TY - JOUR

T1 - YKL-40 in patients with end-stage renal disease receiving haemodialysis

AU - Nielsen, Ture Lange

AU - Plesner, Louis Lind

AU - Warming, Peder Emil

AU - Pallisgaard, Jannik Langtved

AU - Dalsgaard, Morten

AU - Schou, Morten

AU - Høst, Ulla

AU - Rydahl, Casper

AU - Brandi, Lisbet

AU - Køber, Lars

AU - Johansen, Julia Sidenius

AU - Kastrup, Jens

AU - Iversen, Kasper Karmark

PY - 2018

Y1 - 2018

N2 - Purpose: This study aimed to determine serum YKL-40 in patients with end-stage renal disease (ESRD) on haemodialysis (HD) and to evaluate the prognostic value of serum YKL-40. Methods: Patients >18 years on maintenance HD were included. Serum YKL-40 was measured using ELISA before and after a single HD treatment. Results: A total of 306 patients were included. Median serum YKL-40 concentration was 238 µgL−1 (IQR: 193–291 µgL−1) before HD treatment and 198 µgL−1 (IQR: 147–258 µgL−1) after HD treatment, which corresponded to age-corrected 93th percentile in healthy subjects. All-cause mortality after 2.8 years was 35.9%. Patients with serum YKL-40 in the highest quartile compared with the lowest quartile had a univariate HR of 4.0 (95% CI: 2.2–7.3, < 0.001) for all-cause mortality which decreased to 2.4 (95% CI: 1.1–4.5, = 0.01) in multivariate analysis. Time-dependent receiver operating characteristic curves showed that serum YKL-40 after HD treatment had significant higher area under the curves from 90 d (p = 0.004) and throughout the rest of the follow-up period when compared to serum YKL-40 before HD treatment. Conclusion: YKL-40 was highly elevated in patients with ESRD on HD, and dialysis reduced serum YKL-40 concentrations approximately one-sixth. YKL-40 measured after dialysis was independently associated with mortality in HD patients.

AB - Purpose: This study aimed to determine serum YKL-40 in patients with end-stage renal disease (ESRD) on haemodialysis (HD) and to evaluate the prognostic value of serum YKL-40. Methods: Patients >18 years on maintenance HD were included. Serum YKL-40 was measured using ELISA before and after a single HD treatment. Results: A total of 306 patients were included. Median serum YKL-40 concentration was 238 µgL−1 (IQR: 193–291 µgL−1) before HD treatment and 198 µgL−1 (IQR: 147–258 µgL−1) after HD treatment, which corresponded to age-corrected 93th percentile in healthy subjects. All-cause mortality after 2.8 years was 35.9%. Patients with serum YKL-40 in the highest quartile compared with the lowest quartile had a univariate HR of 4.0 (95% CI: 2.2–7.3, < 0.001) for all-cause mortality which decreased to 2.4 (95% CI: 1.1–4.5, = 0.01) in multivariate analysis. Time-dependent receiver operating characteristic curves showed that serum YKL-40 after HD treatment had significant higher area under the curves from 90 d (p = 0.004) and throughout the rest of the follow-up period when compared to serum YKL-40 before HD treatment. Conclusion: YKL-40 was highly elevated in patients with ESRD on HD, and dialysis reduced serum YKL-40 concentrations approximately one-sixth. YKL-40 measured after dialysis was independently associated with mortality in HD patients.

KW - biomarker

KW - end-stage renal disease

KW - Haemodialysis

KW - inflammation

KW - mortality

KW - YKL-40

U2 - 10.1080/1354750X.2018.1428359

DO - 10.1080/1354750X.2018.1428359

M3 - Journal article

C2 - 29357700

AN - SCOPUS:85043315058

VL - 23

SP - 357

EP - 363

JO - Biomarkers

JF - Biomarkers

SN - 1354-750X

IS - 4

ER -