Abstract

Background and Objectives: This cross-sectional study aimed to explore whether plasma myeloperoxidase (MPO) and its active product, 3-chlorotyrosine (3-CT), as markers of inflammation and oxidative stress, have any independent pathophysiological association with sarcopenia-related parameters in patients with chronic kidney disease (CKD). Methods and Study Design: A total of 292 patients, including 147 on maintenance hemodialysis (HD) and 145 non-dialyzed hospitalized patients with CKD stages 1-5, were enrolled from September 2022 to December 2023 and categorized into three groups: CKD stages 1-2, CKD stages 3-5 (non-dialysis), and CKD stage 5 (HD). Clinical data, anthropometric measurements, and body composition via bioelectrical impedance analysis were collected. Plasma MPO and 3-CT levels were measured by enzyme-linked immunosorbent assay and liquid chromatography-mass spectrometry (LC-MS), respectively. Results: Results showed that as kidney function declined, plasma MPO levels significantly increased across the CKD stage 1-2, stage 3-5, and HD groups [93.5 (72.3, 103.0) ng/mL, 90.8 (76.0, 106) ng/mL, and 102 (80.7, 126) ng/mL, respectively; H = 174, p <0.001]. The prevalence of sarcopenia also increased significantly across CKD stages (17.3%, 17.1%, and 29.9%, respectively; χ² = 6.52, p = 0.038). Interestingly, statistical analysis confirmed a significant inverse association between plasma 3-CT levels and pinch strength (r = -0.148, p = 0.036). However, there were no significant correlation between plasma MPO or 3-CT levels and sarcopenia. Conclusions: The negative association between plasma 3-CT and pinch strength suggests a link between MPO-mediated inflammation/oxidative stress and fine hand muscle dysfunction, which provides a new perspective for evaluating early, subclinical muscle dysfunction in CKD patients.

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