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Article: Circulating soluble vascular cell adhesion molecule 1: Relationships with residual renal function, cardiac hypertrophy, and outcome of peritoneal dialysis patients

TitleCirculating soluble vascular cell adhesion molecule 1: Relationships with residual renal function, cardiac hypertrophy, and outcome of peritoneal dialysis patients
Authors
Issue Date2005
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkd
Citation
American Journal Of Kidney Diseases, 2005, v. 45 n. 4, p. 715-729 How to Cite?
AbstractBackground: Vascular cell adhesion molecule 1 (VCAM-1) is involved in leukocyte-endothelial cell interaction and has a pivotal role in inflammation. Whether it contributes to excessive mortality in dialysis patients remains uncertain. In this study, we examined circulating soluble VCAM-1 (sVCAM-1) in relation to different clinical and biochemical parameters, as well as mortality and cardiovascular events, in peritoneal dialysis (PD) patients. Methods: Values for serum sVCAM-1, together with C-reactive protein (CRP), homocysteine, albumin, lipid profile, blood hemoglobin, and indices of dialysis adequacy, were determined at study baseline, and echocardiography was performed in 160 long-term PD patients. Patients were followed up for a mean of 35 ± 16 (SD) months. Results: Serum sVCAM-1 levels were elevated in our continuous ambulatory PD (CAPD) patients and showed a negative correlation with residual glomerular filtration rate (GFR; P < 0.001) and low-density lipoprotein (LDL) cholesterol level (P = 0.004), but a positive correlation with left ventricular mass index (P = 0.025). Using Kaplan-Meier analysis, overall survival rates at 2 years were 96.2%, 75.2%, and 50.6% for patients in the lower, middle, and upper tertiles of sVCAM-1 levels, respectively (P < 0.0001). Fatal and nonfatal cardiovascular event-free survival rates were 58.2%, 56.9%, and 19.4% for patients in the lower, middle, and upper tertiles, respectively (P < 0.0001). Using Cox regression analysis with adjustment for confounding covariates, every 100-ng/mL increase in sVCAM-1 level was associated with 8% (95% confidence interval, 1.03 to 1.13) and 5% (95% confidence interval, 1.00 to 1.10) increases in risk for death and fatal and nonfatal cardiovascular events, respectively. Its significance for all-cause mortality remained with additional adjusting for LDL cholesterol level, but was lost when adjusting for residual GFR. Its association with cardiovascular events became insignificant when adjusting for LDL cholesterol level or residual GFR. Furthermore, patients with both sVCAM-1 and CRP levels elevated at the 50th percentile or greater were associated with the greatest death and fatal and nonfatal cardiovascular event rates compared with those with either CRP or sVCAM-1 level elevated at the 50th percentile or greater. Conclusion: Circulating sVCAM-1 levels show an important link with residual renal function, LDL cholesterol level, and cardiac hypertrophy in CAPD patients. Furthermore, residual renal function, which correlates inversely with circulating sVCAM-1 level, shows an important association with all-cause mortality and cardiovascular events and displaces sVCAM-1 level from the models for all-cause mortality and future cardiovascular events in CAPD patients. Additional study is needed to explore possible mechanistic links between inflammation, soluble adhesion molecules, residual renal function, and cardiac hypertrophy in CAPD patients. © 2005 by the National Kidney Foundation, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/162805
ISSN
2015 Impact Factor: 6.269
2015 SCImago Journal Rankings: 2.313
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, AYMen_US
dc.contributor.authorLam, CWKen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorWoo, Jen_US
dc.contributor.authorChan, IHSen_US
dc.contributor.authorLui, SFen_US
dc.contributor.authorSanderson, JEen_US
dc.contributor.authorLi, PKTen_US
dc.date.accessioned2012-09-05T05:23:47Z-
dc.date.available2012-09-05T05:23:47Z-
dc.date.issued2005en_US
dc.identifier.citationAmerican Journal Of Kidney Diseases, 2005, v. 45 n. 4, p. 715-729en_US
dc.identifier.issn0272-6386en_US
dc.identifier.urihttp://hdl.handle.net/10722/162805-
