Analysis of Thromboinflammatory and Oxidative Stress Biomarkers in Patients with ESRD

Background: Atrial fibrillation (AF) is a frequent comorbid condition in patients with end-stage renal disease (ESRD). AF presents thromboembolic risk, and loss of renal function in ESRD causes susceptibility to increasing oxidative stress level. Endothelial dysregulation may contribute to molecular and cellular imbalance involved in AF and be exacerbated with ESRD, illustrated by increased levels of circulating endothelial, inflammatory, and oxidative stress biomarkers. Methods: The study determines the differences between thrombo-inflammatory and oxidative stress biomarkers in ESRD patients with and without comorbid AF. Banked ESRD plasma samples were selected to identify patients with and without AF. Validated ELISA and appropriate statistical methods were used to profile the biomarkers and clinical correlates. Results: EPIC analysis reveals that the AF group has greater representation of male, black, and older patients than the non-AF group. Additionally, AF patients have higher comorbidity counts for disease states such as DVT, PE, and MI, and higher lab levels of liver enzymes, such as AST, ALP, ASP, and bilirubin. Initial analysis shows statistically significant difference in many thrombo-inflammatory and oxidative stress biomarker levels, such as thrombomodulin, in ESRD patients with and without AF, as well as moderate correlations between various biomarkers. Conclusion: ESRD patients with and without AF show high levels of thromboinflammatory and oxidative stress biomarkers. Moderate correlation between these biomarkers indicates relation between the two disease processes. The differences in correlation between various biomarkers for the two patient groups lends to understanding of the disease processes separately and concurrently. This study will be useful in assessing the pathophysiology of these disease states by evaluating biomarker levels in ESRD patients with or without AF. Funding: Other NIH Support - NIH T35 Research Training Program