Increased Soluble Suppression of Tumorigenicity 2 Level Predicts All-Cause and Cardiovascular Mortality in Maintenance Hemodialysis Patients: A Prospective Cohort Study

Zhang, Zhen; Shen, Bo; Cao, Xuesen; Z, Liu; Chen, Xiaohong; Nie, Yuxin; Yu, Jinbo; Zou, Jianzhou; Ding, Xiaoqiang

doi:10.1159/000452924

Cited by 20 publications

(19 citation statements)

References 37 publications

(33 reference statements)

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“…In the heart, galectin-3 is linked to cardiac fibrosis, remodeling, and ventricular dysfunction 16, 38. In support of these mechanisms, clinical studies have reported an association of higher galectin-3 with all-cause mortality and cardiovascular mortality in patients with impaired kidney function 19 and those on hemodialysis 39, 40. Galectin-3 has been linked to the pathogenesis of several kidney diseases as well, including diabetic nephropathy, 41 infections, acute tubular necrosis, autosomal recessive polycystic kidney disease, renal cell carcinoma, lupus nephritis, and chronic allograft rejection 15 .…”

Section: Discussionmentioning

confidence: 96%

“…Higher sST2 has also been linked to cardiac matrix remodeling 38 . Clinically, sST2 has been shown to predict heart failure, major cardiovascular events, and mortality independently48, 49, 50 and in association with other biomarkers and clinical characteristics in the general population17, 51 and among patients with kidney disease 39, 52. Fewer studies have examined the association of sST2 with kidney outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Soluble ST2 and Galectin-3 and Progression of CKD

Alam

Katz

Bellovich

et al. 2019

Kidney International Reports

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IntroductionCardiac biomarkers soluble ST2 (sST2) and galectin-3 may reflect cardiac inflammation and fibrosis. It is plausible that these mechanisms may also contribute to the progression of kidney disease. We examined associations of sST2 and galectin-3 with kidney function decline in participants with chronic kidney disease (CKD).MethodsThis was a pooled analysis of 2 longitudinal cohorts of participants with CKD: the Clinical Phenotyping and Resource Biobank (C-PROBE) study and the Seattle Kidney Study (SKS). We measured circulating concentrations of sST2 and galectin-3 at baseline. Our primary outcome was progression to estimated glomerular filtration rate (eGFR) <15 ml/min per 1.73 m2 or end-stage renal disease (ESRD). We used competing risk Cox regression models to study the association of sST2 and galectin-3 with CKD progression, adjusting for demographics, kidney function, and comorbidity.ResultsAmong the 841 participants in the pooled cohort, baseline eGFR was 51 ± 27 ml/min per 1.73 m2 and median urine albumin-to-creatinine ratio (UACR) was 141 (interquartile range = 15−736) mg/g. Participants with higher sST2 and galectin-3 were more likely to be older, to have heart failure and diabetes, and to have lower eGFR. Adjusting for demographics, kidney function, and comorbidity, every doubling of sST2 was not associated with progression to eGFR <15 ml/min per 1.73 m2 or ESRD (adjusted hazard ratio 1.02, 95% confidence interval = 0.76−1.38). Every doubling of galectin-3 was significantly associated with a 38% (adjusted hazard ratio = 1.35, 95% confidence interval = 1.01−1.80) increased risk of progression to eGFR <15 ml/min per 1.73 m2 or ESRD.ConclusionHigher concentrations of the cardiac biomarker galectin-3 may be associated with progression of CKD, highlighting potential novel mechanisms that may contribute to the progression of kidney disease.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Soluble ST2 and Galectin-3 and Progression of CKD

Alam

Katz

Bellovich

et al. 2019

Kidney International Reports

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“…Another study showed that ST2 was an independent prognostic factor and had a better prognostic ability than BNP in chronic hemodialysis patients 18 . In other study showing that ST2 is a predictor of all-cause and cardiovascular mortality in maintenance dialysis patients, ST2 showed no greater predictive power than BNP but showed greater predictive power when used with BNP 19 .…”

Section: Discussionmentioning

confidence: 82%

Prognostic Utility of Soluble Suppression of Tumorigenicity 2 level as a Predictor of Clinical Outcomes in Incident Hemodialysis Patients

Seo¹,

Kim²,

Kim³

et al. 2018

Int. J. Med. Sci.

