title: Tumor necrosis factor-related apoptosis-inducing ligand as an independent predictor of mortality in hemodialysis patents.
abstract: BACKGROUND
  Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) was originally isolated as an inducer of apoptosis in transformed cells. In addition to tumor surveillance, recent findings suggest that TRAIL and its receptor system have a protective role against infection and cardiovascular disease (CVD). Patients undergoing hemodialysis have a high mortality rate with a unique risk factor profile. Considering that the leading causes of death in these patients are infection and CVD, TRAIL represents an attractive candidate for predicting mortality in this population. We therefore investigated whether TRAIL predicted mortality in hemodialysis patients.
  
  
  METHODS
  The study was a retrospective observational cohort design of 45-month duration in 149 male hemodialysis patients. The subjects were divided into two groups according to their baseline TRAIL level measured by ELISA (low or high TRAIL group). The main outcome was all-cause mortality.
  
  
  RESULTS
  During the follow-up period, 33 patients died, mostly because of CVD (n=11) or infection (n=9). Crude survival analyses showed that a low TRAIL level was a powerful predictor of all-cause (p=0.011) and infectious mortality (p=0.048). The predictive power of TRAIL remained after adjustment for various confounding factors.
  
  
  CONCLUSIONS
  The serum TRAIL level may be a novel biomarker for predicting prognosis in hemodialysis patients.
authors: Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. ktmori@med.osaka-cu.ac.jp
authors: Katsuhito
authors: K
authors: Mori
authors: Senji
authors: S
authors: Okuno
authors: Tetsuo
authors: T
authors: Shoji
authors: Masanori
authors: M
authors: Emoto
authors: Yoshinori
authors: Y
authors: Kakutani
authors: Kenjiro
authors: K
authors: Yamakawa
authors: Yasuo
authors: Y
authors: Imanishi
authors: Eiji
authors: E
authors: Ishimura
authors: Tomoyuki
authors: T
authors: Yamakawa
authors: Shigeichi
authors: S
authors: Shoji
authors: Masaaki
authors: M
authors: Inaba
mesh_terms: D002423:Cause of Death; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality*; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*
chemical_list: D053221:TNF-Related Apoptosis-Inducing Ligand