J Korean Med Sci.  2017 Jan;32(1):54-59. 10.3346/jkms.2017.32.1.54.

Associations between Soluble Receptor for Advanced Glycation End Products (sRAGE) and S100A12 (EN-RAGE) with Mortality in Long-term Hemodialysis Patients

• Jung ES
• Chung W
• Kim AJ
• Ro H
• Chang JH
• Lee HH
• Jung JY

• KMID: 2417585
• DOI: http://doi.org/10.3346/jkms.2017.32.1.54

Abstract

Hemodialysis (HD) patients experience vascular calcification, ultimately leading to high mortality rates. Previously, we reported associations between soluble receptor for advanced glycation end products (sRAGEs) and extracellular newly identified RAGE-binding protein S100A12 (EN-RAGE) and vascular calcification. Here, we extended our observations, investigating whether these biomarkers may be useful for predicting cardiovascular morbidity and mortality in these subjects. Thus, we evaluated the relationship between sRAGE and S100A12 and mortality in long-term HD patients. This was a prospective observational cohort study in 199 HD patients from an extended analysis of our previous study. Plasma sRAGE, S100A12, comorbidities, and other traditional risk factors were investigated. The cumulative incidences for death using Cox proportional hazards regression were evaluated in multivariable analyses. The observation period was 44 months. During the observation period, 27 (13.6%) patients died. Univariate analysis demonstrated that S100A12 was correlated with diabetes (P = 0.040) and high-sensitivity C-reactive protein (hsCRP) (P = 0.006). In multivariable analyses, plasma sRAGE (hazard ratio [HR] = 1.155; 95% confidence interval [CI] = 0.612-2.183; P = 0.656) and S100A12 (HR = 0.960; 95% CI = 0.566-1.630; P = 0.881) were not associated with mortality in HD patients, although traditional predictors of mortality, including age, history of cardiovascular diseases (CVDs), and serum levels of albumin and hsCRP were related to mortality. Powerful predictors of mortality were age, CVD, and albumin levels. Plasma sRAGE and S100A12 may be weak surrogate markers for predicting all-cause mortality in patients undergoing HD, although S100A12 was partly related to diabetes and inflammation.

Keyword

sRAGE; S100A12; Mortality; Hemodialysis

MeSH Terms

Biomarkers
C-Reactive Protein
Cardiovascular Diseases
Cohort Studies
Comorbidity
Glycosylation End Products, Advanced*
Humans
Incidence
Inflammation
Mortality*
Plasma
Prospective Studies
Renal Dialysis*
Risk Factors
S100A12 Protein*
Vascular Calcification
Biomarkers
C-Reactive Protein
Glycosylation End Products, Advanced
S100A12 Protein

Figure

• 

  Fig. 1 Flow diagram of participants analyzed in this study. HD = hemodialysis.

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