Oxidative Stress as Estimated by Gamma-Glutamyl Transferase Levels Amplifies the Alkaline Phosphatase-Dependent Risk for Mortality in ESKD Patients on Dialysis

Autor: Claudia Torino, Francesco Mattace-Raso, Jan L. C. M. van Saase, Maurizio Postorino, Giovanni Luigi Tripepi, Francesca Mallamaci, Carmine Zoccali, null PROGREDIRE Study Group
Přispěvatelé: Internal Medicine
Rok vydání: 2016
Předmět:
Male
Aging
medicine.medical_treatment
030232 urology & nephrology
030204 cardiovascular system & hematology
medicine.disease_cause
Biochemistry
Liver disease
0302 clinical medicine
Risk Factors
hemic and lymphatic diseases
Prospective Studies
Registries
Gamma-glutamyltransferase
Prospective cohort study
education.field_of_study
biology
lcsh:Cytology
gamma-Glutamyltransferase
General Medicine
Middle Aged
Treatment Outcome
Italy
Alkaline phosphatase
Female
Research Article
medicine.medical_specialty
Article Subject
Population
Risk Assessment
03 medical and health sciences
Predictive Value of Tests
Renal Dialysis
Internal medicine
medicine
Humans
lcsh:QH573-671
education
Dialysis
Aged
Proportional Hazards Models
Cell Biology
Clinical Enzyme Tests
Alkaline Phosphatase
medicine.disease
Endocrinology
biology.protein
Kidney Failure
Chronic
Biomarkers
Oxidative stress
Kidney disease
Zdroj: Oxidative Medicine and Cellular Longevity, Vol 2016 (2016)
Oxidative Medicine and Cellular Longevity
Oxidative Medicine and Cellular Longevity. Hindawi Publishing Corporation
ISSN: 1942-0994
1942-0900
DOI: 10.1155/2016/8490643
Popis: Alkaline phosphatase (Alk-Phos) is a powerful predictor of death in patients with end-stage kidney disease (ESKD) and oxidative stress is a strong inducer of Alk-Phos in various tissues. We tested the hypothesis that oxidative stress, as estimated by a robust marker of systemic oxidative stress likeγ-Glutamyl-Transpeptidase (GGT) levels, may interact with Alk-Phos in the high risk of death in a cohort of 993 ESKD patients maintained on chronic dialysis. In fully adjusted analyses the HR for mortality associated with Alk-Phos (50 IU/L increase) was progressively higher across GGT quintiles, being minimal in patients in the first quintile (HR: 0.89, 95% CI: 0.77–1.03) and highest in the GGT fifth quintile (HR: 1.13, 95% CI: 1.03–1.2) (Pfor the effect modification = 0.02). These findings were fully confirmed in sensitivity analyses excluding patients with preexisting liver disease, excessive alcohol intake, or altered liver disease biomarkers. GGT amplifies the risk of death associated with high Alk-Phos levels in ESKD patients. This observation is compatible with the hypothesis that oxidative stress is a strong modifier of the adverse biological effects of high Alk-Phos in this population.
Databáze: OpenAIRE
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