title: IgA antibodies against β2 glycoprotein I in hemodialysis patients are an independent risk factor for mortality.
abstract: Cardiovascular complications are the most important cause of death in patients on dialysis with end-stage renal disease. Antibodies reacting with β-glycoprotein I seem to play a pathogenic role in antiphospholipid syndrome and stroke and are involved in the origin of atherosclerosis. Here we evaluated the presence of anticardiolipin and anti-β-glycoprotein I antibodies together with other vascular risk factors and their relationship with mortality and cardiovascular morbidity in a cohort of 124 hemodialysis patients prospectively followed for 2 years. Of these, 41 patients were significantly positive for IgA anti-β-glycoprotein I, and the remaining had normal values. At 24 months, overall and cardiovascular mortality and thrombotic events were all significantly higher in patients with high anti-β-glycoprotein I antibodies. Multivariate analysis using Cox regression modeling found that age, hypoalbuminemia, use of dialysis catheters, and IgA β-glycoprotein I antibodies were independent risk factors for death. Thus, IgA antibodies to β-glycoprotein I are detrimental to the clinical outcome of hemodialysis patients.
authors.affiliation: Department of Immunology, Instituto de Investigación Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Serrano
authors.forename: Florencio
authors.initials: F
authors.lastname: García
authors.forename: Manuel
authors.initials: M
authors.lastname: Serrano
authors.forename: Elisa
authors.initials: E
authors.lastname: Ramírez
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Alfaro
authors.forename: David
authors.initials: D
authors.lastname: Lora
authors.forename: Agustín Gómez
authors.initials: AG
authors.lastname: de la Cámara
authors.forename: Estela
authors.initials: E
authors.lastname: Paz-Artal
authors.forename: Manuel
authors.initials: M
authors.lastname: Praga
authors.forename: Jose M
authors.initials: JM
authors.lastname: Morales
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000276:immunology / Q000401:mortality*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality*; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D053482:beta 2-Glycoprotein I / Q000276:immunology*
chemical_list: D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D007070:Immunoglobulin A; D053482:beta 2-Glycoprotein I