Plasma C4 level was associated with mortality, cardiovascular and cerebrovascular complications in hemodialysis...

Area of Science:

• Nephrology
• Immunology
• Cardiovascular Medicine

Background:

• Patients undergoing maintenance hemodialysis (HD) face elevated risks of mortality and cardiovascular/cerebrovascular diseases (CCDs).
• Complement activation has been previously linked to increased cardiovascular disease risk in HD patients.
• This study investigated the association between critical complement factors and adverse outcomes in HD patients.

Purpose of the Study:

• To explore the relationship between specific complement factors and adverse clinical outcomes in patients on maintenance hemodialysis.
• To identify key complement factors that predict mortality and cardiovascular/cerebrovascular events (CCEs) in this patient group.

Main Methods:

• 108 hemodialysis patients were followed for 52 months.
• Baseline plasma levels of complement factors (C3c, C1q, CFH, CFB, C4, MAC, C5a, C3a, MBL) were measured.
• Cox regression and X-tile analyses identified factors associated with death and CCEs, with correlation analyses examining relationships with CCD risk factors.

Main Results:

• Elevated baseline plasma C4 levels were significantly associated with increased risks of all-cause mortality and composite cardiovascular/cerebrovascular events.
• Optimal cut-off values for C4 identified significantly higher risks: >0.47 g/L for death and >0.44 g/L for composite endpoints.
• Plasma C4 showed significant positive correlation with triglycerides (TG) and negative correlation with HDL cholesterol.

Conclusions:

• Higher baseline plasma C4 levels are a significant predictor of future mortality and cardiovascular/cerebrovascular events in hemodialysis patients.
• Plasma C4 levels correlate with key dyslipidemia markers, suggesting a link between complement activation and cardiovascular risk factors.