To explore the correlation between peroxiredoxin 2 (PRDX2) and the prognosis of patients treated by maintenance hemodialysis (MHD).

A total of 134 patients treated by MHD (MHD group) and 100 healthy subjects (control group) were selected from the First Hospital Affiliated to Hebei North University from March to June 2018. The patients treated by MHD were divided into non-MACE group and MACE group according to the occurrence of endpoint events (major adverse cardiovascular events, MACE) during the follow-up period. Plasma PRDX2 level was detected by enzyme-linked immunosorbent assay. COX regression method was used to analyze the risk factors for the occurrence of MACE in the patients treated by MHD. The receiver operating characteristic (ROC) curve was used to evaluate the value of PRDX2 in predicting the occurrence of MACE in MHD patients. The dose-effect relationship between PRDX2 and the occurrence of MACE in MHD patients was analyzed by the restrictive cubic spline fitting COX regression method.

The level of plasma PRDX2 in the MHD group was lower than that in the control group (P<0.05). In the MACE group, the proportion of diabetes history and the level of high-sensitivity C-reactive protein (hs-CRP) were higher than those in the non-MACE group, while the levels of hemoglobin and plasma albumin were lower than those in the non-MACE group (P<0.05). The levels of plasma PRDX2 before and after treatment in the MACE group were lower than those in the non-MACE group (P<0.05). The levels of plasma PRDX2 after treatment in both the MACE group and the non-MACE group were higher than those before treatment (P<0.05). The increase degree of plasma PRDX2 after treatment in the MACE group was higher than that in the non-MACE group (P<0.05). The area under the ROC curve of PRDX2 before treatment in predicting the occurrence of MACE in MHD patients was larger than both that after treatment and that of the difference value of those before and after treatment (P<0.05). COX regression analysis showed that high level of hemoglobin (HR=0.975, 95%CI: 0.959-0.992, P=0.004), high level of plasma albumin (HR=0.928, 95%CI: 0.888-0.971, P=0.001), and high level of pre-treatment PRDX2 (HR=0.827, 95%CI: 0.743-0.920, P<0.001) were independent protective factors for the occurrence of MACE in the MHD patients. The results of COX regression analysis with restricted cubic spline fitting showed that the level of PRDX2 before treatment had a non-linear relationship with the occurrence of MACE in the MHD patients.

The level of plasma PRDX2 before treatment related to the occurrence of MACE in the patients treated by MHD, whose lower level may indicate a high risk of MACE in the MHD patients.