학술논문
The new marker YKL-40, a molecule related to inflammation, is associated with cardiovascular events in stable haemodialysis patients
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Clinical report
Author
Source
Clinical Kidney Journal. April 2020, Vol. 13 Issue 2, p172, 7 p.
Subject
Language
English
ISSN
2048-8505
Abstract
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 [...]
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
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