title: A new predictor of mortality in hemodialysis patients; Tenascin-C.
abstract: OBJECTIVE
  Cardiovascular disease is the most frequent cause of mortality in hemodialysis patients. There are a number of inconsistencies in terms of cardiovascular risk factors in these patients. Tenascin C (TN-C) is a matricellular protein which may be a prognostic predictor after myocardial infarction and many cardiac diseases. The purpose of this study was to determine TN-C levels in hemodialysis patients and to evaluate the association between TN-C levels and cardiac mortality.
  
  
  METHODS
  In this multicenter prospective observational research, blood specimens were collected at the start of the study for the measurement of TN-C and other biochemical parameters. After 2 years' follow-up we investigated the association between TN-C and other biochemical and demographic parameters and cardiac and all cause mortality.
  
  
  RESULTS
  Two hundred thirty-eight patients and 25 healthy individuals were enrolled. TN-C levels in the hemodialysis group were higher than those in the control group (p b 0.001). All-cause mortality was observed in 47 (19%) patients and cardiac mortality in 39 (15%). At multivariate Cox regression analysis, TN-C, age and systolic blood pressure were identified as independent predictors of cardiac mortality. The Kaplan–Meier survival curve revealed greater all-cause and cardiac mortality rates in the high TN-C group (Log rank p b 0.001 and p b 0.05 respectively).
  
  
  CONCLUSIONS
  TN-C levels were higher than those in the control group, and our results suggest that it may be a predictor of cardiac mortality in hemodialysis patients. If further studies support our research, TN-C may be a useful biomarker for detecting cardiac mortality risk.
authors.affiliation: Department of Nephrology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey. Electronic address: sulusoy2002@yahoo.com.
authors.forename: Sukru
authors.initials: S
authors.lastname: Ulusoy
authors.affiliation: Department of Nephrology, Hatay Antakya State Hospital, Hatay, Turkey.
authors.forename: Gulsum
authors.initials: G
authors.lastname: Ozkan
authors.affiliation: Department of Clinical Biochemistry, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Menteşe
authors.affiliation: Department of Internal Medicine, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
authors.forename: Beyhan
authors.initials: B
authors.lastname: Guvercin
authors.affiliation: Department of Clinical Biochemistry, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Caner Karahan
authors.affiliation: Trabzon RNS Hemodialysis Center, Trabzon, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Yavuz
authors.affiliation: Department of Clinical Biochemistry, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
authors.forename: Diler Us
authors.initials: DU
authors.lastname: Altay
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D016019:Survival Analysis; D019063:Tenascin / Q000032:analysis*
chemical_list: D015415:Biomarkers; D019063:Tenascin
keywords: Cardiac mortality; Hemodialysis; Mortality; Tenascin C