Abstract: FR-PO873

Serum Levels of Resistin-Like Molecule Beta Is Associated with Gastrointestinal Complications in Patients with ESRD on Hemodialysis

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Tanaka, Kentaro, Higashikurume Ekimae Clinic, Tokyo, Japan
  • Kushiyama, Akifumi, Division of Diabetes and Metabolism,The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan
  • Tanaka, Yoshihide, Higashiyamato Nangai Clinic, Tokyo, Japan
  • Hara, Shigeko, Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
  • Ozawa, Takashi, Higashiyamato Nangai Clinic, Tokyo, Japan
Background

Resistin-like molecule (RELM) β is a secretory protein homologous to resistin and reportedly contributes to local immune response regulation in gut and bronchial epithelial cells. RELMβ is experimentally associated with chronic inflammation such as metabolic syndrome, diabetes, dyslipidemia, colon cancer, IBD and atherosclerosis. However, there are no reports in patients with end-stage renal disease (ESRD). To investigate the roles of RELMβ in ESRD, we analyzed the serum levels of RELMβ in ESRD patients before and after hemodialysis and the association between serum RELMβ and gastrointestinal complications (GIC).

Methods

69 patients with ESRD on hemodialysis provided written informed consent at our dialysis clinic in October 2015. We newly developed RELMβ ELISA and evaluated serum RELMβ from ESRD patients, compared with values from health check group as reference. Patients with severe bronchial asthma, abdominal operation just before measurement, and one failure measurement with non-specific signal were excluded. Then the remaining 66 patients (38 men, 28 women) were investigated for GIC in ESRD patients after serum RELMβ measurement. Onset date of complications were the day patients admitted to hospital for treatment. Statistical analysis was used by cox regression models.

Results

Serum RELMβ levels before dialysis which were markedly elevated as compared with those of control subjects (median 152 vs.60pg/ml, p=0.0008). Serum RELMβ was not eliminated after dialysis (p=0.54). Over median 14-month follow-up, 13 patients (19.6%) developed GIC (enteritis 2; bleeding 6; cancer 4; perforation 1). The patients in the lowest tertile of serum RELMβ (<90pg/ml) had no GIC. In a Cox univariate analysis, 10pg/mL increase of serum RELMβ was associated with GIC (hazard ratio 1.08, [95% CI 1.01-1.15], p=0.01). In Cox multivariate analysis, 10pg/mL increase of serum RELMβ was an independent predictor of GIC after adjusted by age, sex, diabetes, dialysis vintage, BMI, alb, CRP, Kt/V(1.12 [1.04-1.22], p=0.001).

Conclusion

Serum RELMβ is high in patients with ESRD, and high serum level of RELMβ is associated with the onset of GIC. These results suggest that the RELMβ plays a causal role in pathophysiology of GIC in ESRD and might be a useful marker.