title: The association of high sCD163/sTWEAK ratio with cardiovascular disease in hemodialysis patients.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) is the most common cause of death in hemodialysis (HD) patients. Transmembrane proteins that circulate as soluble form such as tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and CD163 have been proposed in previous studies as CVD biomarkers in chronic kidney disease patients. In HD patients, since studies are scarce, the role of these proteins is not completely understood. We tested the hypothesis that sTWEAK, sCD163 or sCD163/sTWEAK ratio could be associated with cardiovascular disease in HD patients.
  
  
  METHODS
  We recorded current clinical and biological data, and we measured sTWEAK and sCD163 serum levels by ELISA in 70 hemodialysis patients. Univariate analysis and multivariate (logistic regression) analysis were used to identify the relation between sTWEAK, sCD163 and sCD163/sTWEAK ratio and CVD.
  
  
  RESULTS
  In univariate analysis, CVD in HD patients is associated with higher sCD163/sTWEAK ratio (p = 0.04), sCD163 (p = 0.07), CRP (p = 0.04), age (p = 0.07), smoking (p = 0.09) and vascular calcifications (p = 0.10). In multivariate analysis, only logarithm of sCD163/sTWEAK ratio (p = 0.04) and smoking (p = 0.03) was significantly associated with CVD. The levels of these molecules and their ratio were correlated with atherosclerosis risk factors: diabetes mellitus, high fasting glucose, tricipital skinfold thickness and CRP as well as (for sCD163/sTWEAK) intravenous iron therapy.
  
  
  CONCLUSIONS
  Cardiovascular disease is associated with increased sCD163/sTWEAK ratio. To our knowledge, this is the first report about this relationship in HD patients.
authors.affiliation: Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania. crinaclaudiarusu@yahoo.ro.
authors.forename: Crina Claudia
authors.identifier: http://orcid.org/0000-0001-7708-9320
authors.initials: CC
authors.lastname: Rusu
authors.affiliation: Nefromed Dialysis Center, 40 Ana Aslan Street, Cluj-Napoca, Romania.
authors.forename: Simona
authors.initials: S
authors.lastname: Racasan
authors.affiliation: Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania.
authors.forename: Ina Maria
authors.initials: IM
authors.lastname: Kacso
authors.affiliation: Institute of Clinical Urology and Renal Transplantation, 4-6 Clinicilor Street, 400006, Cluj-Napoca, Romania.
authors.forename: Liviu
authors.initials: L
authors.lastname: Ghervan
authors.affiliation: Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania.
authors.forename: Diana
authors.initials: D
authors.lastname: Moldovan
authors.affiliation: Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Potra
authors.affiliation: Nefromed Dialysis Center, 40 Ana Aslan Street, Cluj-Napoca, Romania.
authors.forename: Ioan Mihai
authors.initials: IM
authors.lastname: Patiu
authors.affiliation: Department of Informatics and Biostatistics, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj, 6 Pasteur Street, 400349, Cluj-Napoca, Romania.
authors.forename: Cosmina
authors.initials: C
authors.lastname: Bondor
authors.affiliation: Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania.
authors.forename: Mirela Gherman
authors.initials: MG
authors.lastname: Caprioara
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000097:blood*; D015214:Antigens, Differentiation, Myelomonocytic / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D000074049:Cytokine TWEAK; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D011956:Receptors, Cell Surface / Q000097:blood*; D006435:Renal Dialysis; D012307:Risk Factors; D012907:Smoking; D048069:Tumor Necrosis Factors / Q000097:blood*; D000098902:CD163 Antigen
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D001786:Blood Glucose; D000098902:CD163 Antigen; D008078:Cholesterol, LDL; D000074049:Cytokine TWEAK; D011956:Receptors, Cell Surface; C109743:TNFSF12 protein, human; D048069:Tumor Necrosis Factors; D002097:C-Reactive Protein
keywords: Atherosclerosis; Cardiovascular disease; Hemodialysis; sCD163/sTWEAK ratio