 5.4 and 52.7 ± 10.4%, respectively). Our data showed that the H/HA transport characteristic was associated with lower albumin (3.76 ± 0.48 vs. 4.00 ± 0.35, p < 0.05), and lower levels of advanced oxidized protein product (p = 0.008) when compared with the L/LA type. A correlation analysis showed that there was a positive correlation between dialysate/plasma (D/P) creatinine and f(HMA) levels (r = 0.511, p < 0.0001), as well as hemoglobin levels r = 0.231, p = 0.044 and a negative correlation between D/P creatinine and serum albumin, cholesterol and LDL levels (r = -0.236, p = 0.039; r = -0.237, p = 0.038; r = -0.272, p = 0.018, respectively). Conclusions: This study showed that higher serum levels of reduced albumin f(HMA) appear to be associated with high/high average peritoneal membrane transport characteristics in the incident PD patients.

1.
de Jager DJ, Grootendorst DC, Jager KJ, van Dijk PC, Tomas LM, Ansell D, et al: Cardiovascular and noncardiovascular mortality among patients starting dialysis. JAMA 2009;302:1782-1789.
2.
Churchill DN, Thorpe KE, Nolph KD, Keshaviah PR, Oreopoulos DG, Pagé D: Increased peritoneal membrane transport is associated with decreased patient and technique survival for continuous peritoneal dialysis patients. The Canada-USA (CANUSA) Peritoneal Dialysis Study Group. J Am Soc Nephrol 1998;9:1285-1292.
3.
Davies SJ, Phillips L, Russell GI: Peritoneal solute transport predicts survival on CAPD independently of residual renal function. Nephrol Dial Transplant 1998;13:962-968.
4.
Brimble KS, Walker M, Margetts PJ, Kundhal KK, Rabbat CG: Meta-analysis: peritoneal membrane transport, mortality, and technique failure in peritoneal dialysis. J Am Soc Nephrol 2006;17:2591-2598.
5.
Chung SH, Chu WS, Lee HA, Kim YH, Lee IS, Lindholm B, et al: Peritoneal transport characteristics, comorbid diseases and survival in CAPD patients. Perit Dial Int 2000;20:541-547.
6.
Passadakis PS, Thodis ED, Panagoutsos SA, Selisiou CA, Pitta EM, Vargemezis VA: Outcome for continuous ambulatory peritoneal dialysis patients is not predicted by peritoneal permeability characteristics. Adv Perit Dial 2000;16:2-6.
7.
Paniagua R, Amato D, Vonesh E, Correa-Rotter R, Ramos A, Moran J, et al; Mexican Nephrology Collaborative Study Group: Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial. J Am Soc Nephrol 2002;13:1307-1320.
8.
Yang X, Fang W, Bargman JM, Oreopoulos DG: High peritoneal permeability is not associated with higher mortality or technique failure in patients on automated peritoneal dialysis. Perit Dial Int 2008;28:82-92.
9.
Lee CC, Chen KH, Tian YC, Weng CM, Yang CW, Hung CC: Initial high peritoneal transport status is not a predictor of mortality in peritoneal dialysis patients. Ren Fail 2010;32:788-795.
10.
Chang TI, Park JT, Lee DH, Lee JH, Yoo TH, Kim BS, et al: High peritoneal transport status is not an independent risk factor for high mortality in patients treated with automated peritoneal dialysis. J Korean Med Sci 2010;25:1313-1317.
11.
Colombo G, Clerici M, Giustarini D, Rossi R, Milzani A, Dalle-Donne I: Redox albuminomics: oxidized albumin in human diseases. Antioxid Redox Signal 2012;17:1515-1527.
12.
Tomida M, Ishimaru J, Hayashi T, Nakamura K, Murayama K, Era S: The redox states of serum and synovial fluid of patients with temporomandibular joint disorders. Jpn J Physiol 2003;53:351-355.
13.
Terawaki H, Takada Y, Era S, Funakoshi Y, Nakayama K, Nakayama M, et al: The redox state of albumin and serious cardiovascular incidence in hemodialysis patients. Ther Apher Dial 2010;14:465-471.
14.
Lim PS, Jeng Y, Wu MY, Pai MA, Wu TK, Liu CS, et al: Serum oxidized albumin and cardiovascular mortality in normoalbuminemic hemodialysis patients: a cohort study. PLoS One 2013;8:e70822.
15.
Twardowski ZJ, Nolph KD, Khanna R, et al: Peritoneal equilibration test. Perit Dial Bull 1987;7:138-147.
16.
Witko-Sarsat V, Friedlander M, Capeillère-Blandin C, et al: Advanced oxidation protein products as a novel marker of oxidative stress in uremia. Kidney Int 1996;49:1304-1313.
17.
Rodrigues AS, Almeida M, Fonseca I, Martins M, Carvalho MJ, Silva F, et al: Peritoneal fast transport in incident peritoneal dialysis patients is not consistently associated with systemic inflammation. Nephrol Dial Transplant 2006;21:763-769.
