부산대학교 도서관

Background. YKL-40 is a glycoprotein associated with inflammatory conditions, including atherosclerosis and endothelial dysfunction. The objective was to analyse serum YKL-40 levels in a haemodialysis population and explore their association with dialysis dosing measures, inflammation, body composition and development of cardiovascular (CV) events. Methods. We performed a prospective study of 78 chronic haemodialysis patients enrolled in 2013 and followed up until 2018. At baseline, serum YKL-40, inflammatory and nutrition markers and body composition were assessed. During a median follow-up of 43 (interquartile range 24-66) months, CV events were recorded. Results. The mean age of patients was 62[+ or -]16years and 66% were men. The mean YKL-40 was 207[+ or -]106ng/dL. Higher YKL-40 levels were associated with lower [Kt/V.sub.urea], convective volume, serum albumin and prealbumin and with higher troponin T. During follow-up, 50% developed CV events. Cox analysis showed an association between CV events and YKL-40, diabetes, hypertension, C-reactive protein, lower prealbumin, [[beta].sub.2]-microglobulin, glycosylated haemoglobin and troponin T values. The multivariate Cox analysis confirmed an independent association between CV events and YKL-40 [hazard ratio [HR] 1.067 [95% confidence interval (CI) 1.009-1.211]; P: 0.042}, troponin T [HR 1.037 (95% CI 1.009-1.683); P: 0.007], lower prealbumin [HR 0.827 (95% CI 0.224-0.988); P: 0.009] and diabetes [HR 2.103 (95% CI 1.554-3.172); P: 0.008]. Kaplan--Meier confirmed the association between CV events and YKL-40 (log rank 7.28; P=0.007). Conclusions. YKL-40 is associated with CV events in haemodialysis patients. Higher dialysis dose and convective volume are associated with lower serum YKL-40 levels. Keywords: cardiovascular events, haemodialysis, inflammation, online haemodiafiltration, YKL-40
INTRODUCTION Haemodialysis patients have higher morbidity and mortality than the general population. Cardiovascular (CV) events are the main cause of mortality in this group of patients. Nephrologists have strived to [...]