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Abstract: SA-PO952

Prognostic Value of Serum and Dialysate APX-501 in Chronic Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Cha, Jin Joo, Korea University, Ansan, Korea (the Republic of)
  • Joa, Jungmin, Korea University, Ansan, Korea (the Republic of)
  • Lee, Jeonghwan, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Lim, Chun Soo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Jo, Hyung Ah, Inje University, GoYang, Korea (the Republic of)
  • Han, Sang Youb, Inje University, GoYang, Korea (the Republic of)
  • Jhee, Jong Hyun, Inha University College of Medicine, Incheon, Korea (the Republic of)
  • Hwang, Seon Deok, Inha University College of Medicine, Incheon, Korea (the Republic of)
  • Lee, Dong-Young, Seoul Veterans Hospital, Seoul, Korea (the Republic of)
  • Kang, Young Sun, Korea University, Ansan, Korea (the Republic of)
  • Cha, Dae R., Korea University, Ansan, Korea (the Republic of)
Background

Patients on chronic dialysis are known to be in a chronic inflammation associated with increased oxidative injury, which results in increased morbidity and mortality. Recently APX-501 protein was identified to have regulatory role on oxidative stress. In the present study, we examined the clinical utility of APX-501 levels in serum and dialysate in chronic dialysis patients.

Methods

This study was a multicenter, prospective study that examined the level of serum and dialysate APX-501 in patients on chronic dialysis. Patients on dialysis (both peritoneal (PD) and hemodialysis(HD)) were enrolled between January 2016 to February 2018. Serum APX-501 level was measured using ELISA method. Time to overall mortality was recorded as the primary endpoint. For secondary endpoint, admission for major adverse cardiac events (MACE) and admission due to infection were recorded.

Results

Of 216 patients, patient on PD consisted of 136 patients. 37.5% of PD patients were enrolled initiating PD as the first dialysis modality (defined as new PD). During follow up period of 625±172.8 days, 15 patients died (6.9%), 27 experienced MACE (12.5%), 64 admitted to the hospital due to infection from any cause (29.6%). PD peritonitis event was reported in 35 patients (25.7% of PD group), of which 17(48.6%) patients were who initiated PD for the first time. Serum APX-501 did not predict overall mortality, MACE or acute infection event during the follow up period. In PD patients, dialysate APX-501 level was increased in patients who were initiating PD, and those with increased level of baseline dialysate APX-501 were at an increased risk of incidence for infection including PD peritonitis.

Conclusion

Dialysate APX-501 level may help to predict the risk of infection, especially the risk of PD peritonitis. Whether it can predict imminent PD peritonitis should be studied.

Funding

  • Commercial Support – Fresenius Medical Care