18.
van Esch S, Zweers MM, Jansen MA, de Waart DR, van Manen JG, Krediet RT: Determinants of peritoneal solute transport rates in newly started nondiabetic peritoneal dialysis patients. Perit Dial Int 2004;24:554-561.
19.
Johnson DW, Hawley CM, McDonald SP, Brown FG, Rosman JB, Wiggins KJ, et al: Superior survival of high transporters treated with automated versus continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 2010;25:1973-1979.
20.
Rippe B, Stelin G, Haraldsson B: Computer simulations of peritoneal fluid transport in CAPD. Kidney Int 1991;40:315-325.
21.
Margetts PJ, McMullin JP, Rabbat CG, Churchill DN: Peritoneal membrane transport and hypoalbuminemia: cause or effect? Perit Dial Int 2000;20:14-18.
22.
Kaysen GA: Meta-analysis: biological basis of hypoalbuminemia in ESRD. J Am Soc Nephrol 1998;9:2368-2376.
23.
Elsurer R, Afsar B, Sezer S, Ozdemir FN, Haberal M: Peritoneal albumin leakage: 2 year prospective cardiovascular event occurrence and patient survival analysis. Nephrology (Carlton) 2009;14:712-715.
24.
Balafa O, Halbesma N, Struijk DG, Dekker FW, Krediet RT: Peritoneal albumin and protein losses do not predict outcome in peritoneal dialysis patients. Clin J Am Soc Nephrol 2011;6:561-566.
25.
Mehrotra R: Long-term outcomes in automated peritoneal dialysis: similar or better than in continuous ambulatory peritoneal dialysis? Perit Dial Int 2009;29(suppl 2):S111-S114.
26.
Chung SH, Heimbürger O, Stenvinkel P, Qureshi AR, Lindholm B: Association between residual renal function, inflammation and patient survival in new peritoneal dialysis patients. Nephrol Dial Transplant 2003;18:590-597.
27.
Boulanger E, Moranne O, Wautier MP, Witko-Sarsat V, Descamps-Latscha B, Kandoussi A, Grossin N, Wautier JL: Changes in glycation and oxidation markers in patients starting peritoneal dialysis: a pilot study. Perit Dial Int 2006;26:207-212.
28.
Witko-Sarsat V, Friedlander M, Capeillère-Blandin C, Nguyen-Khoa T, Nguyen AT, Zingraff J, et al: Advanced oxidation protein products as a novel marker of oxidative stress in uremia. Kidney Int 1996;49:1304-1313.
29.
Marques de Mattos A, Marino LV, Ovidio PP, Jordão AA, Almeida CC, Chiarello PG: Protein oxidative stress and dyslipidemia in dialysis patients. Ther Apher Dial 2012;16:68-74.
30.
Zhou Q, Wu S, Jiang J, Tian J, Chen J, Yu X, et al: Accumulation of circulating advanced oxidation protein products is an independent risk factor for ischaemic heart disease in maintenance haemodialysis patients. Nephrology (Carlton) 2012;17:642-649.
31.
Malaponte G, Libra M, Bevelacqua Y, Merito P, Fatuzzo P, Rapisarda F, Cristina M, Naselli G, Stivala F, Mazzarino MC, Castellino P: Inflammatory status in patients with chronic renal failure: the role of PTX3 and pro-inflammatory cytokines. Int J Mol Med 2007;20:471-481.
32.
Boehme M, Kaehne F, Kuehne A, Bernhardt W, Schröder M, Pommer W, Fischer C, Becker H, Müller C, Schindler R: Pentraxin 3 is elevated in haemodialysis patients and is associated with cardiovascular disease. Nephrol Dial Transplant 2007;22:2224-2229.
33.
Kushner I, Jiang SL, Zhang D, Lozanski G, Samols D: Do post-transcriptional mechanisms participate in induction of C-reactive protein and serum amyloid A by IL-6 and IL-1? Ann N Y Acad Sci 1995;762:102-107.
34.
Macy EM, Hayes TE, Tracy RP: Variability in the measurement of C-reactive protein in healthy subjects: implications for reference intervals and epidemiological applications. Clin Chem 1997;43:52-58.
35.
Kovacs A, Tornvall P, Nilsson R, Tegnér J, Hamsten A, Björkegren J: Human C-reactive protein slows atherosclerosis development in a mouse model with human-like hypercholesterolemia. Proc Natl Acad Sci U S A 2007;104:13768-13773.
36.
Muller B, Peri G, Doni A, Torri V, Landmann R, Bottazzi B, Mantovani A: Circulating levels of the long pentraxin PTX3 correlate with severity of infection in critically ill patients. Crit Care Med 2001;29:1404-1407.
37.
Mantovani A, Garlanda C, Bottazzi B: Pentraxin 3, a non-redundant soluble pattern recognition receptor involved in innate immunity. Vaccine 2003;(21 suppl 2):S43-S47.
38.
Vouret-Craviari V, Matteucci C, Peri G, Poli G, Introna M, Mantovani A: Expression of a long pentraxin, PTX3, by monocytes exposed to the mycobacterial cell wall component lipoarabinomannan. Infect Immun 1997;65:1345-1350.
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