Serum gamma-glutamyltransferase levels predict clinical outcomes in hemodialysis patients

Woo Yeong Park, Eun Sil Koh, Su Hyun Kim, Young Ok Kim, Dong Chan Jin, Ho Chul Song, Euy Jin Choi, Yong Lim Kim, Yon Su Kim, Shin Wook Kang, Nam Ho Kim, Chul Woo Yang, Yong Kyun Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Gamma-glutamyltransferase (GGT) is a biomarker of liver injury. GGT has also been reported to be a marker of oxidative stress and a predictor of mortality in the general population. Hemodialysis (HD) patients suffer from oxidative stress. The aim of our study was to investigate the relationship between serum GGT levels and clinical outcomes in HD patients. Methods A total of 1,634 HD patients were enrolled from the Clinical Research Center registry for end-stage renal disease, a prospective cohort in Korea. Patients were categorized into three groups by tertiles of serum GGT levels. The primary outcome was all-cause, cardiovascular, or infection-related mortality and hospitalization. Results During the median follow-up period of 30 months, the highest tertile of serum GGT levels had a significantly higher risk for all-cause mortality (hazard ratio (HR) 2.39, 95% confidence interval (CI), 1.55-3.69, P<0.001), cardiovascular mortality (HR 2.14, 95% CI, 1.07- 4.26, P = 0.031) and infection-related mortality (HR 3.07, 95% CI, 1.30-7.25, P = 0.011) using tertile 1 as the reference group after adjusting for clinical variables including liver diseases. The highest tertile also had a significantly higher risk for first hospitalization (HR 1.22, 95% CI, 1.00-1.48, P = 0.048) and cardiovascular hospitalization (HR 1.42, 95% CI, 1.06-1.92, P = 0.028). Conclusions Our data demonstrate that high serum GGT levels were an independent risk factor for allcause, cardiovascular, and infection-related mortality, as well as cardiovascular hospitalization in HD patients. These findings suggest that serum GGT levels might be a useful biomarker to predict clinical outcomes in HD patients.

Original languageEnglish
Article number0138159
JournalPloS one
Volume10
Issue number9
DOIs
Publication statusPublished - 2015 Sep 16

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hemodialysis
gamma-glutamyltransferase
gamma-Glutamyltransferase
Renal Dialysis
confidence interval
Hazards
Confidence Intervals
Serum
Mortality
Hospitalization
Cardiovascular Infections
Oxidative stress
Biomarkers
Liver
biomarkers
Oxidative Stress
oxidative stress
infection
liver diseases
Korea

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Park, W. Y., Koh, E. S., Kim, S. H., Kim, Y. O., Jin, D. C., Song, H. C., ... Kim, Y. K. (2015). Serum gamma-glutamyltransferase levels predict clinical outcomes in hemodialysis patients. PloS one, 10(9), [0138159]. https://doi.org/10.1371/journal.pone.0138159
Park, Woo Yeong ; Koh, Eun Sil ; Kim, Su Hyun ; Kim, Young Ok ; Jin, Dong Chan ; Song, Ho Chul ; Choi, Euy Jin ; Kim, Yong Lim ; Kim, Yon Su ; Kang, Shin Wook ; Kim, Nam Ho ; Yang, Chul Woo ; Kim, Yong Kyun. / Serum gamma-glutamyltransferase levels predict clinical outcomes in hemodialysis patients. In: PloS one. 2015 ; Vol. 10, No. 9.
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abstract = "Background Gamma-glutamyltransferase (GGT) is a biomarker of liver injury. GGT has also been reported to be a marker of oxidative stress and a predictor of mortality in the general population. Hemodialysis (HD) patients suffer from oxidative stress. The aim of our study was to investigate the relationship between serum GGT levels and clinical outcomes in HD patients. Methods A total of 1,634 HD patients were enrolled from the Clinical Research Center registry for end-stage renal disease, a prospective cohort in Korea. Patients were categorized into three groups by tertiles of serum GGT levels. The primary outcome was all-cause, cardiovascular, or infection-related mortality and hospitalization. Results During the median follow-up period of 30 months, the highest tertile of serum GGT levels had a significantly higher risk for all-cause mortality (hazard ratio (HR) 2.39, 95{\%} confidence interval (CI), 1.55-3.69, P<0.001), cardiovascular mortality (HR 2.14, 95{\%} CI, 1.07- 4.26, P = 0.031) and infection-related mortality (HR 3.07, 95{\%} CI, 1.30-7.25, P = 0.011) using tertile 1 as the reference group after adjusting for clinical variables including liver diseases. The highest tertile also had a significantly higher risk for first hospitalization (HR 1.22, 95{\%} CI, 1.00-1.48, P = 0.048) and cardiovascular hospitalization (HR 1.42, 95{\%} CI, 1.06-1.92, P = 0.028). Conclusions Our data demonstrate that high serum GGT levels were an independent risk factor for allcause, cardiovascular, and infection-related mortality, as well as cardiovascular hospitalization in HD patients. These findings suggest that serum GGT levels might be a useful biomarker to predict clinical outcomes in HD patients.",
author = "Park, {Woo Yeong} and Koh, {Eun Sil} and Kim, {Su Hyun} and Kim, {Young Ok} and Jin, {Dong Chan} and Song, {Ho Chul} and Choi, {Euy Jin} and Kim, {Yong Lim} and Kim, {Yon Su} and Kang, {Shin Wook} and Kim, {Nam Ho} and Yang, {Chul Woo} and Kim, {Yong Kyun}",
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Park, WY, Koh, ES, Kim, SH, Kim, YO, Jin, DC, Song, HC, Choi, EJ, Kim, YL, Kim, YS, Kang, SW, Kim, NH, Yang, CW & Kim, YK 2015, 'Serum gamma-glutamyltransferase levels predict clinical outcomes in hemodialysis patients', PloS one, vol. 10, no. 9, 0138159. https://doi.org/10.1371/journal.pone.0138159

