Sensitivity and specificity prediction of the buccal micronucleus cytome assay in end-stage renal disease patients on dialysis: A case-control study

- ESRD patients had significantly increased frequency of clastogenic/aneugenic, cell-proliferation, cytokinesis-defect and cell death events.
- Patients on longer hemodialysis duration showed association with higher MN frequency.
- ROC curve analysis revealed cells with MN as the best predictor with AUC of 0.998, exhibiting highest validity in discriminating patients from controls.

Patients with end-stage renal disease (ESRD) require hemodialysis. However, dialysis therapy may cause genomic damage due to increased oxidative stress. Non-invasive assessment of genotoxicity may be helpful for developing management strategies. We applied the buccal micronucleus cytome (BMCyt) assay to ESRD patients on dialysis. Patients (n = 35, age 52 ± 2 year) on dialysis therapy (20.9 ± 0.8 months) had low glomerular filtration rates (GFR = 5.00 ± 0.36 ml/min/1.73 m2); controls (n = 21, age 51 ± 2 year) were healthy adults with no known recent illnesses or exposures. Patients had significantly increased chromosome damage: clastogenic/aneugenic events (frequency of cells with MN), cellproliferation (basal cells), cytokinesis defects (binucleated cells), and celldeath (pyknotic cells); Repair Index was lower in the patient group. Receiver Operator Characteristic (ROC) curve analysis showed that cells with MN were the best predictor for discriminating between patients and controls. Other predictivebiomarkers were the frequencies of basal, binucleated,and pyknotic.