Soluble CD14 levels, interleukin 6, and mortality among prevalent hemodialysis patients.
Soluble CD14 levels, interleukin 6, and mortality among prevalent hemodialysis patients.
复制标题
常见血液透析患者中可溶性 CD14 水平、白细胞介素 6 和死亡率。
DOI：
10.1053/j.ajkd.2009.06.022
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发表时间：
2009-12
影响因子：
13.2
通讯作者：
Stenvinkel, Peter
中科院分区：
文献类型：
--
作者：
Raj, Dominic S. C.;Carrero, Juan J.;Shah, Vallabh O.;Qureshi, Abdul R.;Barany, Peter;Heimburger, Olof;Lindholm, Bengt;Ferguson, Jennet;Moseley, Pope L.;Stenvinkel, Peter
关键词：
CD14 is a pattern-recognition receptor that plays a central immunomodulatory role in pro-inflammatory signaling in response to a variety of ligands, including endotoxin. CD14 protein is present in two forms soluble (sCD14) and membrane-bound. Hereby we studied the implications of elevated sCD14 in hemodialysis patients. We hypothesized that sCD14 elevation may link to cytokine activation and protein-energy wasting, predisposing to increased mortality risk. Prospective observational study of prevalent hemodialysis patients. 211 prevalent hemodialysis patients, median age of 66 years, 29 months of vintage dialysis time followed-up for mortality for a median of 31 months. Tertiles of baseline circulating sCD14 corresponding to <2.84, 2.85-3.62, and >3.63 μg/mL, respectively. The major outcome of interest was all-cause mortality. sCD14 and endotoxin, together with other markers of inflammation and protein-energy wasting. The median value of sCD14 was 3.2 μg/mL (25th to 75th percentile, 2.7 to 3.9). sCD14 correlated positively with C-reactive protein, interleukin-6, endotoxin and long pentraxin-3, while negatively with serum albumin, muscle mass and handgrip strength. Patients with elevated sCD14 had lower body mass index and increased prevalence of muscle atrophy. Patients within the highest sCD14 tertile had a crude morality Hazard ratio of 1.94 (95% CI 1.13-3.32), that persisted after adjustment for multiple confounders (Hazard ratio 3.11 [95% CI 1.49-6.46]). Among patients with persistent inflammation, the presence of concurrent elevation of sCD14 levels gradually increased the mortality risk, but this effect was less than multiplicative and failed to show a statistical interaction. Those inherent to an observational study. sCD14 is associated with inflammation and protein-energy wasting in hemodialysis patients. It is a strong and independent predictor of mortality that warrants further assessment in the clinical setting regarding its usefulness as a complementary prognosticator to other general inflammatory markers.
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影响因子：
6.3
作者：
Carrero, Juan Jesus;Chmielewski, Michal;Qureshi, Abdul Rashid
通讯作者：
Qureshi, Abdul Rashid
影响因子：
32.4
作者：
PUGIN, J;HEUMANN, D;ULEVITCH, RJ
通讯作者：
ULEVITCH, RJ
影响因子：
13.6
作者：
Cheema, Bobby;Abas, Haifa;Singh, Maria Fiatarone
通讯作者：
Singh, Maria Fiatarone
DOI：
10.1016/s0169-2607(97)00043-6
发表时间：
1997-11-01
影响因子：
6.1
作者：
Heinzl, H;Kaider, A
通讯作者：
Kaider, A
影响因子：
4.8
作者：
Kitchens, RL;Wolfbauer, G;Munford, RS
通讯作者：
Munford, RS