Association of Growth Differentiation Factor 15 with Mortality in a Prospective Hemodialysis Cohort
| Autor: | Jennie Jing, Kamyar Kalantar-Zadeh, Melissa Soohoo, Lorena Lerner, Lidia Lou, Danh V. Nguyen, Jeno Gyuris, Frank Zaldivar, Tracy Nakata, Mary Veliz, Connie M. Rhee, Nancy Lopez, Amy S. You |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment 030232 urology & nephrology Disease 030204 cardiovascular system & hematology Dialysis patients 03 medical and health sciences 0302 clinical medicine Internal medicine Growth differentiation factor 15 Medicine Mortality Intensive care medicine Wasting Dialysis Original Paper business.industry High mortality Cardiovascular disease Cohort Hemodialysis GDF15 medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | You, AS; Kalantar-Zadeh, K; Lerner, L; Nakata, T; Lopez, N; Lou, L; et al.(2017). Association of Growth Differentiation Factor 15 with Mortality in a Prospective Hemodialysis Cohort. CARDIORENAL MEDICINE, 7(2), 158-168. doi: 10.1159/000455907. UC Irvine: Retrieved from: http://www.escholarship.org/uc/item/7fq4t4dp |
| DOI: | 10.1159/000455907. |
| Popis: | Background/Aims: Cardiovascular disease and protein-energy wasting are among the strongest predictors of the high mortality of dialysis patients. In the general population, the novel cardiovascular and wasting biomarker, growth differentiation factor 15 (GDF15), is associated with decreased survival. However, little is known about GDF15 in dialysis patients. Methods: Among prevalent hemodialysis patients participating in a prospective study (October 2011 to August 2015), we examined the association of baseline GDF15 levels with all-cause mortality using unadjusted and case mix-adjusted death hazard ratios (HRs) that controlled for age, sex, race, ethnicity, diabetes, and dialysis vintage. Results: The mean age ± SD of the 203 patients included in the study was 53.2 ± 14.5 years, and the cohort included 41% females, 34% African-Americans, and 48% Hispanics. GDF15 levels (mean ± SD 5.94 ± 3.90 ng/mL; range 1.58-39.8 ng/mL) were higher among older patients and were inversely associated with serum creatinine concentrations as a surrogate for muscle mass. Each 1.0 ng/mL increase in GDF15 was associated with an approximately 17-18% higher mortality risk in the unadjusted and case mix models (p < 0.05). Increments of about 1 SD (a 4.0 ng/mL increase in GDF15) were associated with a nearly 2-fold higher death risk. The highest GDF15 tertile was associated with higher mortality risk (reference: lowest tertile): the HRs (95% CI) were 3.19 (1.35-7.55) and 2.45 (1.00-6.00) in the unadjusted and the case mix-adjusted model, respectively. These incremental death trends were confirmed in cubic spline models. Conclusion: Higher circulating GDF15 levels are associated with higher mortality risk in hemodialysis patients. Future studies are needed to determine whether GDF15 may represent a novel therapeutic target for cardiovascular disease, wasting, and death in this population. |
| Databáze: | OpenAIRE |
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