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Kidney Blood Press Res. 2012;35(3):192-201. doi: 10.1159/000332086. Epub 2011 Nov 25.

Pregnancy-associated plasma protein A as an independent mortality predictor in long-term hemodialysis patients.

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1
Institute of Clinical Biochemistry and Laboratory Diagnostics, Charles University and General University Hospital, Prague, Czech Republic. marta.kalousova@seznam.cz

Abstract

BACKGROUND/AIMS:

Pregnancy-associated plasma protein A (PAPP-A) is a biomarker related to vascular damage. The aim of the study was to focus on PAPP-A and related parameters and their relationship to the prognosis of long-term hemodialysis (HD) patients.

METHODS:

This is a prospective observational cohort study which included 261 long-term HD patients followed up for 5 years and 66 healthy subjects. PAPP-A, placental growth factor (PlGF), matrix metalloproteinase 2 and 9 (MMP-2, MMP-9), insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein-4 (IGFBP-4), and cardiac, nutritional and inflammatory parameters were measured at the beginning of the study and tested as predictors of mortality.

RESULTS:

PAPP-A, PlGF, IGF-1, IGFBP-4 and MMP-2 were significantly increased in HD patients compared to controls (PAPP-A 27.6 ± 15.5 mIU/l in HD vs. 9.4 ± 2.5 mIU/l in controls, p < 0.001). Increased PAPP-A was a significant independent predictor of overall mortality and mortality due to infection in the multivariate Cox analysis [HR (95% CI): 1.237 (1.060-1.444), p = 0.007, and 1.416 (1.115-1.798), p = 0.004, per standard deviation, respectively]. PAPP-A was not related to cardiovascular mortality.

CONCLUSION:

Increased PAPP-A is a significant independent predictor of overall mortality and mortality due to infection but it was not related to cardiovascular mortality in this study.

PMID:
22123284
DOI:
10.1159/000332086
[Indexed for MEDLINE]
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