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Abstract: FR-PO416

Circulating Levels of CD34+ Cells Predict Long-Term Cardiovascular Outcomes in Patients on Maintenance Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kaihan, Ahmad Baseer, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Hishida, Manabu, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Imaizumi, Takahiro, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Katsuno, Takayuki, Aichi Medical University, Nagakute, Aichi-ken, Japan
  • Kosugi, Tomoki, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Tsuboi, Naotake, Fujita Health University School of Medicine, Toyoake, AICHI-KEN, Japan
  • Yasuda, Yoshinari, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Nagoya, Japan

Group or Team Name

  • Clinical research of Nagoya University Graduate School of Medicine
Background

CD34+ cells maintain vascular homeostasis and predict cardiovascular outcomes. We previously evaluated the association of CD34+ cells with cardiovascular disease (CVD) events over 23 months, but long-term CVD outcomes in relation to levels of CD34+ cells in patients on maintenance hemodialysis are unclear. Herein, we analyzed the long-term predictive potential levels of CD34+ cells for CVD outcomes and all-cause mortality.

Methods

Between March 2005 and May 2005, we enrolled 215 patients on maintenance hemodialysis at Nagoya Kyoritsu Hospital and followed them up to 12.8 years. According to the CD34+ cell counts, patients were classified into the lowest, medium, and highest tertiles. Levels of CD34+ cells were analyzed in association with four-point major adverse CV events (MACEs), CVD death, and all-cause mortality.

Results

The mean CD34+ cell count was 0.09 (range, 0.01 to 0.35 for all study patients). Patients in the lowest tertile were more likely to be older, have higher prevalence of cardiovascular disease, and to smoke than patients in the medium and highest tertiles. Age, smoking habit, lower geriatric nutrition risk index, lower calcium × phosphate product, and lower intact parathyroid hormone were significantly associated with the lowest tertile. Among 139 (64.7%) patients who died during a mean follow-up period of 8.0 years, 39 (28.1%) patients died from CVD. Patients in the lowest tertile had a significantly lower survival rate than those in the medium and highest tertiles (p ≤ 0.001). Using multivariable analyses, the lowest tertile was significantly associated with four-point MACEs (hazard ratio 1.80, p = 0.023) and CVD death (hazard ratio 2.50, p = 0.011).

Conclusion

our long-term observational study revealed that a low level of CD34+ cells in the circulation predicts CVD outcomes among patients on maintenance hemodialysis.

Funding

  • Private Foundation Support