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Decoy receptor 3, a novel inflammatory marker, and mortality in hemodialysis patients.
Clin J Am Soc Nephrol. 2012 Aug; 7(8):1257-65.CJ

Abstract

BACKGROUND AND OBJECTIVES

Inflammation is closely associated with cardiovascular disease, the leading cause of mortality in patients with CKD. Serum decoy receptor 3 (DcR3) is a member of the TNF receptor superfamily. CKD patients have higher levels of DcR3 than the general population, but whether DcR3 predicts mortality in CKD patients on hemodialysis has not been explored.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

DcR3 levels were measured in 316 prevalent hemodialysis patients who were followed up from November 1, 2004, to June 30, 2009, for cardiovascular and all-cause mortality.

RESULTS

The baseline DcR3 concentration showed a strong positive correlation with inflammatory markers including high-sensitivity C-reactive protein, IL-6, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1). During a follow-up period of 54 months, 90 patients died (34 cardiovascular deaths). Kaplan-Meier survival analysis showed higher cardiovascular and all-cause mortality in patients with higher DcR3 levels. The hazard ratios (95% confidence intervals) of the highest versus lowest tertiles of DcR3 were 2.8 (1.1-7.3; P for trend=0.04) for cardiovascular mortality and 2.1 (1.1-3.7; P for trend=0.02) for all-cause mortality, respectively. Based on the minimal increase in the area under the receiver operating characteristic curve from 0.79 to 0.80, the addition of DcR3 to established risk factors including VCAM-1, albumin, and IL-6 does not improve the prediction of mortality.

CONCLUSIONS

Higher DcR3 levels strongly correlate with inflammation and independently predict cardiovascular and all-cause mortality in CKD patients on hemodialysis.

Authors+Show Affiliations

Division of Nephrology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan.No 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

22626963

Citation

Hung, Szu-Chun, et al. "Decoy Receptor 3, a Novel Inflammatory Marker, and Mortality in Hemodialysis Patients." Clinical Journal of the American Society of Nephrology : CJASN, vol. 7, no. 8, 2012, pp. 1257-65.
Hung SC, Hsu TW, Lin YP, et al. Decoy receptor 3, a novel inflammatory marker, and mortality in hemodialysis patients. Clin J Am Soc Nephrol. 2012;7(8):1257-65.
Hung, S. C., Hsu, T. W., Lin, Y. P., & Tarng, D. C. (2012). Decoy receptor 3, a novel inflammatory marker, and mortality in hemodialysis patients. Clinical Journal of the American Society of Nephrology : CJASN, 7(8), 1257-65. https://doi.org/10.2215/CJN.08410811
Hung SC, et al. Decoy Receptor 3, a Novel Inflammatory Marker, and Mortality in Hemodialysis Patients. Clin J Am Soc Nephrol. 2012;7(8):1257-65. PubMed PMID: 22626963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decoy receptor 3, a novel inflammatory marker, and mortality in hemodialysis patients. AU - Hung,Szu-Chun, AU - Hsu,Ta-Wei, AU - Lin,Yao-Ping, AU - Tarng,Der-Cherng, Y1 - 2012/05/24/ PY - 2012/5/26/entrez PY - 2012/5/26/pubmed PY - 2013/1/3/medline SP - 1257 EP - 65 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 7 IS - 8 N2 - BACKGROUND AND OBJECTIVES: Inflammation is closely associated with cardiovascular disease, the leading cause of mortality in patients with CKD. Serum decoy receptor 3 (DcR3) is a member of the TNF receptor superfamily. CKD patients have higher levels of DcR3 than the general population, but whether DcR3 predicts mortality in CKD patients on hemodialysis has not been explored. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: DcR3 levels were measured in 316 prevalent hemodialysis patients who were followed up from November 1, 2004, to June 30, 2009, for cardiovascular and all-cause mortality. RESULTS: The baseline DcR3 concentration showed a strong positive correlation with inflammatory markers including high-sensitivity C-reactive protein, IL-6, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1). During a follow-up period of 54 months, 90 patients died (34 cardiovascular deaths). Kaplan-Meier survival analysis showed higher cardiovascular and all-cause mortality in patients with higher DcR3 levels. The hazard ratios (95% confidence intervals) of the highest versus lowest tertiles of DcR3 were 2.8 (1.1-7.3; P for trend=0.04) for cardiovascular mortality and 2.1 (1.1-3.7; P for trend=0.02) for all-cause mortality, respectively. Based on the minimal increase in the area under the receiver operating characteristic curve from 0.79 to 0.80, the addition of DcR3 to established risk factors including VCAM-1, albumin, and IL-6 does not improve the prediction of mortality. CONCLUSIONS: Higher DcR3 levels strongly correlate with inflammation and independently predict cardiovascular and all-cause mortality in CKD patients on hemodialysis. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/22626963/Decoy_receptor_3_a_novel_inflammatory_marker_and_mortality_in_hemodialysis_patients_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=22626963 DB - PRIME DP - Unbound Medicine ER -