Prognostic assays for maintenance hemodialysis patients
First Claim
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1. A method for predicting mortality risk in a maintenance hemodialysis (MHD) patient comprising:
- a. separating lipoprotein particles from non-lipoprotein particles in a plasma sample from an MHD patient;
b. irradiating with alpha radiation and fractionating the lipoprotein particles according to particle diameter using on mobility lipoprotein fractionation;
c. determining a very small low density lipoprotein (vs-LDL) particle concentration in the plasma sample by detecting and counting the fractionated lipoprotein particles having a particle diameter of 180.0-208.2 A;
d. determining a large low density lipoprotein (1-LDL) particle concentration in the plasma sample by detecting and counting the fractionated lipoprotein particles having a particle diameter of 220.0-233.3 A; and
e. identifying the MHD patient as having;
i. increased risk of mortality when the sample vs-LDL particle concentration is greater than a reference vs-LDL particle concentration;
ii. reduced risk of mortality when the sample 1-LDL particle concentration is greater than a reference 1-LDL particle concentration;
oriii. no change in the risk of mortality when the sample vs-LDL particle concentration is less than or equal to the reference vs-LDL particle concentration and the sample 1-LDL particle concentration is less than the reference 1-LDL concentration,whereby a vs-LDL particle concentration in a plasma sample from a MHD patient that is greater than the reference vs-LDL particle concentration and a 1-LDLparticle concentration in a plasma sample from a MHD patient that is greater than the reference 1-LDL particle concentration indicates an reduced risk of mortality in the MHD patient.
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Abstract
Described herein are methods for determining the overall survival of maintenance hemodialysis patients. The methods include measuring low density lipoprotein (LDL) particle size and subfraction concentrations as prognostic tools for early mortality risk detection. For example, the presence of increased very small LDL concentration or decreased LDL particle size in blood-serum serves as a useful means for prognostic risk assessment and monitoring.
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Citations
18 Claims
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1. A method for predicting mortality risk in a maintenance hemodialysis (MHD) patient comprising:
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a. separating lipoprotein particles from non-lipoprotein particles in a plasma sample from an MHD patient; b. irradiating with alpha radiation and fractionating the lipoprotein particles according to particle diameter using on mobility lipoprotein fractionation; c. determining a very small low density lipoprotein (vs-LDL) particle concentration in the plasma sample by detecting and counting the fractionated lipoprotein particles having a particle diameter of 180.0-208.2 A; d. determining a large low density lipoprotein (1-LDL) particle concentration in the plasma sample by detecting and counting the fractionated lipoprotein particles having a particle diameter of 220.0-233.3 A; and e. identifying the MHD patient as having; i. increased risk of mortality when the sample vs-LDL particle concentration is greater than a reference vs-LDL particle concentration; ii. reduced risk of mortality when the sample 1-LDL particle concentration is greater than a reference 1-LDL particle concentration;
oriii. no change in the risk of mortality when the sample vs-LDL particle concentration is less than or equal to the reference vs-LDL particle concentration and the sample 1-LDL particle concentration is less than the reference 1-LDL concentration, whereby a vs-LDL particle concentration in a plasma sample from a MHD patient that is greater than the reference vs-LDL particle concentration and a 1-LDL particle concentration in a plasma sample from a MHD patient that is greater than the reference 1-LDL particle concentration indicates an reduced risk of mortality in the MHD patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 17, 18)
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10. A method for predicting mortality risk in a maintenance hemodialysis (MHD) patient comprising,
a. separating lipoprotein particles from non-lipoprotein particles in a plasma sample from an MHD patient; -
b. irradiating with alpha radiation and fractionating the lipoprotein particles according to particle diameter using on mobility lipoprotein fractionation; c. determining a small low density lipoprotein (s-LDL) particle concentration in the plasma sample by detecting and counting the fractionated lipoprotein particles having a particle diameter of 208.2-214.1 A; d. determining a large low density lipoprotein (1-LDL) particle concentration in the plasma sample by detecting and counting the fractionated lipoprotein particles having a particle diameter of 220.0-233.3 A; e. determining a ratio of the sample 1-LDL particle concentration to the sample s-LDL particle concentration, and f. identifying the MHD patient as having reduced risk of mortality when the sample l-LDL;
s-LDL ratio is greater than a reference l-LDL;
s-LDL ratio or identifying the MHD patient as having no change in the risk of mortality when the reference LDL;
s-LDL ratio is less than the reference ratio. - View Dependent Claims (11, 12, 13, 14, 15, 16)
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Specification