Assessment of a serum calcification propensity test for the prediction of all-cause mortality among hemodialysis patients

BMC Nephrology

Research

Anke Winter¹  Adam M Zawada¹  Stefano Stuard¹  Manuela Stauss-Grabo¹  Melanie Wolf¹  Bernard Canaud²  Abraham Rincon Bello³  Rosa Ramos-Sanchez³  Laura Ribera Tello⁴  Francesc Moreso⁴  M. Amparo Fernández-Robres⁴  Josep Aguilera Jover⁴  Josep Mora-Macia⁴  Sara Hurtado Munoz⁴  Jordi Soler-Garcia⁵ 

[1] Fresenius Medical Care Deutschland GmbH, Else-Kroener-Str. 1, 61352, Bad Homburg, Germany;Fresenius Medical Care Deutschland GmbH, Else-Kroener-Str. 1, 61352, Bad Homburg, Germany;School of Medicine, University of Montpellier, Montpellier, France;Fresenius Medical Care España, S.A, Tres Cantos, Madrid, Spain;Fresenius Medical Care Services Cataluña, S.L, Barcelona, Spain;Fresenius Medical Care Services Cataluña, S.L, Tarragona, Spain;

关键词: Calcification;    Hemodialysis;    Hospitalization;    Mortality risk;    T50;   

DOI  :  10.1186/s12882-023-03069-6

 received in 2022-08-12, accepted in 2023-01-20,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundVascular calcification is a major contributor to the high cardiac burden among hemodialysis patients. A novel in vitro T50-test, which determines calcification propensity of human serum, may identify patients at high risk for cardiovascular (CV) disease and mortality. We evaluated whether T50 predicts mortality and hospitalizations among an unselected cohort of hemodialysis patients.MethodsThis prospective clinical study included 776 incident and prevalent hemodialysis patients from 8 dialysis centers in Spain. T50 and fetuin-A were determined at Calciscon AG, all other clinical data were retrieved from the European Clinical Database. After their baseline T50 measurement, patients were followed for two years for the occurrence of all-cause mortality, CV-related mortality, all-cause and CV-related hospitalizations. Outcome assessment was performed with proportional subdistribution hazards regression modelling.ResultsPatients who died during follow-up had a significantly lower T50 at baseline as compared to those who survived (269.6 vs. 287.7 min, p = 0.001). A cross-validated model (mean c statistic: 0.5767) identified T50 as a linear predictor of all-cause-mortality (subdistribution hazard ratio (per min): 0.9957, 95% CI [0.9933;0.9981]). T50 remained significant after inclusion of known predictors. There was no evidence for prediction of CV-related outcomes, but for all-cause hospitalizations (mean c statistic: 0.5284).ConclusionT50 was identified as an independent predictor of all-cause mortality among an unselected cohort of hemodialysis patients. However, the additional predictive value of T50 added to known mortality predictors was limited. Future studies are needed to assess the predictive value of T50 for CV-related events in unselected hemodialysis patients.

【 授权许可】

CC BY   
© The Author(s) 2023

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