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Article: Prognostic value of plasma Myeloperoxidase in ESRD patients

TitlePrognostic value of plasma Myeloperoxidase in ESRD patients
Authors
Issue Date2010
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkd
Citation
American Journal Of Kidney Diseases, 2010, v. 56 n. 5, p. 937-946 How to Cite?
AbstractBackground: Myeloperoxidase (MPO) has been suggested to have a role in atherosclerosis through its strong oxidative capacity. We hypothesized that MPO level may predict clinical outcomes in patients with end-stage renal disease receiving long-term peritoneal dialysis (PD) therapy. Study Design: Prospective cohort study. Setting & Participants: 236 long-term PD patients were recruited from a single regional dialysis unit in Hong Kong between April 1999 and February 2001. Predictor: Level of plasma MPO, analyzed using a sandwich enzyme-linked immunosorbent assay. Outcome & Measurement: Mortality and fatal or nonfatal cardiovascular events at 3 years. Results: The distribution of MPO levels was skewed with a median of 31.8 μg/L (25th-75th percentiles, 24.4-42.7). There were 69 deaths and 81 cardiovascular events. Adjusting for traditional and nontraditional risk factors and C-reactive protein, cardiac troponin T, and N-terminal pro-brain natriuretic peptide levels, a doubling in plasma MPO level was associated independently with a 46% (95% CI, 1.02-2.08; P = 0.04) and 60% (95% CI, 1.17-2.18; P = 0.003) increase in risks of mortality and cardiovascular events, respectively. Log 2MPO showed significant additional predictive value for mortality (P = 0.04) and cardiovascular events (P = 0.005) when included in Cox regression models consisting of clinical, demographic, dialysis, echocardiographic, and biochemical parameters, as well as C-reactive protein, cardiac troponin T, and N-terminal pro-brain natriuretic peptide levels. Limitations: MPO was measured at a single time and did not reflect changes over time. Conclusions: These data suggest that plasma MPO level has significant independent and additional prognostic value beyond the standard clinical, biochemical, and echocardiographic parameters and is useful for outcome stratification in long-term PD patients. MPO may be an important mediator of increased cardiovascular risk in patients with end-stage renal disease and warrants further investigation. © 2010 National Kidney Foundation, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/163340
ISSN
2015 Impact Factor: 6.269
2015 SCImago Journal Rankings: 2.313
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, AYMen_US
dc.contributor.authorLam, CWKen_US
dc.contributor.authorChan, IHSen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorLui, SFen_US
dc.contributor.authorSanderson, JEen_US
dc.date.accessioned2012-09-05T05:30:18Z-
dc.date.available2012-09-05T05:30:18Z-
dc.date.issued2010en_US
dc.identifier.citationAmerican Journal Of Kidney Diseases, 2010, v. 56 n. 5, p. 937-946en_US
dc.identifier.issn0272-6386en_US
dc.identifier.urihttp://hdl.handle.net/10722/163340-
dc.description.abstractBackground: Myeloperoxidase (MPO) has been suggested to have a role in atherosclerosis through its strong oxidative capacity. We hypothesized that MPO level may predict clinical outcomes in patients with end-stage renal disease receiving long-term peritoneal dialysis (PD) therapy. Study Design: Prospective cohort study. Setting & Participants: 236 long-term PD patients were recruited from a single regional dialysis unit in Hong Kong between April 1999 and February 2001. Predictor: Level of plasma MPO, analyzed using a sandwich enzyme-linked immunosorbent assay. Outcome & Measurement: Mortality and fatal or nonfatal cardiovascular events at 3 years. Results: The distribution of MPO levels was skewed with a median of 31.8 μg/L (25th-75th percentiles, 24.4-42.7). There were 69 deaths and 81 cardiovascular events. Adjusting for traditional and nontraditional risk factors and C-reactive protein, cardiac troponin T, and N-terminal pro-brain natriuretic peptide levels, a doubling in plasma MPO level was associated independently with a 46% (95% CI, 1.02-2.08; P = 0.04) and 60% (95% CI, 1.17-2.18; P = 0.003) increase in risks of mortality and cardiovascular events, respectively. Log 2MPO showed significant additional predictive value for mortality (P = 0.04) and cardiovascular events (P = 0.005) when included in Cox regression models consisting of clinical, demographic, dialysis, echocardiographic, and biochemical parameters, as well as C-reactive protein, cardiac troponin T, and N-terminal pro-brain natriuretic peptide levels. Limitations: MPO was measured at a single time and did not reflect changes over time. Conclusions: These data suggest that plasma MPO level has significant independent and additional prognostic value beyond the standard clinical, biochemical, and echocardiographic parameters and is useful for outcome stratification in long-term PD patients. MPO may be an important mediator of increased cardiovascular risk in patients with end-stage renal disease and warrants further investigation. © 2010 National Kidney Foundation, Inc.en_US
dc.languageengen_US
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkden_US
dc.relation.ispartofAmerican Journal of Kidney Diseasesen_US
dc.subject.meshCardiovascular Diseases - Epidemiology - Etiologyen_US
dc.subject.meshEnzyme-Linked Immunosorbent Assayen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshIncidenceen_US
dc.subject.meshKidney Failure, Chronic - Enzymology - Mortality - Therapyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOxidative Stress - Physiologyen_US
dc.subject.meshPeritoneal Dialysisen_US
dc.subject.meshPeroxidase - Blooden_US
dc.subject.meshPrognosisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshSurvival Rate - Trendsen_US
dc.titlePrognostic value of plasma Myeloperoxidase in ESRD patientsen_US
dc.typeArticleen_US
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_US
dc.identifier.authorityWang, M=rp00281en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1053/j.ajkd.2010.05.008en_US
dc.identifier.pmid20638167-
dc.identifier.scopuseid_2-s2.0-77958490508en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77958490508&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume56en_US
dc.identifier.issue5en_US
dc.identifier.spage937en_US
dc.identifier.epage946en_US
dc.identifier.isiWOS:000283261700020-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWang, AYM=13606226000en_US
dc.identifier.scopusauthoridLam, CWK=8531362100en_US
dc.identifier.scopusauthoridChan, IHS=8298775100en_US
dc.identifier.scopusauthoridWang, M=7406690398en_US
dc.identifier.scopusauthoridLui, SF=7102379144en_US
dc.identifier.scopusauthoridSanderson, JE=7202371250en_US

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