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Serum hepatocyte growth factor is associated with truncal fat mass and increased mortality in chronic kidney disease stage 5 patients with protein-energy wasting.
- Source :
-
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2015 Feb; Vol. 30 (2), pp. 274-82. Date of Electronic Publication: 2013 Aug 24. - Publication Year :
- 2015
-
Abstract
- Background: Obese sarcopenia characterized by increased fat mass and protein-energy wasting (PEW) is not uncommon in chronic kidney disease (CKD) stage 5 patients in whom it is associated with worse outcomes. Serum hepatocyte growth factor (HGF) is associated with obesity in the general population and is increased in CKD patients in whom its association with body composition is not known. We studied the associations between HGF, PEW and body composition, and between HGF and mortality, in CKD stage 5 patients starting dialysis.<br />Methods: In 224 CKD stage 5 patients (139 males, mean age 52 years, mean glomerular filtration rate (GFR) 6.6 mL/min), blood samples were obtained for analyses of HGF, high-sensitivity C-reactive protein (hsCRP), glucose, insulin and lipids. Total fat mass index (FMI), truncal fat mass index (TFMI) and lean body mass index (LBMI) assessed by dual-energy X-ray absorptiometry and PEW assessed by subjective global assessment (SGA) were recorded at baseline. Patients were followed up for 5 years.<br />Results: Serum HGF levels were higher in patients with high TFMI versus low TFMI [3.1 (IQR: 2.4-4.5) versus 2.7 (IQR: 1.9-3.8) ng/mL; P = 0.01] and in those with PEW versus non-PEW [3.4 (IQR: 2.4-3.6) versus 2.8 (IQR: 2.1-3.8) ng/mL; P = 0.03]. Patients with both high TFMI and presence of PEW had significantly (P < 0.001) higher HGF concentration [4.4 (IQR: 3.3-6.6) ng/mL] than other patient groups (high TFMI and non-PEW, low TFMI and PEW or low TFMI and non-PEW). Multivariate linear regression showed that TFMI was an independent predictor of HGF (R(2) = 0.21, P = 0.048). In Cox analysis, patients with high HGF and presence of PEW had worse all-cause mortality after adjusting for age, gender and hsCRP (HR: 3.59, 95% CI: 1.19-5.35).<br />Conclusions: Increased TFMI was an independent predictor of HGF in CKD stage 5 patients. Moreover, an elevated HGF level increased the mortality risk in the presence of PEW. These results suggest a central role of HGF in the metabolic and nutritional alterations in CKD stage 5 patients.<br /> (© The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)
- Subjects :
- Absorptiometry, Photon
Biomarkers blood
Body Composition
C-Reactive Protein metabolism
Female
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic physiopathology
Lipids blood
Male
Middle Aged
Obesity blood
Obesity etiology
Prognosis
Protein-Energy Malnutrition blood
Protein-Energy Malnutrition complications
Survival Rate
Hepatocyte Growth Factor blood
Kidney Failure, Chronic mortality
Obesity mortality
Protein-Energy Malnutrition mortality
Renal Dialysis adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2385
- Volume :
- 30
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
- Publication Type :
- Academic Journal
- Accession number :
- 23975839
- Full Text :
- https://doi.org/10.1093/ndt/gft265