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Abstract: FR-PO499

Circulating Angiopoietin-Like Protein 2 Levels and Mortality Risk in Patients Receiving Maintenance Hemodialysis: A Prospective Cohort Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Morinaga, Jun, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
  • Fukami, Hirotaka, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
  • Kanki, Tomoko, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
  • Hayata, Manabu, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
  • Kakizoe, Yutaka, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
  • Izumi, Yuichiro, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
  • Kuwabara, Takashige, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
  • Oike, Yuichi, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
  • Mukoyama, Masashi, Kumamoto University, Graduate School of Medical Sciences, Kumamoto, Japan
Background

Prognosis of patients undergoing hemodialysis treatment is poor, as many of them exhibit premature aging. Systemic inflammatory conditions often underlie premature aging phenotypes of the uremic population. Thus, we asked whether Angiopoietin-like protein (ANGPTL) 2, a factor that accelerates progression of aging-related and non-infectious inflammatory diseases, was associated with mortality of hemodialysis patients.

Methods

We conducted a multicenter prospective cohort study of 412 patients receiving maintenance hemodialysis treatment and evaluated relationships between circulating ANGPTL2 levels and risk for all-cause mortality. Circulating ANGPTL2 levels were log-transformed to correct for skewed distribution, and analyzed as continuous variable.

Results

Of 395 subjects analyzed statistically, time-to-event data analysis revealed high circulating ANGPTL2 levels associated with increasing risk for all-cause mortality after adjustment for age, sex, hemodialysis vintage, nutrition status, metabolic parameters, and circulating high sensitivity C-reactive protein values [HR: 2.04, 95%CI (1.10, 3.77)]. High circulating ANGPTL2 levels were also strongly associated with increased mortality risk, particularly in patients with a relatively benign prognosis [HR: 3.06, 95%CI (1.86, 5.03)]. Furthermore, the relationship between circulating ANGPTL2 levels and mortality risk was especially strong in populations showing less senescent phenotypes, such as younger patients [HR: 7.99, 95%CI (3.55, 18.01)], short hemodialysis vintage [HR: 3.99, 95%CI (2.85, 5.58)], or non-diabetes [HR: 5.15, 95%CI (3.19, 8.32)].

Conclusion

We conclude that circulating ANGPTL2 levels are positively associated with mortality risk of patients receiving maintenance hemodialysis, and that ANGPTL2 may uniquely reflect progression of premature aging and subsequent mortality risk in that population.

Funding

  • Government Support - Non-U.S.