Protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease
Serum carbamylated albumin (C-Alb) levels are associated with excess mortality in patients with diabetic end stage renal disease. To gain insight into the pathophysiology of carbamylation, we determined associations between C-Alb and causes of death in patients on chronic hemodialysis. The Die Deuts...
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2015
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449819/ |
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pubmed-44498192015-12-01 Protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease Drechsler, Christiane Kalim, Sahir Wenger, Julia B. Suntharalingam, Pirianthini Hod, Tammy Thadhani, Ravi I. Karumanchi, S. Ananth Wanner, Christoph Berg, Anders H. Article Serum carbamylated albumin (C-Alb) levels are associated with excess mortality in patients with diabetic end stage renal disease. To gain insight into the pathophysiology of carbamylation, we determined associations between C-Alb and causes of death in patients on chronic hemodialysis. The Die Deutsche Diabetes Dialyse Studie (4D study) was a randomized controlled trial testing the effects of atorvastatin on survival in diabetic patients on dialysis during a median follow-up of 4 years. We stratified 1,161 patients by C-Alb to see if differences in carbamylation altered the effects of atorvastatin on survival. Baseline C-Alb significantly correlated with serum cardiac stress markers troponin T and N-terminal pro-B-type-natriuretic peptide, and was associated with history of heart failure and arrhythmia. C-Alb was strongly associated with 1-year adjusted risk of CV mortality, sudden cardiac death and the 4-year risk of death from congestive heart failure (Hazard Ratios of 3.06, 3.78 and 4.64, respectively), but not with myocardial infarction or stroke. Patients with low C-Alb, treated with atorvastatin, experienced a significant improvement in their 4-year survival (Hazard Ratio 0.692). High C-Alb levels are associated with ongoing cardiac damage, risk of congestive heart failure and sudden cardiac death. Thus, carbamylation and uremic cardiomyopathy are associated in patients with diabetes mellitus and kidney disease. Additionally, statins were specifically beneficial to hemodialysis patients with low C-Alb. 2015-02-11 2015-06 /pmc/articles/PMC4449819/ /pubmed/25671766 http://dx.doi.org/10.1038/ki.2014.429 Text en http://www.nature.com/authors/editorial_policies/license.html#terms Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Drechsler, Christiane Kalim, Sahir Wenger, Julia B. Suntharalingam, Pirianthini Hod, Tammy Thadhani, Ravi I. Karumanchi, S. Ananth Wanner, Christoph Berg, Anders H. |
| spellingShingle |
Drechsler, Christiane Kalim, Sahir Wenger, Julia B. Suntharalingam, Pirianthini Hod, Tammy Thadhani, Ravi I. Karumanchi, S. Ananth Wanner, Christoph Berg, Anders H. Protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease |
| author_facet |
Drechsler, Christiane Kalim, Sahir Wenger, Julia B. Suntharalingam, Pirianthini Hod, Tammy Thadhani, Ravi I. Karumanchi, S. Ananth Wanner, Christoph Berg, Anders H. |
| author_sort |
Drechsler, Christiane |
| title |
Protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease |
| title_short |
Protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease |
| title_full |
Protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease |
| title_fullStr |
Protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease |
| title_full_unstemmed |
Protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease |
| title_sort |
protein carbamylation is associated with heart failure and mortality in diabetic patients with end stage renal disease |
| description |
Serum carbamylated albumin (C-Alb) levels are associated with excess mortality in patients with diabetic end stage renal disease. To gain insight into the pathophysiology of carbamylation, we determined associations between C-Alb and causes of death in patients on chronic hemodialysis. The Die Deutsche Diabetes Dialyse Studie (4D study) was a randomized controlled trial testing the effects of atorvastatin on survival in diabetic patients on dialysis during a median follow-up of 4 years. We stratified 1,161 patients by C-Alb to see if differences in carbamylation altered the effects of atorvastatin on survival. Baseline C-Alb significantly correlated with serum cardiac stress markers troponin T and N-terminal pro-B-type-natriuretic peptide, and was associated with history of heart failure and arrhythmia. C-Alb was strongly associated with 1-year adjusted risk of CV mortality, sudden cardiac death and the 4-year risk of death from congestive heart failure (Hazard Ratios of 3.06, 3.78 and 4.64, respectively), but not with myocardial infarction or stroke. Patients with low C-Alb, treated with atorvastatin, experienced a significant improvement in their 4-year survival (Hazard Ratio 0.692). High C-Alb levels are associated with ongoing cardiac damage, risk of congestive heart failure and sudden cardiac death. Thus, carbamylation and uremic cardiomyopathy are associated in patients with diabetes mellitus and kidney disease. Additionally, statins were specifically beneficial to hemodialysis patients with low C-Alb. |
| publishDate |
2015 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449819/ |
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1613229734379913216 |