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Background: The suppression of tumorigenicity 2 (ST2) is associated with cardiac remodeling and tissue fibrosis. It is well known as a novel biomarker on predictor of cardiovascular events in patients with heart failure. In patients needed to start dialysis treatment, most of them had congestive heart failure. However, the prognostic implications of serum ST2 level are unknown in incident hemodialysis patients.Methods: A total 182 patients undergoing incident hemodialysis were consecutively enrolled from November 2011 to December 2014. These patients were classified into two groups according to their median ST2 levels. The two groups were subsequently compared with respect to their major adverse cerebro-cardiovascular events (MACCE) including all-cause mortality, heart failure admission, acute coronary syndrome, and nonfatal stroke.Results: The median duration of follow up was 628 days (interquartile range 382 to 1,052 days). ST2 was significant correlated with variable echocardiographic parameters. The parameters of diastolic function, deceleration time of the early filing velocity and maximal tricuspid regurgitation velocity were independently associated with the ST2 levels. High ST2 group had significantly higher incidence of all-cause mortality, and MACCE. High ST2 was a significant independent predictor of MACCE (adjusted hazard ratio 2.33, 95% confidence interval 1.12 to 4.87, p=0.024).Conclusion: The ST2 is associated with diastolic function and may be a predictor of clinical outcomes in incident hemodialysis patients.

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“…Multivariate Cox regression analysis reported by Obokata et al revealed that only sST2 was an independent risk factor for 2-year mortality when sST2 and NT-proBNP were included in the regression model simultaneously [7]. Another study demonstrated that the prognostic power of sST2 to predict 3year adverse clinical outcomes was weaker than that of NT-proBNP [8]. Apart from the discrepancy, neither of the two studies systematically investigated the prognostic value of the two biomarkers for short-term or long-term mortality in MHD patients; thus, the findings of our study may have an important impact on the clinical application of the two biomarkers.…”

Section: Discussionmentioning

confidence: 98%

“…The association of NT-proBNP with mortality in MHD has been shown by numerous studies [4,5]. Soluble suppression of tumorigenicity 2 (sST2) is a regulatory factor closely related to inflammation [6], and has been reported associated with mortality and fatal cardiovascular events in dialysis patients [7,8]. Moreover, circulating sST2 has been recommended as an additional risk stratification factor for acute and chronic heart failure by the American Heart Association [9].…”

Section: Introductionmentioning

confidence: 99%

Superior prognostic value of soluble suppression of tumorigenicity 2 for the short-term mortality of maintenance hemodialysis patients compared with NT-proBNP: a prospective cohort study

Wang

Chen

et al. 2020

Renal Failure

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Background: Both soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are promising biomarkers associated with the adverse clinical outcomes of dialysis patients. Our research aims at exploring and comparing the roles of sST2 and NT-proBNP in predicting the short-term and long-term mortality of maintenance hemodialysis (MHD) patients. Methods: A prospective cohort study was performed. Patients undergoing hemodialysis in July 2014 were enrolled from the Blood Purification Center of Ruijin Hospital. MHD patients were followed up for 3 years. The primary outcome was all-cause mortality at the 1-year and 3-year follow-up, while the secondary outcome was cardiovascular mortality. Serum sST2 level was detected by quantified ELISA kits. Clinical data were analyzed by SPSS 23.0 version. Results: 205 patients were recruited. The median sST2 level was 15.99 (11.60, 20.49) ng/ml. After 3 years of follow-up, both all-cause and cardiovascular mortality in 1 year and all-cause and cardiovascular mortality in 3 years increased significantly with serum sST2. For short-term mortality, no significant difference was observed in patients with increasing NT-proBNP levels. Cox regression analysis indicated that only sST2 was independent in predicting the risk of short-term outcomes. For long-term mortality, both sST2 and NT-proBNP were independent risk factors, while a higher hazard ratio was observed for NT-proBNP. Conclusions: Serum sST2 is a novel biomarker associated with adverse clinical outcomes in MHD patients. It was significant for both all-cause and cardiovascular mortality in MHD patients and may provide better prognostic value in short-term prognosis than the classic biomarker NT-proBNP.

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Increased Soluble Suppression of Tumorigenicity 2 Level Predicts All-Cause and Cardiovascular Mortality in Maintenance Hemodialysis Patients: A Prospective Cohort Study

Cited by 20 publications

References 37 publications

Soluble ST2 and Galectin-3 and Progression of CKD

Soluble ST2 and Galectin-3 and Progression of CKD

Prognostic Utility of Soluble Suppression of Tumorigenicity 2 level as a Predictor of Clinical Outcomes in Incident Hemodialysis Patients

Superior prognostic value of soluble suppression of tumorigenicity 2 for the short-term mortality of maintenance hemodialysis patients compared with NT-proBNP: a prospective cohort study

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