Independent Correlation Between Ischemia Modified Albumin and Parathormone in End Stage Renal Disease

Background: Oxidative stress (OS) has an important role at development of chronic kidney disease (CKD) and progression to end stage renal disease (ESRD). Hemodialysis (HD) patients are the group which oxidative stress is found more exacerbated. Ischemia modified albumin (IMA) is a new and sensitive marker for ischemia and oxidative stress. At current study we evaluated relation between IMA and biochemical parameters in ESRD patients. Methods and Results Thirty-four patients with ESRD on maintenance HD were included in the study. A fasting blood sample pre-HD and post-HD blood sample at the end of the dialysis session were taken from all of the patients. Serum IMA, complete blood count and routine biochemistry parameters were measured. There was a positive correlation between alkaline phosphatase (ALP) and IMA (r = 0,268, p < 0,05), CRP and IMA (r = 0,452, p = 0,007), PTH and IMA (r = 0,436, p = 0,010), There was a negative correlation between albumin and IMA (r=-0,338, p = 0,05). Multiple regression analysis was run to predict IMA levels from PTH, CRP and creatinine the model statistically significantly predicted relation p < 0,05, R = 0,506, out of four two variables added statistically significant to the prediction, PTH (p = 0,006), CRP (p = 0,029). In multiregression analysis, IMA was found to be associated with PTH and CRP independent of creatinine value. Conclusion In this study, we showed for the first time that PTH is associated with IMA in ESRD patients, independent of the level of renal function. IMA may play an important role in the pathogenesis of inflammation due to increased PTH in ESRD. Further studies are needed to further elucidate this issue.