Ture Lange Nielsen1, Louis Lind Plesner1, Peder Emil Warming1, Jannik Langtved Pallisgaard1, Morten Dalsgaard1, Morten Schou1, Ulla Høst2, Casper Rydahl3, Lisbet Brandi4, Lars Køber5, Julia Sidenius Johansen6, Jens Kastrup5, Kasper Karmark Iversen1. 1. a Department of Cardiology , Herlev Hospital University of Copenhagen , Copenhagen , Denmark. 2. b Medical Department , Glostrup Hospital, Rigshospitalet University of Copenhagen , Copenhagen , Denmark. 3. c Department of Nephrology , Herlev Hospital University of Copenhagen , Copenhagen , Denmark. 4. d Department of Cardiology, Endocrinology and Nephrology , North Zealand Hospital University of Copenhagen , Copenhagen , Denmark. 5. e Department of Cardiology , Rigshospitalet University of Copenhagen , Copenhagen , Denmark. 6. f Departments of Medicine and Oncology , Herlev Hospital University of Copenhagen , Copenhagen , Denmark.
Abstract
PURPOSE: This study aimed to determine serum YKL-40 in patients with end-stage renal disease (ESRD) on haemodialysis (HD) and to evaluate the prognostic value of serum YKL-40. METHODS: Patients >18 years on maintenance HD were included. Serum YKL-40 was measured using ELISA before and after a single HD treatment. RESULTS: A total of 306 patients were included. Median serum YKL-40 concentration was 238 µgL-1 (IQR: 193-291 µgL-1) before HD treatment and 198 µgL-1 (IQR: 147-258 µgL-1) after HD treatment, which corresponded to age-corrected 93th percentile in healthy subjects. All-cause mortality after 2.8 years was 35.9%. Patients with serum YKL-40 in the highest quartile compared with the lowest quartile had a univariate HR of 4.0 (95% CI: 2.2-7.3, p < 0.001) for all-cause mortality which decreased to 2.4 (95% CI: 1.1-4.5, p = 0.01) in multivariate analysis. Time-dependent receiver operating characteristic curves showed that serum YKL-40 after HD treatment had significant higher area under the curves from 90 d (p = 0.004) and throughout the rest of the follow-up period when compared to serum YKL-40 before HD treatment. CONCLUSION: YKL-40 was highly elevated in patients with ESRD on HD, and dialysis reduced serum YKL-40 concentrations approximately one-sixth. YKL-40 measured after dialysis was independently associated with mortality in HD patients.
PURPOSE: This study aimed to determine serum YKL-40 in patients with end-stage renal disease (ESRD) on haemodialysis (HD) and to evaluate the prognostic value of serum YKL-40. METHODS:Patients >18 years on maintenance HD were included. Serum YKL-40 was measured using ELISA before and after a single HD treatment. RESULTS: A total of 306 patients were included. Median serum YKL-40 concentration was 238 µgL-1 (IQR: 193-291 µgL-1) before HD treatment and 198 µgL-1 (IQR: 147-258 µgL-1) after HD treatment, which corresponded to age-corrected 93th percentile in healthy subjects. All-cause mortality after 2.8 years was 35.9%. Patients with serum YKL-40 in the highest quartile compared with the lowest quartile had a univariate HR of 4.0 (95% CI: 2.2-7.3, p < 0.001) for all-cause mortality which decreased to 2.4 (95% CI: 1.1-4.5, p = 0.01) in multivariate analysis. Time-dependent receiver operating characteristic curves showed that serum YKL-40 after HD treatment had significant higher area under the curves from 90 d (p = 0.004) and throughout the rest of the follow-up period when compared to serum YKL-40 before HD treatment. CONCLUSION:YKL-40 was highly elevated in patients with ESRD on HD, and dialysis reduced serum YKL-40 concentrations approximately one-sixth. YKL-40 measured after dialysis was independently associated with mortality in HDpatients.
Authors: Tuula K Outinen; Paula Mantula; Pia Jaatinen; Mari Hämäläinen; Eeva Moilanen; Antti Vaheri; Heini Huhtala; Satu Mäkelä; Jukka Mustonen Journal: Viruses Date: 2019-08-21 Impact factor: 5.048