Low circulating CD34+ cell count is associated with poor prognosis in chronic hemodialysis patients.
Circulating CD34-positive (CD34(+)) cells, a population that includes endothelial progenitor cells, are believed to contribute to vascular homeostasis. Here we determine the prognostic value of CD34(+) cell measurements in 216 chronic hemodialysis patients. A total of 43 cardiovascular events and 13 deaths occurred over an average 23 months follow-up in this cohort. A cutoff number for circulating CD34(+) cells was determined by receiver operating characteristic curve analysis to maximize the power of the CD34(+) cell count in predicting future cardiovascular events. Based on this, 93 patients were categorized as having low and 123 patients as having high numbers of CD34(+) cells, determined by flow cytometry at the time of enrollment. Both cumulative cardiovascular event-free survival and all-cause survival were significantly less in the group of patients with low numbers of CD34(+) cells. By multivariate analyses, a low level of circulating CD34(+) cells was an independent and significant predictor for both cardiovascular events and all-cause mortality. Our study shows that a reduced number of circulating CD34(+) cells is significantly associated with vascular risks and all-cause mortality in patients on chronic hemodialysis. These cells may be a useful biomarker.
Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. marus@med.nagoya-u.ac.jp
Shoichi
S
Maruyama
Akihiko
A
Taguchi
Shigejiro
S
Iwashima
Takenori
T
Ozaki
Kaoru
K
Yasuda
Akie
A
Kikuchi-Taura
Toshihiro
T
Soma
Hideki
H
Ishii
Toyoaki
T
Murohara
Hiroshi
H
Takahashi
Hirotake
H
Kasuga
Yoshitaka
Y
Kumada
Takanobu
T
Toriyama
Yasuhiko
Y
Ito
Hirohisa
H
Kawahara
Yukio
Y
Yuzawa
Seiichi
S
Matsuo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018952:Antigens, CD34; D001772:Blood Cell Count; D001773:Blood Cells / Q000166:cytology*; D002318:Cardiovascular Diseases / Q000175:diagnosis; D002908:Chronic Disease; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D006435:Renal Dialysis
D018952:Antigens, CD34