Kidney Week

Abstract: TH-PO0466

Circulating Growth Differentiation Factor 15 and Coronary Artery Calcification in a Prospective Hemodialysis Cohort: A Substudy of the NIH THYROID-HD Trial

Session Information

• Hemodialysis: Novel Markers and Case Reports
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• You, Seungsook, University of California Los Angeles, Los Angeles, California, United States

Seungsook You, MS

• Kalantar-Zadeh, Kamyar, The Lundquist Institute, Torrance, California, United States

Kamyar Kalantar-Zadeh, MD, DrMed, PhD, MPH, FASN

• Shah, Anuja P., The Lundquist Institute, Torrance, California, United States

Anuja P. Shah, MD

• Daza Aguilar, Andrea C., University of California Los Angeles, Los Angeles, California, United States

Andrea C. Daza Aguilar

• Narasaki, Yoko, University of California Los Angeles, Los Angeles, California, United States

Yoko Narasaki, MS, PhD

• Nguyen, Danh V., University of California Irvine, Irvine, California, United States

Danh V. Nguyen, PhD

• Rhee, Connie, University of California Los Angeles, Los Angeles, California, United States

Connie Rhee, MD, MS

Background

In the general population, Growth differentiation factor 15 (GDF15) is a protein in the transforming growth factor-β protein that is potently upregulated by vascular smooth muscle cells and cardiomyocytes following injury, ischemia, and other forms of oxidative/metabolic stress. Emerging data suggest that circulating GDF15 levels are associated with higher death risk in ESKD patients. We examined the relationship of coronary artery calcification (CAC) measured by cardiac CT with GDF15 levels in a prospective HD cohort.

Methods

In a substudy of the multi-center NIH THYROID-HD Trial, we examined the association of CAC Agatston score (categorized as tertiles) with elevated serum GDF15 levels (defined as greater than the 1^st tertile of observed values) in HD patients with low-normal and subclinical hypothyroid range TSH levels (>3.0-10.0mIU/L) using unadjusted, case-mix, and expanded case-mix logistic regression.

Results

Among 190 HD patients who underwent baseline CAC and GDF15 measurements, those in the highest CAC Agatston score tertile (Tertile 3) had a higher likelihood of elevated GDF15 levels in unadjusted, case-mix, and expanded case-mix adjusted analyses (ref: Tertile 1): adjusted ORs (95%CIs) 5.30 (2.30, 12.21) and 3.69 (1.52, 8.97), and 3.83 (1.56, 9.39), respectively.

Conclusion

In a subcohort of HD patients from the NIH THYROID-HD Trial, higher CAC scores were associated with elevated serum GDF15 levels. Further research is needed to determine the underlying mechanistic pathways by which greater CAC burden is linked with higher circulating GDF15 as an adverse cardiovascular biomarker in ESKD.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025wa2dfk79