title: The long pentraxin PTX-3 in prevalent hemodialysis patients: associations with comorbidities and mortality.
abstract: BACKGROUND
  Pentraxin (PTX)-3, a new candidate marker for inflammation is expressed in a variety of cell types. Recently, we have shown that increase in PTX-3 level is associated with clinical outcome in incident CKD stage 5 patients at start of renal replacement therapy. However, no data are available on PTX-3 and its relationship with clinical outcome in prevalent dialysis patients.
  
  
  METHODS
  We analyzed plasma PTX-3 concentrations in relation to comorbidities (Davies score), protein-energy wasting (PEW) and inflammation markers in 200 prevalent hemodialysis (HD) patients, aged 64 +/- 14 years, who had been on HD treatment for a median period of 36 months. Survival (42 months) was analyzed in relation to PTX-3 levels (high PTX-3 tertile vs. low two tertiles).
  
  
  RESULTS
  Plasma PTX-3 correlated positively with C-reactive protein and interleukin-6, and negatively with s-albumin and fetuin-A. Patients with cardiovascular disease (CVD) and PEW had higher levels of PTX-3 than their counterparts and PTX-3 was associated with comorbidity score. In multiple logistic regression analysis, the high comorbidity score and PEW were the significant predictive variables of high PTX-3. In unadjusted analysis high PTX-3 was significantly associated with all-cause mortality. After adjustment for sex, age, dialysis vintage, comorbidity score, PEW and CRP using the multivariate Cox regression analysis, death rate was still significantly higher in patients with high PTX-3 (HR 1.7; CI 1.1-2.7, P = 0.03).
  
  
  CONCLUSIONS
  Markedly increased levels of PTX-3 were found in HD patients with signs of CVD and PEW. In addition, the concentration of PTX-3 was associated with inflammation markers and comorbidity score. Our data also shows that high PTX-3 level was independently associated with all-cause mortality.
authors.affiliation: Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors.forename: M E
authors.initials: ME
authors.lastname: Suliman
authors.forename: A R
authors.initials: AR
authors.lastname: Qureshi
authors.forename: J J
authors.initials: JJ
authors.lastname: Carrero
authors.forename: P
authors.initials: P
authors.lastname: Bárány
authors.forename: M I
authors.initials: MI
authors.lastname: Yilmaz
authors.forename: S
authors.initials: S
authors.lastname: Snaedal-Jonsdottir
authors.forename: A
authors.initials: A
authors.lastname: Alvestrand
authors.forename: O
authors.initials: O
authors.lastname: Heimbürger
authors.forename: B
authors.initials: B
authors.lastname: Lindholm
authors.forename: P
authors.initials: P
authors.lastname: Stenvinkel
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D011502:Protein-Energy Malnutrition / Q000209:etiology; D012044:Regression Analysis; D006435:Renal Dialysis / Q000401:mortality; D051437:Renal Insufficiency / Q000150:complications* / Q000401:mortality / Q000628:therapy; D000683:Serum Amyloid P-Component / Q000378:metabolism*; D016019:Survival Analysis; D000099153:Pentraxins
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins