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Unbalanced circulating Humanin levels and cardiovascular risk in chronic hemodialysis patients: a pilot, prospective study.
Bolignano, Davide; Greco, Marta; Presta, Pierangela; Duni, Anila; Zicarelli, Mariateresa; Mercuri, Simone; Pappas, Efthymios; Lakkas, Lampros; Musolino, Michela; Naka, Katerina K; Pugliese, Sara; Misiti, Roberta; Foti, Daniela Patrizia; Andreucci, Michele; Coppolino, Giuseppe; Dounousi, Evangelia.
Afiliación
  • Bolignano D; Nephrology and Dialysis Unit, Magna Graecia University, Catanzaro, Italy. davide.bolignano@gmail.com.
  • Greco M; Department of Medical and Surgical Sciences-Renal Unit, University "Magna Graecia", Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy. davide.bolignano@gmail.com.
  • Presta P; Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
  • Duni A; Clinical Pathology Lab, Magna Graecia University, Catanzaro, Italy.
  • Zicarelli M; Nephrology and Dialysis Unit, Magna Graecia University, Catanzaro, Italy.
  • Mercuri S; Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece.
  • Pappas E; Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
  • Lakkas L; Nephrology and Dialysis Unit, Magna Graecia University, Catanzaro, Italy.
  • Musolino M; Hemodialysis Unit, General Hospital of Filiates, Filiates, Greece.
  • Naka KK; Physiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
  • Pugliese S; Nephrology and Dialysis Unit, Magna Graecia University, Catanzaro, Italy.
  • Misiti R; Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
  • Foti DP; Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.
  • Andreucci M; Nephrology and Dialysis Unit, Magna Graecia University, Catanzaro, Italy.
  • Coppolino G; Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
  • Dounousi E; Clinical Pathology Lab, Magna Graecia University, Catanzaro, Italy.
J Nephrol ; 2024 Aug 05.
Article en En | MEDLINE | ID: mdl-39102184
ABSTRACT

BACKGROUND:

Mortality and cardiovascular (CV) risk prediction in individuals with end-stage kidney disease (ESKD) on chronic hemodialysis (HD) remains challenging due to the multitude of implicated factors. In a multicenter ESKD-HD cohort, we tested the prognostic yield of the assessment of circulating Humanin, a small mitochondrial-derived peptide involved in CV protection, on CV events and mortality.

METHODS:

We conducted a prospective, observational, pilot study on 94 prevalent HD patients. The prognostic capacity of circulating Humanin levels was tested on a primary composite (all-cause mortality + non-fatal CV events) and a secondary exploratory endpoint (all-cause mortality alone).

RESULTS:

Baseline Humanin level was comparable in patients reaching the primary or secondary endpoint as compared to others (p = 0.69 and 0.76, respectively). Unadjusted followed by multivariable Cox regression analyses adjusted for age, left ventricular mass index (LVMi), E/e', pulse pressure and diabetes mellitus indicated a non-linear relationship between Humanin levels and the composite outcome with the highest Hazard Ratio (HR) associated with very low (< 450.7 pg/mL; HR ranging from 4.25 to 2.49) and very high (> 759.5 pg/mL; HR ranging from 5.84 to 4.50) Humanin values. Restricted cubic splines fitting univariate and multivariate Cox regression analyses visually confirmed a curvilinear trend with an increasing risk observed for lower and higher Humanin values around the median, respectively. A similar, u-shaped association was also evidenced with the secondary endpoint.

CONCLUSIONS:

Altered Humanin levels may impart prognostic information in ESKD-HD patients at risk of death or CV events. Future investigations are needed to confirm whether Humanin measurement could improve CV and mortality risk prediction beyond traditional risk models.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Nephrol Asunto de la revista: NEFROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Nephrol Asunto de la revista: NEFROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia