TY - JOUR
T1 - Connective tissue growth factor is related to all-cause mortality in hemodialysis patients and is lowered by on-line hemodiafiltration
T2 - Results from the convective transport study
AU - Den Hoedt, Claire H.
AU - van Gelder, Maaike K.
AU - Grooteman, Muriel P.
AU - Nubé, Menso J.
AU - Blankestijn, Peter J.
AU - Goldschmeding, Roel
AU - Kok, Robbert Jan
AU - Bots, Michiel L.
AU - van den Dorpel, Marinus A.
AU - Gerritsen, Karin G.F.
N1 - Funding Information:
CONTRAST is financially supported by a grant from the Dutch Kidney Foundation (Nierstichting Nederland, grant C02.2019) and unrestricted grants from Fresenius Medical Care (The Netherlands) and Gambro Lundia AB (Sweden). Additional support was received from the Dr. E.E. Twiss Fund, Roche Netherlands; the International Society of Nephrology/Baxter Extramural Grant Program; the Dutch Organization for Health Research and Development (ZonMW, grant 17088.2802); and Amgen BV Netherlands.
Funding Information:
Funding: CONTRAST is financially supported by a grant from the Dutch Kidney Foundation (Nierstichting Nederland, grant C02.2019) and unrestricted grants from Fresenius Medical Care (The Netherlands) and Gambro Lundia AB (Sweden). Additional support was received from the Dr. E.E. Twiss Fund, Roche Netherlands; the International Society of Nephrology/Baxter Extramural Grant Program; the Dutch Organization for Health Research and Development (ZonMW, grant 17088.2802); and Amgen BV Netherlands.
Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2019/5/13
Y1 - 2019/5/13
N2 - Connective tissue growth factor (CTGF) plays a key role in the pathogenesis of tissue fibrosis. The aminoterminal fragment of CTGF is a middle molecule that accumulates in chronic kidney disease. The aims of this study are to explore determinants of plasma CTGF in hemodialysis (HD) patients, investigate whether CTGF relates to all-cause mortality in HD patients, and investigate whether online-hemodiafiltration (HDF) lowers CTGF. Data from 404 patients participating in the CONvective TRAnsport STudy (CONTRAST) were analyzed. Patients were randomized to low-flux HD or HDF. Pre-dialysis CTGF was measured by sandwich ELISA at baseline, after six and 12 months. CTGF was inversely related in multivariable analysis to glomerular filtration rate (GFR) (p < 0.001) and positively to cardiovascular disease (CVD) (p = 0.006), dialysis vintage (p < 0.001), interleukin-6 (p < 0.001), beta-2-microglobulin (p = 0.045), polycystic kidney disease (p < 0.001), tubulointerstitial nephritis (p = 0.002), and renal vascular disease (p = 0.041). Patients in the highest quartile had a higher mortality risk compared to those in the lowest quartile (HR 1.7, 95% CI: 1.02–2.88, p = 0.043). HDF lowered CTGF with 4.8% between baseline and six months, whereas during HD, CTGF increased with 4.9% (p < 0.001). In conclusion, in HD patients, CTGF is related to GFR, CVD and underlying renal disease and increased the risk of all-cause mortality. HDF reduces CTGF.
AB - Connective tissue growth factor (CTGF) plays a key role in the pathogenesis of tissue fibrosis. The aminoterminal fragment of CTGF is a middle molecule that accumulates in chronic kidney disease. The aims of this study are to explore determinants of plasma CTGF in hemodialysis (HD) patients, investigate whether CTGF relates to all-cause mortality in HD patients, and investigate whether online-hemodiafiltration (HDF) lowers CTGF. Data from 404 patients participating in the CONvective TRAnsport STudy (CONTRAST) were analyzed. Patients were randomized to low-flux HD or HDF. Pre-dialysis CTGF was measured by sandwich ELISA at baseline, after six and 12 months. CTGF was inversely related in multivariable analysis to glomerular filtration rate (GFR) (p < 0.001) and positively to cardiovascular disease (CVD) (p = 0.006), dialysis vintage (p < 0.001), interleukin-6 (p < 0.001), beta-2-microglobulin (p = 0.045), polycystic kidney disease (p < 0.001), tubulointerstitial nephritis (p = 0.002), and renal vascular disease (p = 0.041). Patients in the highest quartile had a higher mortality risk compared to those in the lowest quartile (HR 1.7, 95% CI: 1.02–2.88, p = 0.043). HDF lowered CTGF with 4.8% between baseline and six months, whereas during HD, CTGF increased with 4.9% (p < 0.001). In conclusion, in HD patients, CTGF is related to GFR, CVD and underlying renal disease and increased the risk of all-cause mortality. HDF reduces CTGF.
KW - connective tissue growth factor
KW - CCN intercellular signalling proteins
KW - haemodialysis
KW - haemodiafiltration
KW - convection
KW - end stage kidney disease
KW - cardiovascular disease
KW - mortality
KW - Mortality
KW - Cardiovascular disease
KW - Connective tissue growth factor
KW - Haemodiafiltration
KW - Haemodialysis
KW - Convection
KW - End stage kidney disease
UR - https://www.scopus.com/pages/publications/85066280339
U2 - 10.3390/toxins11050268
DO - 10.3390/toxins11050268
M3 - Article
C2 - 31086050
SN - 2072-6651
VL - 11
JO - Toxins
JF - Toxins
IS - 5
M1 - 268
ER -