Endostatin, Cathepsin S, and Cathepsin L, and Their Association with Inflammatory Markers and Mortality in Patients Undergoing Hemodialysis.
OBJECTIVE
Although both endostatin and cathepsins S have been associated with higher mortality, data in patients with end-stage renal disease (ESRD) are scarce.


METHODS
A longitudinal cohort study of 207 prevalent patients undergoing hemodialysis.


RESULTS
Cathepsins S and L were associated with soluble receptors for tumor necrosis factor (sTNFR1 and sTNFR2, rho between 0.28 and 0.43, p < 0.001 for all). Weaker or absent associations between endostatin, cathepsins S and L were seen with other inflammatory biomarkers, that is, CRP, interleukin 6, pentraxin 3, and TNF. In Cox and Laplace regression models adjusted for age, sex, dialysis vintage, and diabetes: standard deviation increments of endostatin was associated with a lower mortality (hazard ratio 0.75, 95% confidence interval (CI) 0.57-0.98), and with 6.8 months longer median survival.


CONCLUSIONS
The high levels of endostatin, cathepsins S and L, and their associations with sTNFR1 and sTNFR2 warrant further studies exploring mortality, and the angiogenic and inflammatory pathways in ESRD.
Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Axel C
AC
Carlsson
Juan-Jesús
JJ
Carrero
Peter
P
Stenvinkel
Matteo
M
Bottai
Peter
P
Barany
Anders
A
Larsson
Johan
J
Ärnlöv
D000368:Aged; D015415:Biomarkers; D056668:Cathepsin L / Q000097:blood*; D002403:Cathepsins / Q000097:blood*; D043169:Endostatins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D006435:Renal Dialysis
D015415:Biomarkers; D043169:Endostatins; D018836:Inflammation Mediators; D002403:Cathepsins; D056668:Cathepsin L; C028217:cathepsin S