Presentation is loading. Please wait.

Presentation is loading. Please wait.

Volume 93, Issue 1, Pages (January 2018)

Similar presentations


Presentation on theme: "Volume 93, Issue 1, Pages (January 2018)"— Presentation transcript:

1 Volume 93, Issue 1, Pages 221-230 (January 2018)
Mortality prediction in stable hemodialysis patients is refined by YKL-40, a 40-kDa glycoprotein associated with inflammation  Georg Lorenz, Michael Schmalenberg, Stephan Kemmner, Bernhard Haller, Dominik Steubl, Dang Pham, Anita Schreiegg, Quirin Bachmann, Alina Schmidt, Sandra Haderer, Monika Huber, Susanne Angermann, Roman Günthner, Matthias Braunisch, Christine Hauser, Anna-Lena Reichelt, Julia Matschkal, Yana Suttmann, Philipp Moog, Konrad Stock, Claudius Küchle, Klaus Thürmel, Lutz Renders, Axel Bauer, Marcus Baumann, Uwe Heemann, Peter B. Luppa, Christoph Schmaderer  Kidney International  Volume 93, Issue 1, Pages (January 2018) DOI: /j.kint Copyright © 2017 International Society of Nephrology Terms and Conditions

2 Figure 1 Correlation of YKL-40 with IP-10, IL-6, and age. Inflammatory mediators were natural logarithm (ln)–transformed. (a) Correlation of YKL-40 and IL-6 with age. (b) Correlation of YKL-40 and IL-6/IP-10. Kidney International  , DOI: ( /j.kint ) Copyright © 2017 International Society of Nephrology Terms and Conditions

3 Figure 2 Estimated event probabilities for inflammatory mediators stratified into terciles. Estimated event probability for (a) all-cause mortality; cumulative incidence functions were fitted considering renal transplantation to be a competing event. (b) Cardiovascular (CV) mortality. (c) Non-CV mortality. Renal transplantation and non-CV mortality or CV mortality were competing events. Baseline-mediator concentrations were used to stratify patients into terciles. Log-rank P values for each mediator are shown in the upper right corner of each plot. For all-cause and cardiovascular events, 2 patients were censored before the earliest event occurred. For non-CV mortality 7 patients were censored before the earliest event. Patients at risk are shown below the graphs. IL-6, interleukin-6; IP-10, interferon gamma–induced protein; MCP-1, monocyte chemotactic protein-1. Kidney International  , DOI: ( /j.kint ) Copyright © 2017 International Society of Nephrology Terms and Conditions

4 Figure 3 Cox models for all-cause, cardiovascular, and noncardiovascular mortality. Inflammatory mediators were natural logarithm (ln)–transformed before addition to the models. Patients were censored at the time of transplantation of other causes of death or at loss to follow-up evaluation to model cause-specific hazard ratios (HRs). HRs are reported per 1 unit of ln increase for inflammatory mediators (logarithmic scale). ▪ HR estimates; — 95% confidence intervals of HR estimates. Similar results were obtained by fitting subdistribution hazard models as proposed by Fine and Gray23 considering renal transplantation and occurrence of other causes of death to be competing events (Supplementary Table S6). (a) HR for interleukin (IL)-6, YKL-40, interferon gamma–induced protein-10 (IP-10), and monocyte chemotactic protein-1 (MCP-1) for all-cause mortality when added to model 1. (b) HR for YKL-40 and IP-10 when added to all-cause mortality model 2. (c) Net reclassification improvement (NRI>0) of the final model 3 (model 2 + YKL-40) versus all-cause mortality model 2 (model 1 + IL-6). NRI>0 is reported separately for the event (NRIe) and nonevent group (NRIne). All-cause mortality Cox model 1 was adjusted for age, sex, body mass index, chronic obstructive pulmonary disease (COPD), rheumatic disease, hypertension, the adapted Charlson comorbidity index (CCI), history of myocardial infarction, diabetes, phosphate, calcium, albumin, Kt/V, HD not hemodiafiltration, presence of central venous catheters, and oral anticoagulation. (d) HR for mediators within cardiovascular (CV) model 1. CV model 1 was adjusted for age, sex, the adapted CCI, history of myocardial infarction, COPD, rheumatic disease, diabetes, presence of central venous catheters, and ultrafiltration per kilogram of dry weight. Adjustment for intake of loop diuretics instead of ultrafiltration showed comparable results (Supplementary Table S7). (e) HR for mediators within the CV model 2. (f) NRI>0 of CV model 3 (CV model 2 + YKL-40) versus model 2 (CV model 1 + IL-6). (g) HR per ln-increase for YKL-40, IL-6, IP-10, and MCP-1 for noncardiovascular mortality when added to the non-CV model 1. (h) HR for YKL-40 and IP-10 when added to the non-CV mortality model 2 (non-CV model 1 + IL-6). Noncardiovascular model 1 was adjusted for age, sex, adapted CCI, COPD, rheumatic disease, phosphate, albumin, oral anticoagulation, and the presence of a central venous catheter. Kidney International  , DOI: ( /j.kint ) Copyright © 2017 International Society of Nephrology Terms and Conditions


Download ppt "Volume 93, Issue 1, Pages (January 2018)"

Similar presentations


Ads by Google