Serum Galectin-3 levels and all-cause and cardiovascular mortality in maintenance hemodialysis patients: a prospective cohort study

Abstract

Background Higher serum galectin-3 levels are related to adverse outcomes in different disease states. However, the association of galectin-3 with mortality in the maintenance hemodialysis (HD) population has not been fully described. Thus, we aimed to assess the predictive significance of galectin-3 for all-cause and cardiovascular (CV) mortality through a Chinese maintenance HD population. Methods A prospective cohort study was conducted in five hundred and six patients with end-stage renal disease who underwent hemodialysis at Dalian Central Hospital before December 31, 2014. Serum galectin-3 levels were measured at baseline and classified as high (> 8.65 ng/ml) or low (≤ 8.65 ng/ml) according to the “X-tile” program. Primary and secondary outcomes were all-cause and CV mortality, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazards regression models. Results During the median follow-up of 60 months, there were 188 all-cause deaths and 125 CV deaths. Compared with maintenance HD population with galectin-3 ≤ 8.65 ng/ml, the adjusted HR for all-cause mortality among those with galectin-3 > 8.65 ng/ml was 1.59 (CI: 0.96–2.65, p = 0.07). Furthermore, multivariable analysis showed that maintenance HD patients with galectin-3 > 8.65 ng/ml had a 2.13-fold higher risk of CV death than those with galectin-3 ≤ 8.65 ng/ml (HR = 2.13, 95% CI 1.07–4.26). Conclusion Galectin-3 is an independent predictor of CV mortality in maintenance HD patients.

Current Trends in Biohumoral Screening for the Risk of Sudden Cardiac Death: A Systematic Review

“…Galectin 3 is associated with inflammatory processes and myocardial fibrosis, being found to be present at the myocardial level after the onset of ischemia [ 73 ]. There are studies that have correlated increased levels of galectin 3 with increased mortality, including cardiovascular mortality, being considered an independent predictor in this regard [ 74 , 75 ]. A 2015 study found that elevated galectin 3 levels in hospitalized patients with heart failure confer an additional negative prognosis, but without predictive power of death [ 76 ].…”

Novel Biomarkers in Evaluating Cardiac Function in Patients on Hemodialysis—A Pilot Prospective Observational Cohort Study

“…Galectin-3 is a relatively new biomarker that is well studied as a promoter of cardiac inflammation and fibrosis leading to heart failure [ 19 , 20 ]. In hemodialysis-treated patients, higher levels of galectin-3 seem to be associated with increased cardiac and all-cause mortality [ 21 , 22 , 23 ]. In our study, galectin-3 levels did not influence mortality during the two years of follow-up.…”

“…In our study, galectin-3 levels did not influence mortality during the two years of follow-up. One should mention that the study by Liu on 506 HD patients showed that galectin levels above 8.65 ng/mL increased mortality, and the study by Hogas on 88 HD patients found a galectin-3 cut-off value of 23.73 ng/mL as an increased mortality risk [ 22 , 23 ]. The interesting result is that galectin-3 levels are negatively correlated with aortic valve fibrosis and mitral valve calcifications.…”

“…In addition, there are studies suggesting that galectin 3 plays a central role in heart failure pathophysiology through myocardial inflammation and fibrosis, thus becoming a predictor of heart failure [ 19 , 20 ]. Some studies evaluated the impact on all-cause mortality and cardiovascular events and showed that higher levels of galectin 3 are an independent risk factor for death in HD patients [ 21 , 22 , 23 ].…”

The potential roles of galectin-3 in AKI and CKD

“…Furthermore, there was a positive correlation of serum Gal3 with neointima development (Ruan et al, 2021). In a prospective cohort study, higher serum Gal3 concentration was associated with a higher risk of cardiovascular mortality in patients receiving maintenance hemodialysis (hazard ratio (HR) = 2.13, 95% CI 1.07-4.26) (Liu et al, 2022). In addition, a cohort study of 2,477 participants showed that greater longitudinal increase in plasma Gal3 concentration was associated with increased incidence of heart failure and all-cause mortality (Ghorbani et al, 2018).…”