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Original Paper – Advances in CKD 2017
Blood Purif 2017;43:210–217
DOI: 10.1159/000452731
Plasma Gelsolin and Its Association with
Mortality and Hospitalization in Chronic
Hemodialysis Patients
Cesar Flores Gama
a
Laura M. Rosales
b
Georges Ouellet
c
Yanna Dou
d
Stephan Thijssen
b
Len Usvyat
e
Hanjie Zhang
b
Viktoriya Kuntsevich
f
Nathan W. Levin
f
Peter Kotanko
b, f
a
Department of Nephrology, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico;
b
Renal Research
Institute, New York, NY, USA;
c
Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada;
d
The Nephrology Center, The
First Affiliated Hospital of Zhengzhou University, Henan, China;
e
Fresenius Medical Care North America, Waltham,
MA, and
f
Icahn School of Medicine at Mount Sinai, New York, NY, USA
and cardiovascular mortality, and recurrent event survival
analysis for hospitalization. Results: We studied 153 pa-
tients; mean age was 60.5 ± 14.7; 52% were males. The mean
pGSN level was 6,617 ± 1,789 mU/ml. In univariate analysis,
pGSN was positively correlated with body mass index (r =
0.2, p = 0.01), pre-HD serum albumin (r = 0.247, p = 0.002),
and pre-HD serum creatinine (r = 0.381, p < 0.001), and in-
versely with age (r = –0.286, p < 0.001), CRP (r = –0.311, p <
0.001), and IL-6 (r = –0.317, p < 0.001). In the adjusted analy-
sis, the associations with CRP and creatinine were retained.
pGSN levels tended to be lower in patients who died (p =
0.08). There was no association with all-cause or cardiovas-
cular mortality, or all-cause hospitalization. Of note, fT3 was
lower in patients who died (p = 0.001). Conclusions: Even
though pGSN was inversely correlated with age, CRP and IL-
6, suggesting that inflammation may influence pGSN, lower
pGSN levels were not associated with hospitalization, all-
cause and cardio-vascular mortality in this patient popula-
tion. © 2017 S. Karger AG, Basel
Key Words
Cytokines · Gelsolin · Hemodialysis · Inflammation ·
Uremic toxins · Free triiodothyronine · Hemodialysis ·
Mortality · Hospitalization
Abstract
Background: Human plasma gelsolin (pGSN) is an actin-
binding protein that is secreted into the extracellular fluid,
with the skeletal muscle and myocardial tissues being its
major source. Depletion of pGSN has been shown to be re-
lated to a variety of inflammatory and clinical conditions.
Methods: pGSN levels were prospectively determined
in prevalent maintenance hemodialysis (HD) patients from
3 U.S. dialysis centers. Demographics (age, time since dialysis
initiation, race, gender, body height and weight, comorbidi-
ties), inflammatory markers (C reactive protein, CRP; inter-
leukin 6, IL-6), free triiodothyronine (fT3), and routine labora-
tory parameters were obtained. We performed Kaplan–Mei-
er and Cox proportional hazard survival analysis for all-cause
Published online: January 24, 2017
Laura M. Rosales, MD
Renal Research Institute
315 East, 62nd Street, 4th Floor
New York, NY 10065 (USA)
E-Mail laura.rosales @ rriny.com
© 2017 S. Karger AG, Basel
www.karger.com/bpu