Increased dialysate MCP-1 is associated with cardiovascular mortality in peritoneal dialysis patients

A prospective observational study

Kwang Il Ko, Kyoung Sook Park, Mi Jung Lee, Fa Mee Doh, Chan Ho Kim, Hyang Mo Koo, Hyung Jung Oh, Jung Tak Park, SeungHyeok Han, Shin-Wook Kang, TaeHyun Yoo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The aim of this study was to investigate the association between the dialysate MCP-1 (dMCP-1) and systemic inflammatory and nutritional markers in peritoneal dialysis (PD) patients. In addition, we examined the prognostic value of dMCP-1 on all-cause or cardiovascular mortality in these patients. Methods: We prospectively followed 169 prevalent PD patients from April 1st 2008 to December 31st 2012. At baseline, dMCP-1 and serum biochemical parameters including high sensitivity CRP (hs-CRP) and albumin were checked. All-cause mortality and cause of death were evaluated during the follow-up period. Based on the median level of dMCP-1, patients were classified as either low or high dMCP-1 groups. Results: Mean age, hs-CRP, and D/Pcr ratio at 4 h were significantly higher, while serum albumin levels and %lean body mass (LBM) were significantly lower in the high dMCP-1 group. During the mean follow-up period of 47.7 months, all-cause mortality and cardiovascular mortality rate were significantly higher in the high dMCP-1 group (9.6 and 6.3 per 100 person-years, respectively) compared to the low dMCP-1 group (5.1 and 3.1 per 100 person-years, respectively; p = 0.021, 0.038). In multivariate Cox analysis, high dMCP-1 was a significant independent predictor of all-cause mortality (hazard ratio: 1.83, 95% confidence interval: 1.03-3.24, p = 0.039). Conclusions: dMCP-1 levels are closely correlated with nutritional and systemic inflammatory markers in PD patients. In addition, increased dMCP-1 is significantly associated with higher all-cause and cardiovascular mortality. These findings suggest that local peritoneal inflammation could contribute to poor clinical outcomes in PD patients.

Original languageEnglish
Pages (from-to)291-299
Number of pages9
JournalAmerican Journal of Nephrology
Volume40
Issue number4
DOIs
Publication statusPublished - 2014 Jan 1

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Dialysis Solutions
Peritoneal Dialysis
Observational Studies
Prospective Studies
Mortality
Serum Albumin
Cause of Death
Albumins
Multivariate Analysis
Confidence Intervals
Inflammation

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Ko, Kwang Il ; Park, Kyoung Sook ; Lee, Mi Jung ; Doh, Fa Mee ; Kim, Chan Ho ; Koo, Hyang Mo ; Oh, Hyung Jung ; Park, Jung Tak ; Han, SeungHyeok ; Kang, Shin-Wook ; Yoo, TaeHyun. / Increased dialysate MCP-1 is associated with cardiovascular mortality in peritoneal dialysis patients : A prospective observational study. In: American Journal of Nephrology. 2014 ; Vol. 40, No. 4. pp. 291-299.
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title = "Increased dialysate MCP-1 is associated with cardiovascular mortality in peritoneal dialysis patients: A prospective observational study",
abstract = "Background: The aim of this study was to investigate the association between the dialysate MCP-1 (dMCP-1) and systemic inflammatory and nutritional markers in peritoneal dialysis (PD) patients. In addition, we examined the prognostic value of dMCP-1 on all-cause or cardiovascular mortality in these patients. Methods: We prospectively followed 169 prevalent PD patients from April 1st 2008 to December 31st 2012. At baseline, dMCP-1 and serum biochemical parameters including high sensitivity CRP (hs-CRP) and albumin were checked. All-cause mortality and cause of death were evaluated during the follow-up period. Based on the median level of dMCP-1, patients were classified as either low or high dMCP-1 groups. Results: Mean age, hs-CRP, and D/Pcr ratio at 4 h were significantly higher, while serum albumin levels and {\%}lean body mass (LBM) were significantly lower in the high dMCP-1 group. During the mean follow-up period of 47.7 months, all-cause mortality and cardiovascular mortality rate were significantly higher in the high dMCP-1 group (9.6 and 6.3 per 100 person-years, respectively) compared to the low dMCP-1 group (5.1 and 3.1 per 100 person-years, respectively; p = 0.021, 0.038). In multivariate Cox analysis, high dMCP-1 was a significant independent predictor of all-cause mortality (hazard ratio: 1.83, 95{\%} confidence interval: 1.03-3.24, p = 0.039). Conclusions: dMCP-1 levels are closely correlated with nutritional and systemic inflammatory markers in PD patients. In addition, increased dMCP-1 is significantly associated with higher all-cause and cardiovascular mortality. These findings suggest that local peritoneal inflammation could contribute to poor clinical outcomes in PD patients.",
author = "Ko, {Kwang Il} and Park, {Kyoung Sook} and Lee, {Mi Jung} and Doh, {Fa Mee} and Kim, {Chan Ho} and Koo, {Hyang Mo} and Oh, {Hyung Jung} and Park, {Jung Tak} and SeungHyeok Han and Shin-Wook Kang and TaeHyun Yoo",
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Increased dialysate MCP-1 is associated with cardiovascular mortality in peritoneal dialysis patients : A prospective observational study. / Ko, Kwang Il; Park, Kyoung Sook; Lee, Mi Jung; Doh, Fa Mee; Kim, Chan Ho; Koo, Hyang Mo; Oh, Hyung Jung; Park, Jung Tak; Han, SeungHyeok; Kang, Shin-Wook; Yoo, TaeHyun.

