The predictive role of serum calprotectin on mortality in hemodialysis patients with high phosphoremia.
Aged
Biomarkers
/ blood
C-Reactive Protein
/ metabolism
Chronic Disease
Female
Follow-Up Studies
Humans
Inflammation
/ blood
Kaplan-Meier Estimate
Kidney Failure, Chronic
/ blood
Leukocyte Count
Leukocyte L1 Antigen Complex
/ blood
Male
Middle Aged
Phosphates
/ blood
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Renal Dialysis
Retrospective Studies
Chronic inflammation
Hemodialysis patients
Phosphate
Prognostic biomarker
Serum calprotectin
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
04 05 2020
04 05 2020
Historique:
received:
24
01
2020
accepted:
16
04
2020
entrez:
6
5
2020
pubmed:
6
5
2020
medline:
26
8
2021
Statut:
epublish
Résumé
The inflammatory mediator calprotectin (CPT, myeloid-related protein 8/14) is known as an endogenous ligand contributing to pathophysiology in inflammatory diseases. Serum CPT reportedly became a potential biomarker in these conditions, though there is no report predicting the prognosis in hemodialysis patients. The aim of this study is to investigate the predictive role of serum CPT on mortality in hemodialysis patients. We conducted a multicenter, observational cohort study of 388 Japanese subjects undergoing hemodialysis. Serum CPT were measured using an ELISA. The potential associations between serum CPT and clinical variables were cross-sectionally examined. Multivariate Cox regression was used to estimate the association between serum CPT, high-sensitivity C reactive protein (hs-CRP), white blood cell (WBC) count and mortality. Median follow-up was 6.6 years. The median CPT level was 6108 ng/ml (median in healthy subjects, 2800) at baseline. Serum CPT positively correlated with WBC count (ρ = 0.54, P < 0.001) and hs-CRP values (ρ = 0.35, P < 0.001). In multivariate analysis, hs-CRP was an independent predictor of all-cause mortality after adjusting confounding factors (middle vs. low: hazard ratio [HR] 2.09, 95% confidence interval [CI] 1.23-3.66; high vs. low: 2.47, 1.40-4.47). In the analysis by stratum of phosphate levels, elevated CPT levels were significantly associated with all-cause mortality in the highest tertile (18.1; 3.15-345.9) among the high-phosphate group, but not among the low-phosphate group. Serum CPT would become a potential predictive marker on mortality in hemodialysis patients with high-phosphate levels.
Sections du résumé
BACKGROUND
The inflammatory mediator calprotectin (CPT, myeloid-related protein 8/14) is known as an endogenous ligand contributing to pathophysiology in inflammatory diseases. Serum CPT reportedly became a potential biomarker in these conditions, though there is no report predicting the prognosis in hemodialysis patients. The aim of this study is to investigate the predictive role of serum CPT on mortality in hemodialysis patients.
METHODS
We conducted a multicenter, observational cohort study of 388 Japanese subjects undergoing hemodialysis. Serum CPT were measured using an ELISA. The potential associations between serum CPT and clinical variables were cross-sectionally examined. Multivariate Cox regression was used to estimate the association between serum CPT, high-sensitivity C reactive protein (hs-CRP), white blood cell (WBC) count and mortality. Median follow-up was 6.6 years.
RESULTS
The median CPT level was 6108 ng/ml (median in healthy subjects, 2800) at baseline. Serum CPT positively correlated with WBC count (ρ = 0.54, P < 0.001) and hs-CRP values (ρ = 0.35, P < 0.001). In multivariate analysis, hs-CRP was an independent predictor of all-cause mortality after adjusting confounding factors (middle vs. low: hazard ratio [HR] 2.09, 95% confidence interval [CI] 1.23-3.66; high vs. low: 2.47, 1.40-4.47). In the analysis by stratum of phosphate levels, elevated CPT levels were significantly associated with all-cause mortality in the highest tertile (18.1; 3.15-345.9) among the high-phosphate group, but not among the low-phosphate group.
CONCLUSIONS
Serum CPT would become a potential predictive marker on mortality in hemodialysis patients with high-phosphate levels.
Identifiants
pubmed: 32366231
doi: 10.1186/s12882-020-01812-x
pii: 10.1186/s12882-020-01812-x
pmc: PMC7197146
doi:
Substances chimiques
Biomarkers
0
Leukocyte L1 Antigen Complex
0
Phosphates
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
158Subventions
Organisme : Japan Society for the Promotion of Science
ID : 19K08728
Pays : International
Organisme : Japan Society for the Promotion of Science
ID : 17K09703
Pays : International
Organisme : Japan Society for the Promotion of Science
ID : 17K09706
Pays : International
Organisme : Strategic Grant from Center for Metabolic Regulation of Healthy Aging, Kumamoto University Faculty of Life Sciences
ID : 009-0909005001011
Pays : International
Organisme : Japan Kidney Foundation
ID : JFKB19-21
Pays : International
Organisme : Takeda Medical Research Foundation
ID : 09700220
Pays : International
Organisme : Japanese Association of Dialysis Physicians
ID : 2019-23
Pays : International
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