Association of trimethylamine N -Oxide with cardiovascular and all-cause mortality in hemodialysis patients.

Autor: Zhang P; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Zou JZ; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Chen J; Department of Pharmaceutics, School of Pharmacy, Fudan University, Shanghai, China., Tan X; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Xiang FF; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Shen B; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Hu JC; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Wang JL; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Wang YQ; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Yu JB; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Nie YX; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Chen XH; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Yu JW; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Zhang Z; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Lv WL; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Xie YQ; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Cao XS; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China., Ding XQ; Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.; Hemodialysis Quality Control Center of Shanghai, Shanghai, China.; Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.; Shanghai Institute for Kidney and Dialysis, Shanghai, China.; Shanghai Clinical Medical Center for Kidney Disease, Shanghai, China.
Jazyk: angličtina
Zdroj: Renal failure [Ren Fail] 2020 Nov; Vol. 42 (1), pp. 1004-1014.
DOI: 10.1080/0886022X.2020.1822868
Abstrakt: Background: Trimethylamine- N -Oxide (TMAO) is a proatherogenic and prothrombotic metabolite. Our study examined the association of plasma TMAO level with cardiovascular and all-cause mortality in hemodialysis (HD) patients.
Methods: Patients who were at least 18 years-old and received HD for at least 6 months were enrolled within 6 months. Patients with coronary heart disease, congestive heart failure, arrhythmia, or stroke within 3 months before study onset were excluded. The primary endpoints were cardiovascular and all-cause death, and the secondary endpoint was cerebrovascular death.
Results: We recruited 252 patients and divided them into a high-TMAO group (>4.73 μg/mL) and a low-TMAO group (≤4.73 μg/mL). The median follow-up time was 73.4 months (interquartile range: 42.9, 108). A total of 123 patients died, 39 from cardiovascular disease, 19 from cerebrovascular disease, and 65 from other causes. Kaplan-Meier analysis indicated that the high-TMAO group had a greater incidence of cardiovascular death (Log-Rank: p  = 0.006) and all-cause death (Log-Rank: p  < 0.001). Cox regression analysis showed that high TMAO level was significantly associated with cardiovascular and all-cause mortality. After adjustment for confounding, this association remained significant for cardiovascular mortality (TMAO as a continuous variable: HR: 1.18, 95%CI: 1.07, 1.294, p  < 0.001; TMAO as a dichotomous variable: HR: 3.44, 95%CI: 1.68, 7.08, p  < 0.001) and all-cause mortality (TMAO as a continuous variable: HR: 1.14, 95%CI: 1.08, 1.21, p  < 0.001; TMAO as a dichotomous variable: HR: 2.54, 95%CI: 1.71, 3.76, p  < 0.001).
Conclusions: High plasma TMAO level is significantly and independently associated with cardiovascular and all-cause mortality in HD patients.
Databáze: MEDLINE
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