In: American Journal of Nephrology, Vol. 40, No. 4, 01.01.2014, p. 291-299.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Increased dialysate MCP-1 is associated with cardiovascular mortality in peritoneal dialysis patients

T2 - A prospective observational study

AU - Ko, Kwang Il

AU - Park, Kyoung Sook

AU - Lee, Mi Jung

AU - Doh, Fa Mee

AU - Kim, Chan Ho

AU - Koo, Hyang Mo

AU - Oh, Hyung Jung

AU - Park, Jung Tak

AU - Han, SeungHyeok

AU - Kang, Shin-Wook

AU - Yoo, TaeHyun

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: The aim of this study was to investigate the association between the dialysate MCP-1 (dMCP-1) and systemic inflammatory and nutritional markers in peritoneal dialysis (PD) patients. In addition, we examined the prognostic value of dMCP-1 on all-cause or cardiovascular mortality in these patients. Methods: We prospectively followed 169 prevalent PD patients from April 1st 2008 to December 31st 2012. At baseline, dMCP-1 and serum biochemical parameters including high sensitivity CRP (hs-CRP) and albumin were checked. All-cause mortality and cause of death were evaluated during the follow-up period. Based on the median level of dMCP-1, patients were classified as either low or high dMCP-1 groups. Results: Mean age, hs-CRP, and D/Pcr ratio at 4 h were significantly higher, while serum albumin levels and %lean body mass (LBM) were significantly lower in the high dMCP-1 group. During the mean follow-up period of 47.7 months, all-cause mortality and cardiovascular mortality rate were significantly higher in the high dMCP-1 group (9.6 and 6.3 per 100 person-years, respectively) compared to the low dMCP-1 group (5.1 and 3.1 per 100 person-years, respectively; p = 0.021, 0.038). In multivariate Cox analysis, high dMCP-1 was a significant independent predictor of all-cause mortality (hazard ratio: 1.83, 95% confidence interval: 1.03-3.24, p = 0.039). Conclusions: dMCP-1 levels are closely correlated with nutritional and systemic inflammatory markers in PD patients. In addition, increased dMCP-1 is significantly associated with higher all-cause and cardiovascular mortality. These findings suggest that local peritoneal inflammation could contribute to poor clinical outcomes in PD patients.

AB - Background: The aim of this study was to investigate the association between the dialysate MCP-1 (dMCP-1) and systemic inflammatory and nutritional markers in peritoneal dialysis (PD) patients. In addition, we examined the prognostic value of dMCP-1 on all-cause or cardiovascular mortality in these patients. Methods: We prospectively followed 169 prevalent PD patients from April 1st 2008 to December 31st 2012. At baseline, dMCP-1 and serum biochemical parameters including high sensitivity CRP (hs-CRP) and albumin were checked. All-cause mortality and cause of death were evaluated during the follow-up period. Based on the median level of dMCP-1, patients were classified as either low or high dMCP-1 groups. Results: Mean age, hs-CRP, and D/Pcr ratio at 4 h were significantly higher, while serum albumin levels and %lean body mass (LBM) were significantly lower in the high dMCP-1 group. During the mean follow-up period of 47.7 months, all-cause mortality and cardiovascular mortality rate were significantly higher in the high dMCP-1 group (9.6 and 6.3 per 100 person-years, respectively) compared to the low dMCP-1 group (5.1 and 3.1 per 100 person-years, respectively; p = 0.021, 0.038). In multivariate Cox analysis, high dMCP-1 was a significant independent predictor of all-cause mortality (hazard ratio: 1.83, 95% confidence interval: 1.03-3.24, p = 0.039). Conclusions: dMCP-1 levels are closely correlated with nutritional and systemic inflammatory markers in PD patients. In addition, increased dMCP-1 is significantly associated with higher all-cause and cardiovascular mortality. These findings suggest that local peritoneal inflammation could contribute to poor clinical outcomes in PD patients.

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