Serum gamma-glutamyltransferase levels predict clinical outcomes in hemodialysis patients. / Park, Woo Yeong; Koh, Eun Sil; Kim, Su Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong Lim; Kim, Yon Su; Kang, Shin Wook; Kim, Nam Ho; Yang, Chul Woo; Kim, Yong Kyun.

In: PloS one, Vol. 10, No. 9, 0138159, 16.09.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Serum gamma-glutamyltransferase levels predict clinical outcomes in hemodialysis patients

AU - Park, Woo Yeong

AU - Koh, Eun Sil

AU - Kim, Su Hyun

AU - Kim, Young Ok

AU - Jin, Dong Chan

AU - Song, Ho Chul

AU - Choi, Euy Jin

AU - Kim, Yong Lim

AU - Kim, Yon Su

AU - Kang, Shin Wook

AU - Kim, Nam Ho

AU - Yang, Chul Woo

AU - Kim, Yong Kyun

PY - 2015/9/16

Y1 - 2015/9/16

N2 - Background Gamma-glutamyltransferase (GGT) is a biomarker of liver injury. GGT has also been reported to be a marker of oxidative stress and a predictor of mortality in the general population. Hemodialysis (HD) patients suffer from oxidative stress. The aim of our study was to investigate the relationship between serum GGT levels and clinical outcomes in HD patients. Methods A total of 1,634 HD patients were enrolled from the Clinical Research Center registry for end-stage renal disease, a prospective cohort in Korea. Patients were categorized into three groups by tertiles of serum GGT levels. The primary outcome was all-cause, cardiovascular, or infection-related mortality and hospitalization. Results During the median follow-up period of 30 months, the highest tertile of serum GGT levels had a significantly higher risk for all-cause mortality (hazard ratio (HR) 2.39, 95% confidence interval (CI), 1.55-3.69, P<0.001), cardiovascular mortality (HR 2.14, 95% CI, 1.07- 4.26, P = 0.031) and infection-related mortality (HR 3.07, 95% CI, 1.30-7.25, P = 0.011) using tertile 1 as the reference group after adjusting for clinical variables including liver diseases. The highest tertile also had a significantly higher risk for first hospitalization (HR 1.22, 95% CI, 1.00-1.48, P = 0.048) and cardiovascular hospitalization (HR 1.42, 95% CI, 1.06-1.92, P = 0.028). Conclusions Our data demonstrate that high serum GGT levels were an independent risk factor for allcause, cardiovascular, and infection-related mortality, as well as cardiovascular hospitalization in HD patients. These findings suggest that serum GGT levels might be a useful biomarker to predict clinical outcomes in HD patients.

AB - Background Gamma-glutamyltransferase (GGT) is a biomarker of liver injury. GGT has also been reported to be a marker of oxidative stress and a predictor of mortality in the general population. Hemodialysis (HD) patients suffer from oxidative stress. The aim of our study was to investigate the relationship between serum GGT levels and clinical outcomes in HD patients. Methods A total of 1,634 HD patients were enrolled from the Clinical Research Center registry for end-stage renal disease, a prospective cohort in Korea. Patients were categorized into three groups by tertiles of serum GGT levels. The primary outcome was all-cause, cardiovascular, or infection-related mortality and hospitalization. Results During the median follow-up period of 30 months, the highest tertile of serum GGT levels had a significantly higher risk for all-cause mortality (hazard ratio (HR) 2.39, 95% confidence interval (CI), 1.55-3.69, P<0.001), cardiovascular mortality (HR 2.14, 95% CI, 1.07- 4.26, P = 0.031) and infection-related mortality (HR 3.07, 95% CI, 1.30-7.25, P = 0.011) using tertile 1 as the reference group after adjusting for clinical variables including liver diseases. The highest tertile also had a significantly higher risk for first hospitalization (HR 1.22, 95% CI, 1.00-1.48, P = 0.048) and cardiovascular hospitalization (HR 1.42, 95% CI, 1.06-1.92, P = 0.028). Conclusions Our data demonstrate that high serum GGT levels were an independent risk factor for allcause, cardiovascular, and infection-related mortality, as well as cardiovascular hospitalization in HD patients. These findings suggest that serum GGT levels might be a useful biomarker to predict clinical outcomes in HD patients.

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