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A new predictor of mortality in hemodialysis patients; Tenascin-C
Sukru Ulusoy1, Gulsum Ozkan2, Ahmet Menteşe3
1Department of Nephrology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
Insights
Tenascin C (TN-C) levels are elevated in hemodialysis patients and predict cardiac mortality. Higher TN-C levels are associated with increased cardiovascular and all-cause mortality risk in this population.
Area of Science:
- Cardiology
- Nephrology
- Biomarkers
Background:
- Cardiovascular disease is a leading cause of death in hemodialysis patients.
- Cardiovascular risk factors in hemodialysis patients are not fully understood.
- Tenascin C (TN-C) is implicated in cardiac disease prognosis.
Purpose of the Study:
- To measure Tenascin C (TN-C) levels in hemodialysis patients.
- To assess the association between TN-C levels and cardiac mortality.
- To identify TN-C as a potential biomarker for cardiac risk in hemodialysis.
Main Methods:
- Multicenter prospective observational study.
- Blood samples collected for TN-C and biochemical analysis.
- Two-year follow-up for mortality and parameter association.
Main Results:
- Hemodialysis patients showed higher TN-C levels than controls (p < 0.001).
- TN-C, age, and systolic blood pressure independently predicted cardiac mortality.
- Elevated TN-C correlated with increased all-cause and cardiac mortality (Log rank p < 0.001 and p < 0.05).
Conclusions:
- Tenascin C (TN-C) levels are significantly higher in hemodialysis patients.
- TN-C may serve as a predictor of cardiac mortality in this cohort.
- Further research could establish TN-C as a valuable biomarker for cardiac risk assessment.
Aim:
Cardiovascular disease is the most frequent cause of mortality in hemodialysis patients. There are a number of inconsistencies in terms of cardiovascular risk factors in these patients. Tenascin C (TN-C) is a matricellular protein which may be a prognostic predictor after myocardial infarction and many cardiac diseases. The purpose of this study was to determine TN-C levels in hemodialysis patients and to evaluate the association between TN-C levels and cardiac mortality.
Main Methods:
In this multicenter prospective observational research, blood specimens were collected at the start of the study for the measurement of TN-C and other biochemical parameters. After 2 years' follow-up we investigated the association between TN-C and other biochemical and demographic parameters and cardiac and all cause mortality.
Key Findings:
Two hundred thirty-eight patients and 25 healthy individuals were enrolled. TN-C levels in the hemodialysis group were higher than those in the control group (p b 0.001). All-cause mortality was observed in 47 (19%) patients and cardiac mortality in 39 (15%). At multivariate Cox regression analysis, TN-C, age and systolic blood pressure were identified as independent predictors of cardiac mortality. The Kaplan–Meier survival curve revealed greater all-cause and cardiac mortality rates in the high TN-C group (Log rank p b 0.001 and p b 0.05 respectively).
Significance:
TN-C levels were higher than those in the control group, and our results suggest that it may be a predictor of cardiac mortality in hemodialysis patients. If further studies support our research, TN-C may be a useful biomarker for detecting cardiac mortality risk.
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