Tags

Type your tag names separated by a space and hit enter

Additive effects of soluble TWEAK and inflammation on mortality in hemodialysis patients.
Clin J Am Soc Nephrol. 2009 Jan; 4(1):110-8.CJ

Abstract

BACKGROUND AND OBJECTIVES

Chronic kidney disease (CKD) is characterized by an exceptionally high mortality rate, primarily due to cardiovascular disease. Reduced soluble TNF-like weak inducer of apoptosis (sTWEAK) plasma levels have been reported both in patients with subclinical atherosclerosis and CKD.

DESIGN, PARTICIPANTS, & MEASUREMENTS

A cross-sectional study was conducted in 218 prevalent patients (121 men; 63 +/- 14 yr) undergoing hemodialysis (HD). sTWEAK levels in relation with the patients' outcome were studied.

RESULTS

sTWEAK plasma levels were 208 [(165 to 272) pg/ml, median interquartile range], significantly lower than healthy controls (P < 0.0001). sTWEAK was negatively associated with inflammatory markers, such as C-reactive protein and IL-6. Overall mortality was assessed after an average follow-up of 31 mo, during which 81 patients died. After controlling for potential confounding variables, patients in the upper tertile of sTWEAK plasma levels had an increased risk of cardiovascular and all-cause mortality. A significant interaction effect between sTWEAK and IL-6 levels was found [synergy index: 2.19 (0.80, 5.93)]. Thus, the association of sTWEAK with mortality was strongest in patients with inflammation (defined as IL-6 > 7.0 pg/ml), in whom high sTWEAK strongly predicted cardiovascular and all-cause mortality. These results were confirmed in a second cohort of HD patients.

CONCLUSIONS

The concurrent presence of elevated sTWEAK plasma concentrations and an inflammatory environment have additive effects on mortality in HD patients. Further studies on the potential different role of sTWEAK in health and disease are warranted.

Authors+Show Affiliations

Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18945991

Citation

Carrero, Juan J., et al. "Additive Effects of Soluble TWEAK and Inflammation On Mortality in Hemodialysis Patients." Clinical Journal of the American Society of Nephrology : CJASN, vol. 4, no. 1, 2009, pp. 110-8.
Carrero JJ, Ortiz A, Qureshi AR, et al. Additive effects of soluble TWEAK and inflammation on mortality in hemodialysis patients. Clin J Am Soc Nephrol. 2009;4(1):110-8.
Carrero, J. J., Ortiz, A., Qureshi, A. R., Martín-Ventura, J. L., Bárány, P., Heimbürger, O., Marrón, B., Metry, G., Snaedal, S., Lindholm, B., Egido, J., Stenvinkel, P., & Blanco-Colio, L. M. (2009). Additive effects of soluble TWEAK and inflammation on mortality in hemodialysis patients. Clinical Journal of the American Society of Nephrology : CJASN, 4(1), 110-8. https://doi.org/10.2215/CJN.02790608
Carrero JJ, et al. Additive Effects of Soluble TWEAK and Inflammation On Mortality in Hemodialysis Patients. Clin J Am Soc Nephrol. 2009;4(1):110-8. PubMed PMID: 18945991.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Additive effects of soluble TWEAK and inflammation on mortality in hemodialysis patients. AU - Carrero,Juan J, AU - Ortiz,Alberto, AU - Qureshi,Abdul R, AU - Martín-Ventura,Jose L, AU - Bárány,Peter, AU - Heimbürger,Olof, AU - Marrón,Belén, AU - Metry,George, AU - Snaedal,Sunna, AU - Lindholm,Bengt, AU - Egido,Jesús, AU - Stenvinkel,Peter, AU - Blanco-Colio,Luis M, Y1 - 2008/10/22/ PY - 2008/10/24/pubmed PY - 2009/4/11/medline PY - 2008/10/24/entrez SP - 110 EP - 8 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 4 IS - 1 N2 - BACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) is characterized by an exceptionally high mortality rate, primarily due to cardiovascular disease. Reduced soluble TNF-like weak inducer of apoptosis (sTWEAK) plasma levels have been reported both in patients with subclinical atherosclerosis and CKD. DESIGN, PARTICIPANTS, & MEASUREMENTS: A cross-sectional study was conducted in 218 prevalent patients (121 men; 63 +/- 14 yr) undergoing hemodialysis (HD). sTWEAK levels in relation with the patients' outcome were studied. RESULTS: sTWEAK plasma levels were 208 [(165 to 272) pg/ml, median interquartile range], significantly lower than healthy controls (P < 0.0001). sTWEAK was negatively associated with inflammatory markers, such as C-reactive protein and IL-6. Overall mortality was assessed after an average follow-up of 31 mo, during which 81 patients died. After controlling for potential confounding variables, patients in the upper tertile of sTWEAK plasma levels had an increased risk of cardiovascular and all-cause mortality. A significant interaction effect between sTWEAK and IL-6 levels was found [synergy index: 2.19 (0.80, 5.93)]. Thus, the association of sTWEAK with mortality was strongest in patients with inflammation (defined as IL-6 > 7.0 pg/ml), in whom high sTWEAK strongly predicted cardiovascular and all-cause mortality. These results were confirmed in a second cohort of HD patients. CONCLUSIONS: The concurrent presence of elevated sTWEAK plasma concentrations and an inflammatory environment have additive effects on mortality in HD patients. Further studies on the potential different role of sTWEAK in health and disease are warranted. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/18945991/Additive_effects_of_soluble_TWEAK_and_inflammation_on_mortality_in_hemodialysis_patients_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=18945991 DB - PRIME DP - Unbound Medicine ER -