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Study identifies new risk factor for heart disease among kidney dialysis patients
Date:3/6/2013

BOSTON Kidney failure affects 25 million individuals in the U.S. and many more throughout the world. Loss of kidney function means the majority of these patients must undergo dialysis treatments to remove excess fluids and waste products. Although dialysis therapy coupled with medication has improved the life expectancy for people with kidney failure, for unknown reasons, patients' risk of sudden heart failure and death remains 10 to 20 times greater than average.

Now, a study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) and Massachusetts General Hospital helps explain why this may be the case. Appearing on-line today in Science Translational Medicine, the new findings show that a process known as protein carbamylation contributes to heart disease risk among patients with kidney failure undergoing dialysis, and demonstrates that a blood test to measure carbamylated albumin protein can help clinicians better gauge the effectiveness of dialysis and identify patients at risk of cardiac complications. The findings additionally suggest the need for further investigation to determine if therapy with supplemental amino acids could help to prevent the carbamylation process.

"Patients with kidney failure often accumulate urea in their blood because it is a chemical byproduct of metabolism normally eliminated in the urine or removed by dialysis treatments," explains first author Anders Berg, MD, PhD, a clinical chemist in the Department of Pathology at BIDMC and Instructor in Pathology at Harvard Medical School. Although urea is generally non-toxic, in some cases it can degrade into cyanate, a toxic chemical that binds to and permanently modifies proteins through a process known as carbamylation.

"These modifications can make proteins inactive, or worse, can make them toxic," says Berg. "For example, when the cholesterol-carrying blood proteins LDL and HDL are carbamylated, instead of heading for tissues where they
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Contact: Bonnie Prescott
bprescot@bidmc.harvard.edu
617-667-7306
Beth Israel Deaconess Medical Center
Source:Eurekalert

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