Periostin Predicts All-Cause Mortality in Male but Not Female End-Stage Renal Disease Patients on Hemodialysis

Cardiorenal Med. 2024;14(1):407-415. doi: 10.1159/000539765. Epub 2024 Jul 18.

Abstract

Introduction: Periostin is a matricellular protein. Elevated serum concentrations of periostin have been reported in patients with various cardiovascular diseases, including heart failure. Patients with end-stage renal disease have a substantially increased risk for cardiovascular diseases. However, there is a lack of clinical studies to clarify the prognostic significance of systemic periostin on all-cause mortality in patients with end-stage renal disease on hemodialysis.

Methods: 313 stable end-stage renal disease patients were recruited and followed for 5 years concerning all-cause mortality. At baseline, we collected blood samples and clinical data. Serum periostin concentrations were measured using a certified ELISA.

Results: The optimal cut-off value for serum periostin regarding all-cause mortality, calculated through receiver operating characteristic analysis, was 777.5 pmol/L. Kaplan-Meier survival analysis using this cut-off value demonstrated that higher periostin concentrations are linked to higher all-cause mortality (log-rank test: p = 0.002). Subgroup analysis revealed that serum periostin concentrations only affected all-cause mortality in male but not in female patients (p = 0.002 in male patients and p = 0.474 in female patients). Multivariate Cox regression analyses, adjusted for confounding factors, likewise showed that elevated serum periostin concentrations were positively associated with all-cause mortality in male (p = 0.028) but not in female patients on hemodialysis (p = 0.313).

Conclusion: Baseline serum periostin is an independent risk factor for all-cause mortality in male patients with chronic renal disease on hemodialysis.

Keywords: All-cause mortality; Hemodialysis patients; Periostin; Sex dependency.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Cause of Death / trends
  • Cell Adhesion Molecules* / blood
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic* / blood
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / mortality
  • Kidney Failure, Chronic* / therapy
  • Male
  • Middle Aged
  • Periostin
  • Prognosis
  • ROC Curve
  • Renal Dialysis*
  • Risk Factors
  • Sex Factors

Substances

  • Cell Adhesion Molecules
  • POSTN protein, human
  • Biomarkers
  • Periostin