title: Prognostic utility of plasma S100A12 levels to establish a novel scoring system for predicting mortality in maintenance hemodialysis patients: a two-year prospective observational study in Japan.
abstract: BACKGROUND
  S100A12 protein is an endogenous receptor ligand for advanced glycation end products. In this study, the plasma S100A12 level was assessed as an independent predictor of mortality, and its utility in clinical settings was examined.
  
  
  METHODS
  In a previous cross-sectional study, plasma S100A12 levels were measured in 550 maintenance hemodialysis patients to determine the association between S100A12 and the prevalence of cardiovascular diseases (CVD). In this prospective study, the risk of mortality within a two-year period was determined. An integer scoring system was developed to predict mortality on the basis of the plasma S100A12 levels.
  
  
  RESULTS
  Higher plasma S100A12 levels (≥18.79 ng/mL) were more closely associated with higher all-cause mortality than lower plasma S100A12 levels (<18.79 ng/mL; P = 0.001). Multivariate Cox proportional hazards analysis revealed higher plasma S100A12 levels [hazard ratio (HR), 2.267; 95% confidence interval (CI), 1.195-4.302; P = 0.012], age ≥65 years (HR, 1.961; 95%CI, 1.017-3.781; P = 0.044), serum albumin levels <3.5 g/dL (HR, 2.198; 95%CI, 1.218-3.968; P = 0.012), and history of CVD (HR, 2.068; 95%CI, 1.146-3.732; P = 0.016) to be independent predictors of two-year all-cause mortality. The integer score was derived by assigning points to these factors and determining total scores. The scoring system revealed trends across increasing scores for predicting the all-cause mortality [c-statistic = 0.730 (0.656-0.804)]. The resulting model demonstrated good discriminative power for distinguishing the validation population of 303 hemodialysis patients [c-statistic = 0.721 (0.627-0.815)].
  
  
  CONCLUSIONS
  The results indicate that plasma S100A12 level is an independent predictor for two-year all-cause mortality. A simple integer scoring system was therefore established for predicting mortality on the basis of plasma S100A12 levels.
authors: Division of Nephrology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
authors: Yayoi
authors: Y
authors: Shiotsu
authors: Yasukiyo
authors: Y
authors: Mori
authors: Masato
authors: M
authors: Nishimura
authors: Tsuguru
authors: T
authors: Hatta
authors: Naoki
authors: N
authors: Imada
authors: Noboru
authors: N
authors: Maki
authors: Kumiko
authors: K
authors: Iida
authors: Noriyuki
authors: N
authors: Iwamoto
authors: Eiko
authors: E
authors: Matsuoka
authors: Keiichi
authors: K
authors: Tamagaki
authors: Atsushi
authors: A
authors: Kosaki
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D009418:S100 Proteins / Q000097:blood*; D000067616:S100A12 Protein; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D009418:S100 Proteins; D000067616:S100A12 Protein; C090441:S100A12 protein, human