title: Soluble TWEAK independently predicts atherosclerosis in renal transplant patients.
abstract: BACKGROUND
  Cardiovascular risk is increased in the early stages of chronic kidney disease (CKD) and also found to be ongoing in renal transplant (Rtx) patients. As a sign of atherosclerosis, increased carotid intima-media thickness (CIMT) has been widely accepted as a strong predictor of cardiovascular disease (CVD) and mortality in CKD patients. A novel markers, soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and neutrophil-to-lymphocyte ratio (NLR) were introduced as potential markers in inflammatory disorders including CKD. The role of Rtx in terms of atherogenesis is still unclear. We aimed to investigate the relationship between sTWEAK, NLR and CIMT in Rtx patients without overt CVD and to compare these results with those obtained from healthy subjects.
  
  
  METHODS
  Cross-sectional analysis in which CIMT measurements, NLR and serum TWEAK levels were assessed in 70 Rtx patients (29 females; mean age, 40.6 ± 12.4 years) and 25 healthy subjects (13 females, mean age; 37.4±8.8 years).
  
  
  RESULTS
  sTWEAK levels were significantly decreased (p=0.01) and hs-CRP, NLR and CIMT levels of Rtx patients were significantly increased compared to healthy subjects (p<0.0001, p=0.001, p<0.0001, respectively). sTWEAK was also found to be decreased when eGFR was decreased (p=0.04 between all groups). CIMT was positively correlated with sTWEAK and NLR in Rtx patients (r=0.81, p<0.0001 and r=0.33, p=0.006, respectively). sTWEAK was also positively correlated with NLR (r=0.37, p=0.002). In the multivariate analysis only sTWEAK was found to be an independent variable of increased CIMT.
  
  
  CONCLUSIONS
  sTWEAK might have a role in the pathogenesis of ongoing atherosclerosis in Rtx patients.
authors.affiliation: Department of Nephrology, Erzincan University Mengucek Gazi Training and Reseach Hospital, Erzincan, Turkey. mdkt2010@yahoo.com
authors.forename: Kultigin
authors.initials: K
authors.lastname: Turkmen
authors.forename: Halil Zeki
authors.initials: HZ
authors.lastname: Tonbul
authors.forename: Fatih Mehmet
authors.initials: FM
authors.lastname: Erdur
authors.forename: Aysun
authors.initials: A
authors.lastname: Toker
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Biyik
authors.forename: Huseyin
authors.initials: H
authors.lastname: Ozbiner
authors.forename: Abduzhappar
authors.initials: A
authors.lastname: Gaipov
authors.forename: Elvin Enes
authors.initials: EE
authors.lastname: Gul
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kayrak
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Solak
authors.forename: Orhan
authors.initials: O
authors.lastname: Ozbek
authors.forename: Suleyman
authors.initials: S
authors.lastname: Turk
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D000074049:Cytokine TWEAK; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012995:Solubility; D048069:Tumor Necrosis Factors / Q000097:blood*
chemical_list: D015415:Biomarkers; D000074049:Cytokine TWEAK; C109743:TNFSF12 protein, human; D048069:Tumor Necrosis Factors