Elevated Circulating Cell-Free DNA in Hemodialysis-Treated Patients Is Associated with Increased Mortality
| Autor: | Alla Shnaider, Boris Rogachev, Yosef S. Haviv, Ilan Rozenberg, Yotam Lior, Naomi Nacasch, Keren Cohen-Hagai, Anna Basok, Sydney Benchetrit, Khaled Ghanayem, Tali Zitman-Gal, Amos Douvdevani, Yael Einbinder |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology 030204 cardiovascular system & hematology Logistic regression Risk Assessment Gastroenterology 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Renal Dialysis Risk Factors Internal medicine Diabetes mellitus Diabetes Mellitus medicine Humans Prospective Studies Prospective cohort study Aged Aged 80 and over business.industry Hazard ratio Age Factors Middle Aged Prognosis medicine.disease Circulating Cell-Free DNA Cell-free fetal DNA Nephrology Kidney Failure Chronic Biomarker (medicine) Female Hemodialysis business Cell-Free Nucleic Acids Biomarkers Follow-Up Studies |
| Zdroj: | American Journal of Nephrology. 51:852-860 |
| ISSN: | 1421-9670 0250-8095 |
| Popis: | Background: Predicting the mortality risk of patients undergoing hemodialysis (HD) is challenging. Cell-free DNA (cfDNA) is released into circulation from dying cells, and its elevation is predictive of unfavorable outcome. In a pilot study, we found post-HD cfDNA level to be a predictor of all-cause mortality. Thus, the aim of this study was to confirm the prognostic power of cfDNA in a larger prospective cohort study conducted at 2 medical centers. Methods: CfDNA levels were measured by a rapid fluorometric assay on sera obtained before and after 1 HD session. One hundred fifty-three patients were followed up to 46 months for mortality during which time 47 patients died. We compared the predictive value of cfDNA to age, comorbidities, and standard blood tests. Results: Examining standard blood tests, only post-HD cfDNA levels were elevated in the non-survivor group compared to survivors (959 vs. 803 ng/mL, p = 0.04). Pre- and post-HD cfDNA levels correlated with age and diabetes. Patients with elevated cfDNA (>850 ng/mL) showed lower survival than those with normal levels. A Cox proportional hazard regression model demonstrated a significant hazard ratio of 1.92 for post-HD cfDNA levels. Logistic regression models showed that post-HD cfDNA was a significant predictor of mortality at 1–3 years with odd ratios of 4.61, 4.36, and 6.22, respectively. Conclusions: Post-HD cfDNA level was superior to standard blood tests and could serve as a biomarker to assist in decision-making for HD-treated patients. |
| Databáze: | OpenAIRE |
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