The Association of Kidney Function and Cardiovascular Disease Indices with Pro-Oxidant and Antioxidant Markers in CKD

Oxidative stress (OS) is highly prevalent in chronic kidney disease (CKD), yet its clinical significance and association with cardiovascular disease (CVD) has not been yet clearly demonstrated. In this cohort study, 477 adults with CKD at various stages and 20 healthy controls were enrolled. In all participants, an extensive panel of OS biomarkers was measured. Malondialdehyde (MDA) was correlated with glomerular filtration rate (eGFR) and carotid intima media thickness (cIMT) (p = 0.008 and p = 0.024, respectively, according to Spearman’s rho). Advanced oxidation protein products (AOPPs) were correlated with the urine protein-to-creatinine ratio (uPCR), parathormone (PTH) and eGFR (p = 0.048, p = 0.025 and p = 0.045 respectively, according to Spearman’s rho) and oxidized albumin (oxALB) was correlated with PTH (p = 0.032) and pulse wave velocity (PWV) (p = 0.017). The antioxidant enzyme superoxide dismutase (SOD) was correlated with PWV (p = 0.042), urea (p < 0.001), uPCR (p = 0.024), and eGFR (p < 0.001). Meanwhile, catalase (CAT) was correlated with eGFR (p = 0.029) and indices of central pressure. Xanthine oxidase (XO) was correlated with the duration of CVD and PWV. Multivariate analysis showed that kidney function and/or arterial stiffness and CVD were independent predictors of all OS markers.