Cargando…

Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study

BACKGROUND: Diabetic patients on hemodialysis are at high risk of death from cardiovascular disease, and research has suggested that various biologic markers of inflammation, oxidative stress and hemostasis may give added value to clinical information for predicting cardiovascular event (CVE)-free s...

Descripción completa

Detalles Bibliográficos
Autores principales: Bayliss, George P., Weinrauch, Larry A., Gleason, Ray E., Lee, Annette T., D'Elia, John A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438364/
https://www.ncbi.nlm.nih.gov/pubmed/26069829
http://dx.doi.org/10.1093/ckj/sft116
_version_ 1782372318513725440
author Bayliss, George P.
Weinrauch, Larry A.
Gleason, Ray E.
Lee, Annette T.
D'Elia, John A.
author_facet Bayliss, George P.
Weinrauch, Larry A.
Gleason, Ray E.
Lee, Annette T.
D'Elia, John A.
author_sort Bayliss, George P.
collection PubMed
description BACKGROUND: Diabetic patients on hemodialysis are at high risk of death from cardiovascular disease, and research has suggested that various biologic markers of inflammation, oxidative stress and hemostasis may give added value to clinical information for predicting cardiovascular event (CVE)-free survival. This information could be particularly important in evaluating this population for renal transplant, given the scarcity of organs. We hypothesized that in diabetic patients undergoing renal replacement therapy (RRT) these biologic markers would prove useful in predicting event-free follow-up in a prospective study. METHODS: One hundred and fifty diabetic (76 type 1, 74 type 2) and 27 non-diabetic stable RRT patients were followed for 0.04–13.69 years for CVE (myocardial infarction, coronary arterial intervention, peripheral arterial bypass or amputation, cerebrovascular accident or carotid artery intervention), cardiac and all-cause mortality. Measured biologic markers of inflammation included the following: Il-6, C reactive protein, fibrinogen; of hemostasis: fibrinogen, plasminogen activator inhibitor (PAI), fibrinolytic activity, von Willebrand factor VII (vWF), platelet-selectin, viscosity and of oxidative stress: advanced glycated end products and antibody to oxidized low-density lipoprotein. For each, upper versus lower tertiles were compared for duration of event-free follow-up. RESULTS: Cardiovascular events prior to study entry occurred in 51.3% of DM1, 54.0% of DM2 and 25.9% of DM0 patients. Subsequent cardiovascular events were noted in 31.6% of DM1, 45.9% of DM2 and 11.1% of DM0 patients. All mean levels of biologic markers at baseline were abnormal (P < 0.05). CONCLUSIONS: In this RRT population, all biologic marker levels except PAI did not improve clinical prediction of events.
format Online
Article
Text
id pubmed-4438364
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-44383642015-06-11 Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study Bayliss, George P. Weinrauch, Larry A. Gleason, Ray E. Lee, Annette T. D'Elia, John A. Clin Kidney J Original Contributions BACKGROUND: Diabetic patients on hemodialysis are at high risk of death from cardiovascular disease, and research has suggested that various biologic markers of inflammation, oxidative stress and hemostasis may give added value to clinical information for predicting cardiovascular event (CVE)-free survival. This information could be particularly important in evaluating this population for renal transplant, given the scarcity of organs. We hypothesized that in diabetic patients undergoing renal replacement therapy (RRT) these biologic markers would prove useful in predicting event-free follow-up in a prospective study. METHODS: One hundred and fifty diabetic (76 type 1, 74 type 2) and 27 non-diabetic stable RRT patients were followed for 0.04–13.69 years for CVE (myocardial infarction, coronary arterial intervention, peripheral arterial bypass or amputation, cerebrovascular accident or carotid artery intervention), cardiac and all-cause mortality. Measured biologic markers of inflammation included the following: Il-6, C reactive protein, fibrinogen; of hemostasis: fibrinogen, plasminogen activator inhibitor (PAI), fibrinolytic activity, von Willebrand factor VII (vWF), platelet-selectin, viscosity and of oxidative stress: advanced glycated end products and antibody to oxidized low-density lipoprotein. For each, upper versus lower tertiles were compared for duration of event-free follow-up. RESULTS: Cardiovascular events prior to study entry occurred in 51.3% of DM1, 54.0% of DM2 and 25.9% of DM0 patients. Subsequent cardiovascular events were noted in 31.6% of DM1, 45.9% of DM2 and 11.1% of DM0 patients. All mean levels of biologic markers at baseline were abnormal (P < 0.05). CONCLUSIONS: In this RRT population, all biologic marker levels except PAI did not improve clinical prediction of events. Oxford University Press 2013-12 2013-09-23 /pmc/articles/PMC4438364/ /pubmed/26069829 http://dx.doi.org/10.1093/ckj/sft116 Text en © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For permissions, please email: journals.permissions@oup.com. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Contributions
Bayliss, George P.
Weinrauch, Larry A.
Gleason, Ray E.
Lee, Annette T.
D'Elia, John A.
Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study
title Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study
title_full Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study
title_fullStr Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study
title_full_unstemmed Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study
title_short Do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? A prospective longitudinal study
title_sort do biologic markers predict cardiovascular end points in diabetic end-stage renal disease? a prospective longitudinal study
topic Original Contributions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438364/
https://www.ncbi.nlm.nih.gov/pubmed/26069829
http://dx.doi.org/10.1093/ckj/sft116
work_keys_str_mv AT baylissgeorgep dobiologicmarkerspredictcardiovascularendpointsindiabeticendstagerenaldiseaseaprospectivelongitudinalstudy
AT weinrauchlarrya dobiologicmarkerspredictcardiovascularendpointsindiabeticendstagerenaldiseaseaprospectivelongitudinalstudy
AT gleasonraye dobiologicmarkerspredictcardiovascularendpointsindiabeticendstagerenaldiseaseaprospectivelongitudinalstudy
AT leeannettet dobiologicmarkerspredictcardiovascularendpointsindiabeticendstagerenaldiseaseaprospectivelongitudinalstudy
AT deliajohna dobiologicmarkerspredictcardiovascularendpointsindiabeticendstagerenaldiseaseaprospectivelongitudinalstudy