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CA 125 levels and left ventricular function in patients with end-stage renal disease on maintenance hemodialysis
Hakki Yilmaz1, Ozgül Malcok Gürel, Hüseyin Tugrul Celik
1Department of Internal Medicine, Section of Nephrology, Turgut Ozal University, School of Medicine , Ankara , Turkey .
Insights
This study found that higher cancer antigen 125 (CA 125) levels in patients on hemodialysis (HD) are linked to impaired left ventricular (LV) systolic function and inflammation. These findings suggest CA 125 may indicate cardiac issues in HD patients.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- End-stage renal disease (ESRD) patients on maintenance hemodialysis (HD) often experience cardiovascular complications.
- Left ventricular (LV) dysfunction is a common issue in this population, but its early indicators are not fully understood.
Purpose of the Study:
- To investigate the association between serum cancer antigen 125 (CA 125) levels and LV function in patients undergoing maintenance HD.
- To explore the role of inflammation in this relationship.
Main Methods:
- Serum CA 125, pro-brain natriuretic peptide (pro-BNP), and biochemical markers were measured in 110 HD patients and 47 healthy controls.
- Echocardiography was performed to assess LV function, including ejection fraction (EF) and dimensions.
- Statistical analyses, including correlation and multivariate regression, were used to determine associations.
Main Results:
- HD patients exhibited significantly higher CA 125 levels compared to controls.
- Elevated CA 125 levels were associated with lower albumin, reduced LV ejection fraction (EF), and increased left ventricular end-diastolic diameter (LVEDd) and LV end-systolic diameter (LVESd).
- CA 125 showed positive correlations with pro-BNP and C-reactive protein (CRP), and negative correlations with EF and hemoglobin. Depressed EF and increased CRP were independent predictors of high CA 125.
Conclusions:
- This study provides the first evidence linking elevated serum CA 125 levels to LV systolic dysfunction in patients on maintenance HD.
- Inflammation, indicated by elevated CRP, appears to mediate the association between CA 125 and LV dysfunction.
- CA 125 may serve as a potential biomarker for cardiac abnormalities in ESRD patients on hemodialysis.
Purpose:
The aim of this study was to analyze associations between serum cancer antigen 125 (CA 125) levels and left ventricular (LV) function in patients with end-stage renal disease on maintenance hemodialysis (HD).
Methods:
CA 125 levels, pro-brain natriuretic peptide (pro-BNP) and biochemical parameters were measured, and echocardiography was performed for 110 patients and 47 healthy controls.
Results:
The mean CA 125 level in patients, 38.78 ± 35.48 U/mL, was significantly higher than that found in healthy controls (9.20 ± 4.55 U/mL; p = 0.003). Patients with elevated CA 125 levels (n = 40) had significantly lower levels of albumin and reduced relative wall thickness, LV ejection fraction (EF) and fractional shortening but significantly higher levels of pro-BNP and a greater left ventricular end-diastolic diameter (LVEDd) and -systolic diameter (LVESd). CA 125 levels were positively correlated with pro-BNP (r = 0.596, p < 0.05) and C-reactive protein (CRP) levels (r = 0.439, p < 0.05), as well as LVEDd (r = 0.599, p < 0.001), LVESd (r = 0.750, p < 0.001) and LV mass index (r = 0.378, p < 0.05). In contrast, serum CA 125 levels were negatively correlated with albumin (r = -0.513, p < 0.05) and hemoglobin (r = -0.475, p < 0.05) as well as the EF (r = -0.878, p < 0.0001). A depressed EF (β = -1.121, p < 0.0001) and increased CRP levels (β = 0.247, p = 0.035) were independent predictors of high CA 125 levels in the whole group in the multivariate-model.
Conclusions:
Our study is the first to demonstrate an association between serum CA 125 levels and LV systolic dysfunction via inflammation in patients on maintenance HD.
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