Oxidative Stress‐Related HDL Dysfunction in Hemodialysis: The Clinical Utility of MPO / PON1 and MPO / HDL ‐C Ratios in Cardiovascular Risk Assessment

Q: What are the key findings of this study?

Hemodialysis patients exhibited higher MPO activity and HCY levels and lower PON1 activity compared with healthy controls.

Q: What is the clinical evidence from this study?

Study design: Case-Control. Population: Chronic kidney disease undergoing hemodialysis (n=84). Intervention: Hemodialysis vs. Healthy controls. Primary outcome: MPO activity, PON1 activity, and HCY levels (p=< 0.001).

Q: What does this research mean for the field?

Hemodialysis patients exhibit significantly higher MPO activity and homocysteine levels and lower PON1 activity compared with healthy controls, leading to elevated MPO/PON1 and MPO/HDL-C ratios. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess whether oxidative stress biomarkers—including myeloperoxidase, paraoxonase-1, homocysteine, and their ratios—correlate with cardiovascular risk in hemodialysis patients.

Elif Azize ÖZŞAHİN DELİBAŞ; Kader Köse; Cevat Yazıcı; Bülent Tokgöz

doi:10.1111/1744-9987.70094

November 9, 2025Therapeutic Apheresis and Dialysis

Oxidative Stress‐Related HDL Dysfunction in Hemodialysis: The Clinical Utility of MPO / PON1 and MPO / HDL ‐C Ratios in Cardiovascular Risk Assessment

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Key result

Hemodialysis is linked to higher MPO activity, elevated HCY, and lower PON1 activity vs controls.

P<0.001
n=84

Why the study?

Are oxidative stress-related biomarkers (MPO, PON1, HCY) and their derived ratios altered in hemodialysis patients compared to healthy controls as markers of cardiovascular risk?

Key Points

To assess whether oxidative stress biomarkers—including myeloperoxidase, paraoxonase-1, homocysteine, and their ratios—correlate with cardiovascular risk in hemodialysis patients.
Conducted a case-control study evaluating 42 hemodialysis patients and 42 matched healthy controls.
Quantified plasma homocysteine levels, myeloperoxidase (MPO) activity, paraoxonase-1 (PON1) activity, and standard lipid profiles before and after dialysis to compute functional oxidative stress ratios.
Hemodialysis patients demonstrated significantly elevated MPO activity and homocysteine levels, alongside reduced PON1 activity, compared to healthy controls (p < 0.001).
Both MPO/PON1 and MPO/HDL-C ratios were significantly increased before and after hemodialysis sessions, demonstrating persistent oxidative imbalance.

Study Design

Type

Case-Control (n=84)

Structured PICO

Are oxidative stress-related biomarkers (MPO, PON1, HCY) and their derived ratios altered in hemodialysis patients compared to healthy controls as markers of cardiovascular risk?

P

Population

84 participants comprising 42 hemodialysis patients and 42 matched healthy controls.

C

Comparator

Matched healthy controls (n=42)

O

Outcome

Plasma homocysteine (HCY) levels, myeloperoxidase (MPO) activity, paraoxonase-1 (PON1) activity, lipid profiles, and functional oxidative stress ratios (MPO/PON1, MPO/HDL-C, PON1/HDL-C)surrogate

Main Result

p-value: p=< 0.001

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Implication

The MPO/PON1 ratio may serve as a novel biomarker for oxidative stress and cardiovascular risk stratification in hemodialysis patients.

Abstract

INTRODUCTION: Oxidative stress (OS), inflammation, and lipoprotein dysfunction contribute to the high cardiovascular disease (CVD) risk in chronic kidney disease (CKD) patients undergoing hemodialysis (HD). This study examined whether OS-related biomarkers-myeloperoxidase (MPO), paraoxonase-1 (PON1), and homocysteine (HCY)-and their derived ratios (MPO/PON1, MPO/HDL-C, PON1/HDL-C) are associated with cardiovascular risk. METHODS: A case-control study was conducted including 42 HD patients and 42 matched healthy controls. Plasma HCY levels, MPO activity, and PON1 activity were measured, along with lipid profiles. Functional OS ratios were calculated. RESULTS: HD patients showed higher MPO activity and HCY levels and lower PON1 activity compared with controls (p < 0.001). MPO/PON1 and MPO/HDL-C ratios were significantly elevated before and after dialysis, indicating increased oxidative imbalance. CONCLUSION: The MPO/PON1 ratio may represent a novel biomarker of OS and CVD risk in HD patients, supporting the evaluation of HDL functionality for improved risk stratification.

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Cite This Study

DELİBAŞ et al. (2025) conducted a case-control in Chronic kidney disease undergoing hemodialysis (n=84). Hemodialysis vs. Healthy controls was evaluated on MPO activity, PON1 activity, and HCY levels (p=< 0.001). Hemodialysis patients exhibited higher MPO activity and HCY levels and lower PON1 activity compared with healthy controls.

synapsesocial.com/papers/6a829bee0b4c7242394406b2 https://doi.org/10.1111/1744-9987.70094

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Oxidative Stress‐Related HDL Dysfunction in Hemodialysis: The Clinical Utility of MPO / PON1 and MPO / HDL ‐C Ratios in Cardiovascular Risk Assessment

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Oxidative Stress‐Related HDL Dysfunction in Hemodialysis: The Clinical Utility of MPO / PON1 and MPO / HDL ‐C Ratios in Cardiovascular Risk Assessment

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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