Haptoglobin phenotype as a predictive factor of mortality in diabetic haemodialysis patients.
BACKGROUND
The mortality rate in diabetic dialysis patients (DDPs) is over 15% per year, with the cause of death most often attributed to cardiovascular disease (CVD) or bacterial infection (sepsis). Identification of genetic markers predictive of early mortality would be useful in the evaluation of therapies for the reduction of mortality rate in this population. Haptoglobin (Hp) is a polymorphic protein which appears to confer differential susceptibility to bacterial infection and CVD. We therefore proposed that Hp phenotype can predict mortality in DDPs.


METHODS
We tested this hypothesis prospectively in a longitudinal study of 392 dialysis patients from eight medical centres in Israel. Hp was determined by polyacrylamide gel electrophoresis. Patients were followed for all-cause mortality over a 3-year period.


RESULTS
We found that Hp phenotype was a significant predictor of mortality in DDPs stratified by age. In diabetic individuals over 60 years of age there was a decrease in mortality associated with the Hp 1-1 phenotype (P = 0.03). However, in younger DDPs the Hp 2-2 phenotype was associated with a decreased mortality rate (P = 0.003).


CONCLUSIONS
Hp phenotype may be useful in the risk stratification algorithm and management of DDPs.
Burbea
Zvi
Z
Department of Nephrology, Rambam Medical Center, Haifa, Israel. burbea@yahoo.com
Nakhoul
Farid
F
Zoabi
Roaa
R
Hochberg
Irit
I
Levy
Nina S
NS
Benchetrit
Sidney
S
Weissgarten
Joshua
J
Tovbin
David
D
Knecht
Aaron
A
Iaina
Adrian
A
Herman
Michal
M
Kristal
Batya
B
Levy
Andrew P
AP
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D048909:Diabetes Complications / Q000235:genetics / Q000378:metabolism / Q000401:mortality*; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006242:Haptoglobins / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate
D006242:Haptoglobins