High soluble vascular cell adhesion molecule-1 concentrations predict long-term mortality in hemodialysis patients

Int Urol Nephrol. 2013 Dec;45(6):1693-701. doi: 10.1007/s11255-013-0425-z. Epub 2013 Apr 6.

Abstract

Purpose: Soluble vascular cell adhesion molecule-1 (sVCAM-1) has a strong association with cardiovascular deaths in patients with coronary artery disease. The aim of this study is to explore the association between sVCAM-1 and cardiovascular mortality in maintenance hemodialysis (MHD) patients.

Methods: Eighty-three clinically stable MHD patients (mean age of 59.4 ± 13.7 years) at a single hospital-based dialysis facility were included. sVCAM-1, soluble intercellular adhesion molecule-1 (sICAM-1), and soluble E-selectin (sE-selectin) were determined at study baseline. The study cohort was divided into higher and lower concentration groups by the median value. The all-cause and cardiovascular mortality of this cohort were followed for 7 years.

Results: The mean concentrations of sVCAM-1, sICAM-1, and sE-selectin were 1,393.08 ± 300.96, 230.16 ± 84.86, and 60.01 ± 42.00 ng/mL, respectively. The higher concentration groups of sVCAM-1 and sICAM-1 had higher all-cause mortality by Kaplan-Meier analysis (p = 0.002 and p = 0.030, respectively). Higher sVCAM-1 concentrations had a higher risk of all-cause and cardiovascular mortality (p = 0.006 p = 0.046, respectively) in Cox proportional hazards model analysis.

Conclusion: In MHD patients, higher sVCAM-1 concentrations independently predict all-cause and cardiovascular mortality. This biomarker may be used as a valid surrogate marker for predicting outcomes.

MeSH terms

  • Aged
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / mortality*
  • E-Selectin / blood*
  • Female
  • Follow-Up Studies
  • Humans
  • Intercellular Adhesion Molecule-1 / blood*
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Renal Dialysis / mortality*
  • Time Factors
  • Vascular Cell Adhesion Molecule-1 / blood*

Substances

  • E-Selectin
  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1