dc.description.abstractBackground: Vascular cell adhesion molecule 1 (VCAM-1) is involved in leukocyte-endothelial cell interaction and has a pivotal role in inflammation. Whether it contributes to excessive mortality in dialysis patients remains uncertain. In this study, we examined circulating soluble VCAM-1 (sVCAM-1) in relation to different clinical and biochemical parameters, as well as mortality and cardiovascular events, in peritoneal dialysis (PD) patients. Methods: Values for serum sVCAM-1, together with C-reactive protein (CRP), homocysteine, albumin, lipid profile, blood hemoglobin, and indices of dialysis adequacy, were determined at study baseline, and echocardiography was performed in 160 long-term PD patients. Patients were followed up for a mean of 35 ± 16 (SD) months. Results: Serum sVCAM-1 levels were elevated in our continuous ambulatory PD (CAPD) patients and showed a negative correlation with residual glomerular filtration rate (GFR; P < 0.001) and low-density lipoprotein (LDL) cholesterol level (P = 0.004), but a positive correlation with left ventricular mass index (P = 0.025). Using Kaplan-Meier analysis, overall survival rates at 2 years were 96.2%, 75.2%, and 50.6% for patients in the lower, middle, and upper tertiles of sVCAM-1 levels, respectively (P < 0.0001). Fatal and nonfatal cardiovascular event-free survival rates were 58.2%, 56.9%, and 19.4% for patients in the lower, middle, and upper tertiles, respectively (P < 0.0001). Using Cox regression analysis with adjustment for confounding covariates, every 100-ng/mL increase in sVCAM-1 level was associated with 8% (95% confidence interval, 1.03 to 1.13) and 5% (95% confidence interval, 1.00 to 1.10) increases in risk for death and fatal and nonfatal cardiovascular events, respectively. Its significance for all-cause mortality remained with additional adjusting for LDL cholesterol level, but was lost when adjusting for residual GFR. Its association with cardiovascular events became insignificant when adjusting for LDL cholesterol level or residual GFR. Furthermore, patients with both sVCAM-1 and CRP levels elevated at the 50th percentile or greater were associated with the greatest death and fatal and nonfatal cardiovascular event rates compared with those with either CRP or sVCAM-1 level elevated at the 50th percentile or greater. Conclusion: Circulating sVCAM-1 levels show an important link with residual renal function, LDL cholesterol level, and cardiac hypertrophy in CAPD patients. Furthermore, residual renal function, which correlates inversely with circulating sVCAM-1 level, shows an important association with all-cause mortality and cardiovascular events and displaces sVCAM-1 level from the models for all-cause mortality and future cardiovascular events in CAPD patients. Additional study is needed to explore possible mechanistic links between inflammation, soluble adhesion molecules, residual renal function, and cardiac hypertrophy in CAPD patients. © 2005 by the National Kidney Foundation, Inc.en_US
dc.languageengen_US
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkden_US
dc.relation.ispartofAmerican Journal of Kidney Diseasesen_US
dc.subject.meshAgeden_US
dc.subject.meshC-Reactive Protein - Analysisen_US
dc.subject.meshCardiovascular Diseases - Epidemiologyen_US
dc.subject.meshCause Of Deathen_US
dc.subject.meshCholesterol, Ldl - Blooden_US
dc.subject.meshComorbidityen_US
dc.subject.meshFemaleen_US
dc.subject.meshGlomerular Filtration Rateen_US
dc.subject.meshHemoglobins - Analysisen_US
dc.subject.meshHomocysteine - Blooden_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshHypertrophy, Left Ventricular - Blood - Etiology - Ultrasonographyen_US
dc.subject.meshKidney - Physiopathologyen_US
dc.subject.meshKidney Failure, Chronic - Blood - Complications - Therapyen_US
dc.subject.meshLife Tablesen_US
dc.subject.meshLipids - Blooden_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMortalityen_US
dc.subject.meshPeritoneal Dialysis, Continuous Ambulatoryen_US
dc.subject.meshProportional Hazards Modelsen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisken_US
dc.subject.meshSerum Albumin - Analysisen_US
dc.subject.meshSolubilityen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshVascular Cell Adhesion Molecule-1 - Blood - Physiologyen_US
dc.titleCirculating soluble vascular cell adhesion molecule 1: Relationships with residual renal function, cardiac hypertrophy, and outcome of peritoneal dialysis patientsen_US
dc.typeArticleen_US
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_US
dc.identifier.authorityWang, M=rp00281en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1053/j.ajkd.2004.12.012en_US
dc.identifier.pmid15806475-
dc.identifier.scopuseid_2-s2.0-16244382834en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-16244382834&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume45en_US
dc.identifier.issue4en_US
dc.identifier.spage715en_US
dc.identifier.epage729en_US
dc.identifier.isiWOS:000228718000013-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWang, AYM=13606226000en_US
dc.identifier.scopusauthoridLam, CWK=8531362100en_US
dc.identifier.scopusauthoridWang, M=7406690398en_US
dc.identifier.scopusauthoridWoo, J=36040369400en_US
dc.identifier.scopusauthoridChan, IHS=8298775100en_US
dc.identifier.scopusauthoridLui, SF=7102379144en_US
dc.identifier.scopusauthoridSanderson, JE=7202371250en_US
dc.identifier.scopusauthoridLi, PKT=25928016800en_US

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