Carbamylated Hemoglobin as an Indicator of Hemodialysis Adequacy and Complications |
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Authors: | Saeed Abdelwhab Hayam Ahmed |
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Institution: | (1) Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt |
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Abstract: | Carbamylation is an irreversible process of non-enzymatic modification of proteins by the breakdown products of urea. The
degree of carbamylation has been proposed as an indicator of the control of uremia by dialysis. Our aim is to study potential
determinants of carbamylated hemoglobin (CarbHb) and the relationship between CarbHb with dialysis adequacy and common complications
of CRF. The study was carried out on 35 patients with CRF on regular hemodialysis (HD) (group 1), 35 patients with CRF on
conservative treatments (group 2), and 35 normal controls (group 3). For all groups complete history, clinical examination,
routine laboratory investigations, ECG, efficiency of dialysis for group 1 using KT/V, nerve conduction, resting ECG, and
CarbHb level were taken. In HD patients, CarbHb correlates with Kt/V (P < 0.001) and neuropathy (P = 0.004). Mean CarbHb is 129.47 ± 23.50, 88.09 ± 9.41, and 30.7950 ± 1.9395 μg CV/g Hb for groups 1, 2, and 3, respectively.
ROC curve CarbHb with resting ECG shows the area under the curve (0.765, 0.718) for group 1 and 2, respectively. ROC curve
study for CarbHb and nerve affection shows group area under the curve (0.766, 0.551) for group 1 and 2, respectively. CarbHb
is higher in uremia and more with regular HD than in patients under conservative treatment. In HD patients CarbHb correlates
with KT/V and can be used as a supportive measure for adequacy of dialysis. The presence of complications like IHD and neuropathy
in dialysis patients correlates with CarbHb, which can be used as a marker for the tendency to develop these complications. |
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Keywords: | Hemodialysis Dialysis adeqaucy End-stage renal disease Carbamylated hemoglobin Dialysis complications |
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