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Elevated levels of soluble ST2 but not galectin-3 are associated with increased risk of mortality in hemodialysis patients

Kidney Research and Clinical Practice 2021년 40권 1호 p.109 ~ 119
김애진, Ro Han, 김현숙, 고광필, 장재현, 이현희, 정우경, 정지용,
소속 상세정보
김애진 ( Kim Ae-Jin ) - Gachon University Gil Medical Center Department of Internal Medicine
 ( Ro Han ) - Gachon University Gil Medical Center Department of Internal Medicine
김현숙 ( Kim Hyun-Sook ) - Gachon University Department of Health Sciences and Technology
고광필 ( Ko Kwang-Pil ) - Gachon University College of Medicine Department of Preventive Medicine
장재현 ( Chang Jae-Hyun ) - Gachon University Gil Medical Center Department of Internal Medicine
이현희 ( Lee Hyun-Hee ) - Gachon University Gil Medical Center Department of Internal Medicine
정우경 ( Chung Woo-Kyung ) - Gachon University Gil Medical Center Department of Internal Medicine
정지용 ( Jung Ji-Yong ) - Gachon University Gil Medical Center Department of Internal Medicine

Abstract


Background: The soluble forms of suppression of tumorigenicity-2 (ST2) and galectin-3 have been proposed as novel biomarkers for cardiac fibrosis and heart failure, as well as predictors of cardiovascular events and mortality. However, there are limited data on the association between soluble ST2 and galectin-3 and clinical outcomes in patients with kidney failure on replacement therapy. To determine this, we examined the associations between soluble ST2 and galectin-3 and all-cause mortality and cardiovascular events in patients on hemodialysis.

Methods: This study included maintenance hemodialysis patients (over 18 years old) who consented to preserve their serum in the Biobank at our institution between March 2014 and March 2015. We used Cox proportional hazards regression analysis to evaluate the associations between soluble ST2, galectin-3 levels, and clinical outcomes. The primary outcome was all-cause mortality, the secondary outcome was cardiovascular disease, and patients were followed for both outcomes until March 2018.

Results: A total of 296 patients were analyzed in this study. The mean age was 57 ± 13 years, and 53.0% were male. Serum concentration of soluble ST2 was significantly associated with higher mortality, after adjustment for confounding factors, but was not associated with cardiovascular disease. Serum galectin-3 level was not independently associated with either outcome after adjustment.

Conclusion: Elevated soluble ST2 is independently associated with an increased risk of mortality, but not with cardiovascular disease, in patients on hemodialysis. Elevated galectin-3 was not associated with mortality or cardiovascular disease.

키워드

Cardiovascular diseases; Galectin 3; Hemodialysis; Mortality; Soluble ST2

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