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Abstract: TH-PO0317

Apelin-13 and Impaired Physical Function in Patients on Hemodialysis

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Campos, Monique Opuszcka, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Jain, Krishan Gopal, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Narayanan, Gayatri, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Alarcon Acurero, Leonardo Jose, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Groninger, Nolan, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Lu, Tzongshi, Harvard Medical School, Boston, Massachusetts, United States
  • Lim, Kenneth, Indiana University School of Medicine, Indianapolis, Indiana, United States
Background

Impaired physical function is a major complication in patients on dialysis that is linked with frailty, falls, increased hospitalization, and mortality. Apelin-13 is a circulating peptide cardiokine and myokine that exerts pleiotropic effects, including regulation of skeletal muscle metabolism. Whether Apelin-13 is involved in the regulation of physical function in patients with kidney failure is unclear. Herein, we evaluated the role of Apelin-13 levels in HD patients and healthy controls, and its association with physical function measures.

Methods

We performed secondary analysis of 66 participants (n=46 thrice-weekly HD patients and n=20 healthy controls) from the SPARK, ECON, and ROCK-D cohorts. Healthy controls were age- and gender-matched. All participants completed physical function tests. Plasma Apelin-13 levels were measured via ELISA (Novus Biologicals). Group differences were assessed with t-tests or Mann-Whitney U tests. Associations were analyzed using Pearson’s correlation and multiple regression.

Results

The HD group exhibited a higher BMI, and greater prevalence of black participants, hypertension, diabetes, beta-blocker use, and lower hemoglobin (all P<0.05). Despite similar blood pressure, resting heart rate was higher in the HD group (75.8 ± 10.2 vs. 63.5 ± 8.7 bpm, P<0.001). Significantly, Apelin-13 levels were lower in HD group compared to controls (1107 (835; 1525) pg/mL vs 1107 (835; 1525) pg/mL, P<0.001). HD patients had significantly impaired physical function across all metrics, including usual and fast gait speed, standing balance, the 30-second Sit-to-Stand Test (STS), handgrip strength, the 6-Minute Walk Test (MWT), and Short Physical Performance Battery (SPPB) scores, compared to controls (P< 0.001). Apelin-13 was positively correlated with usual gait speed (r=0.32), fast gait speed (r=0.38), standing balance (r=0.26), 30-sec STS (r=0.39), and handgrip strength (r=0.30) (all P<0.05). However, only fast gait speed and handgrip strength were associated after adjusting for age, sex, and race on multiple regression. No association was found with the 6-MWT or SPPB scores.

Conclusion

Apelin-13 levels are deficient in patients on HD and are significantly associated with impaired gait performance and handgrip strength.

Funding

  • Private Foundation Support

Digital Object Identifier (DOI)