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Circulating monocyte subpopulations with high expression of angiotensin-converting enzyme predict mortality in

Christof Ulrich1, Gunnar H Heine, Eric Seibert

  • 1Department of Internal Medicine II, Martin Luther University of Halle-Wittenberg, Halle, Germany.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|February 13, 2010
PubMed

Insights

A new biomarker combining high CD14(++)CD16(+) monocyte counts and high angiotensin-converting enzyme (ACE) expression predicts mortality in dialysis patients. This finding offers a novel tool for risk stratification in chronic kidney disease (CKD).

Area of Science:

  • Immunology
  • Nephrology
  • Cardiovascular Medicine

Background:

  • Circulating monocytes, defined by CD14 and CD16 expression, comprise distinct populations.
  • In chronic kidney disease (CKD), an expansion of CD14(++)CD16(+) monocytes is linked to cardiovascular disease risk.
  • This study investigates a combined biomarker for mortality prediction in advanced CKD patients.

Purpose of the Study:

  • To evaluate the predictive role of combined high CD14(++)CD16(+) monocyte numbers and high angiotensin-converting enzyme (ACE) expression for mortality in CKD Stage V(D) patients.
  • To identify a novel biomarker for risk stratification in dialysis patients.

Main Methods:

  • A prospective observational study involving 74 CKD Stage V(D) patients.
  • Flow cytometry was used to enumerate monocyte subpopulations and quantify ACE expression.
  • Patients were grouped based on median values for monocyte numbers and ACE expression; mortality and cardiovascular events were tracked for 46 months.

Main Results:

  • The 'high CD14(++)CD16(+), high ACE' group (n=22) exhibited a 70% mortality rate at 2 years, significantly higher than other groups (14.8% mortality).
  • Hazard ratio for mortality in this group was 4.86 (P < 0.0001).
  • Atherosclerosis-associated events were the predominant cause of death.

Conclusions:

  • A novel combined biomarker (high CD14(++)CD16(+) monocytes and high ACE expression) shows significant predictive value for mortality in CKD patients.
  • Further research is needed to elucidate the underlying pathophysiology.
  • This biomarker may aid in identifying high-risk dialysis patients.
Abstract

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