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Increased Dialysate MCP-1 is Associated with Cardiovascular Mortality in Peritoneal Dialysis Patients: A Prospective Observational Study

Authors
 Ko K.I.  ;  Park K.S.  ;  Lee M.J.  ;  Doh F.M.  ;  Kim C.H.  ;  Koo H.M.  ;  Oh H.J.  ;  Park J.T.  ;  Han S.H.  ;  Kang S.-W.  ;  Yoo T.-H. 
Citation
 AMERICAN JOURNAL OF NEPHROLOGY, Vol.40(4) : 291-299, 2014 
Journal Title
 AMERICAN JOURNAL OF NEPHROLOGY 
ISSN
 0250-8095 
Issue Date
2014
MeSH
Adult ; Aged ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/metabolism* ; Cardiovascular Diseases/mortality ; Chemokine CCL2/metabolism* ; Female ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/metabolism* ; Kidney Failure, Chronic/mortality ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory ; Prospective Studies ; Republic of Korea/epidemiology
Keywords
Dialysate MCP-1 ; hs-CRP ; Peritoneal dialysis ; Cardiovascular mortality
Abstract
Background: The aim of this study was to investigate the association between the dialysate MCP-1 (dMCP-1) and systemic inflammatory and nutritional markers in peritoneal dialysis (PD) patients. In addition, we examined the prognostic value of dMCP-1 on all-cause or cardiovascular mortality in these patients. Methods: We prospectively followed 169 prevalent PD patients from April 1st 2008 to December 31st 2012. At baseline, dMCP-1 and serum biochemical parameters including high sensitivity CRP (hs-CRP) and albumin were checked. All-cause mortality and cause of death were evaluated during the follow-up period. Based on the median level of dMCP-1, patients were classified as either low or high dMCP-1 groups. Results: Mean age, hs-CRP, and D/Pcr ratio at 4 h were significantly higher, while serum albumin levels and %lean body mass (LBM) were significantly lower in the high dMCP-1 group. During the mean follow-up period of 47.7 months, all-cause mortality and cardiovascular mortality rate were significantly higher in the high dMCP-1 group (9.6 and 6.3 per 100 person-years, respectively) compared to the low dMCP-1 group (5.1 and 3.1 per 100 person-years, respectively; p = 0.021, 0.038). In multivariate Cox analysis, high dMCP-1 was a significant independent predictor of all-cause mortality (hazard ratio: 1.83, 95% confidence interval: 1.03-3.24, p = 0.039). Conclusions: dMCP-1 levels are closely correlated with nutritional and systemic inflammatory markers in PD patients. In addition, increased dMCP-1 is significantly associated with higher all-cause and cardiovascular mortality. These findings suggest that local peritoneal inflammation could contribute to poor clinical outcomes in PD patients.
Full Text
http://www.karger.com/Article/FullText/368201
DOI
10.1159/000368201
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Ko, Kwang Il(고광일)
Koo, Hyang Mo(구향모)
Kim, Chan Ho(김찬호)
Doh, Fa Mee(도화미) ORCID logo https://orcid.org/0000-0002-4780-6728
Park, Kyoung Sook(박경숙)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Mi Jung(이미정)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100093
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