부산대학교 도서관

BACKGROUND: Vascular endothelial growth factor (VEGF) was recently shown to predict survival in prevalent haemodialysis patients. Soluble VEGF receptors (sVEGFR)-1 and -2 are circulating endogenous modulators of VEGF activity. We thus studied the relationship between sVEGFR-1 and -2 and survival in a cohort of prevalent haemodialysis (HD) patients. METHODS: Components of the VEGF system were measured (ELISAs) in 185 prevalent HD patients and levels related to clinical characteristics, biochemical markers and survival. The patients were followed up prospectively for a median 31 (20–37) months. RESULTS: While ischaemic heart disease was independently associated with a lower sVEGFR-2 (OR=2.75, P=0.02), sVEGFR-1 was positively associated with IL-6 (ρ=0.22, P=0.003) and white blood cell count (ρ=0.22, P=0.002). In survival analysis, the patients with a high sVEGFR-1 level had a higher all-cause mortality (Kaplan–Meier Chi-Square=5.6, P=0.02) and a higher adjusted mortality risk (Cox HR=1.93, P=0.009) than those with low levels. CONCLUSION: In the first clinical study of sVEGFR-1 and -2 in CKD, we found novel associations between the sVEGFRs and cardiac disease. This may be of clinical importance, as a high sVEGFR-1 was an independent risk factor for all-cause mortality.