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Pigment Epithelium‐Derived Factor as a New Predictor of Mortality Among Chronic Kidney Disease Patients Treated With Hemodialysis
Author(s) -
Terawaki Hiroyuki,
Yamagishi Shoichi,
Funakoshi Yoichi,
Matsuyama Yukie,
Terada Tomoyoshi,
Nakayama Keisuke,
Ogura Makoto,
Hosoya Tatsuo,
Ito Sadayoshi,
Era Seiichi,
Nakayama Masaaki
Publication year - 2013
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12020
Subject(s) - pedf , medicine , hemodialysis , creatinine , diabetes mellitus , dialysis , risk factor , gastroenterology , kidney disease , hazard ratio , disease , endocrinology , confidence interval , vegf receptors
Pigment epithelium‐derived factor ( PEDF ) plays a protective role against atherosclerosis. Although serum PEDF level is increased in patients undergoing regular hemodialysis ( HD ), the pathophysiological role of PEDF in HD patients is unknown. We measured serum PEDF levels in 74 HD patients, and the association between serum PEDF and adverse events such as all‐cause death and cardiovascular accident was evaluated prospectively. During the follow up of 45.4 ± 25.1 months, 24 patients (32.4%) experienced cardiovascular accident and 18 (24.3%) died. Significantly higher incidences of all‐cause mortality and cardiovascular accident were observed in the lower PEDF group than in the higher PEDF group. After adjusting for propensity score calculated from multiple confounding factors (age, gender, systolic blood pressure, history of previous cardiovascular disease, level of carbonyl content, albumin, hemoglobin, total cholesterol, creatinine, C ‐reactive protein, dialysis vintage, Kt/V ‐urea and history of diabetes), lower predialytic PEDF was a significant risk factor for all‐cause mortality (relative hazard = 6.060, standard error = 0.68467, P = 0.0085). Lower levels of predialytic PEDF was associated with an increased risk of mortality.