title: Serum mannose-binding lectin levels in maintenance hemodialysis patients: impact on all-cause mortality.
abstract: OBJECTIVE
  Mannose-binding lectin (MBL) is characteristic of an acute-phase-reacting protein like C-reactive protein (CRP). However, the prognostic value of the serum MBL level has not been examined. The aim of this study was to evaluate whether the serum MBL level can predict all-cause mortality in hemodialysis (HD) patients.
  
  
  METHODS
  A total of 131 patients without active infection, who had been on maintenance HD for at least 2 years, were included in this study. The serum MBL, high-sensitivity CRP (hs-CRP) level, nutrition markers, and biochemical parameters were measured in June 1999. The cohort was then followed prospectively for 36 months, and clinical data were recorded.
  
  
  RESULTS
  The MBL level of the 131 HD patients was 9.054 +/- 5.115 microg/ml (mean +/- SD). During the follow-up period, 18 patients (9 males and 9 females) died and 113 (64 males and 49 females) survived. The two leading causes of death were cardiovascular events (n = 6, 33.3%) and infection (n = 4, 22.2%). The serum MBL level was significantly lower among the nonsurvivors (6.596 +/- 4.990 microg/ml) than among the survivors (9.445 +/- 5.046 microg/ml; p < 0.05). There was a significant, although very weak, correlation between the MBL level and albumin level (p < 0.05), but there was no correlationbetween the MBL level and the hs-CRP level. The patients were divided into two groups according to the serum MBL level (< 5 and > 5 microg/ml). Multivariate analysis of factors predicting all-cause mortality in multivariate logistic regression analysis identified a serum MBL level < 5 microg/ml as a variable that independently predicted all-cause mortality (adjusted odds ratio: 7.632; 95% CI: 2.244-25.961; p = 0.0011). Other significant and independent predictors for mortality included the hs-CRP level (every 100 microg/dl increase), hypertension and diabetes mellitus.
  
  
  CONCLUSIONS
  Our findings suggest that the serum MBL level is a significant predictor of outcome in HD patients. HD patients with a low level of serum MBL should be carefully monitored.
authors.affiliation: Division of Nephrology and Endocrinology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. atsushis@med.nihon-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Satomura
authors.forename: Morito
authors.initials: M
authors.lastname: Endo
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ohi
authors.forename: Isao
authors.initials: I
authors.lastname: Ohsawa
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Fuke
authors.forename: Koichi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Sukemasa
authors.initials: S
authors.lastname: Sudo
authors.forename: Misao
authors.initials: M
authors.lastname: Matsushita
authors.forename: Teizo
authors.initials: T
authors.lastname: Fujita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D037601:Mannose-Binding Lectin