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Abstract: FR-PO799

Plasma Syndecan-1 in Hemodialysis Patients Associates with Survival and Reduced Volume Status

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Koch, Josephine, University of Groningen, Groningen, Netherlands
  • Idzerda, Nienke, University Medical Center Groningen, Groningen, Netherlands
  • Dam, Wendy, University medical center groningen, Groningen, Netherlands
  • Assa, Solmaz, University Medical Center Groningen, Groningen, Netherlands
  • van den Born, Jacob, Univ. Med. Center Groningen, Groningen, Netherlands
  • Franssen, Casper F.M., University Medical Center Groningen, Groningen, Netherlands
Background

Syndecan-1, a transmembrane heparan sulfate proteoglycan, associates with renal and cardiovascular functioning. We earlier reported syndecan-1 to be involved in renal tubular regeneration. We now examined plasma values of syndecan-1 in a hemodialysis cohort and its association with volume, inflammatory and endothelial markers in addition to outcome parameters.

Methods

Eighty-four hemodialysis patients were evaluated for their plasma syndecan-1 levels by ELISA before, 60, 180 and 240 minutes after starting dialysis. Patients were divided into sex-stratified tertiles based on predialysis plasma syndecan-1 levels. We studied the association between plasma levels of syndecan-1 and volume, inflammation and endothelial markers and its association with cardiovascular events and all-cause mortality using Kaplan-Meier curves and cox regression analyses with adjustments for gender, age, diabetes and dialysis vintage.

Results

Predialysis syndecan-1 levels were two-fold higher in males compared to females (P=0.0003). Patients in the highest predialysis plasma syndecan-1 tertile had a significantly higher ultrafiltration rate (P=0.034) and lower plasma values of BNP (P=0.019), pro-ANP (P=0.024) and endothelin (P<0.0001) compared with the two lower predialysis syndecan-1 tertiles. No significant associations with inflammatory markers were found. Cox regression analysis showed that patients in the highest syndecan-1 tertile had significantly less cardiovascular events and better survival compared with the lowest syndecan-1 tertile (P=0.02 and P=0.005, respectively).

Conclusion

In hemodialysis patients, higher plasma syndecan-1 levels were associated with lower concentrations of BNP, pro-ANP and endothelin, and with better patient survival. This may suggest that control of volume status in hemodialysis patients allows an adaptive tissue regenerative response as reflected by higher plasma syndecan-1 levels.

Funding

  • Government Support - Non-U.S.