title: Plasma Gelsolin and Its Association with Mortality and Hospitalization in Chronic Hemodialysis Patients.
abstract: BACKGROUND
  Human plasma gelsolin (pGSN) is an actin-binding protein that is secreted into the extracellular fluid, with the skeletal muscle and myocardial tissues being its major source. Depletion of pGSN has been shown to be related to a variety of inflammatory and clinical conditions.
  
  
  METHODS
  pGSN levels were prospectively determined in prevalent maintenance hemodialysis (HD) patients from 3 U.S. dialysis centers. Demographics (age, time since dialysis initiation, race, gender, body height and weight, comorbidities), inflammatory markers (C reactive protein, CRP; interleukin 6, IL-6), free triiodothyronine (fT3), and routine laboratory parameters were obtained. We performed Kaplan-Meier and Cox proportional hazard survival analysis for all-cause and cardiovascular mortality, and recurrent event survival analysis for hospitalization.
  
  
  RESULTS
  We studied 153 patients; mean age was 60.5 ± 14.7; 52% were males. The mean pGSN level was 6,617 ± 1,789 mU/ml. In univariate analysis, pGSN was positively correlated with body mass index (r = 0.2, p = 0.01), pre-HD serum albumin (r = 0.247, p = 0.002), and pre-HD serum creatinine (r = 0.381, p < 0.001), and inversely with age (r = -0.286, p < 0.001), CRP (r = -0.311, p < 0.001), and IL-6 (r = -0.317, p < 0.001). In the adjusted analysis, the associations with CRP and creatinine were retained. pGSN levels tended to be lower in patients who died (p = 0.08). There was no association with all-cause or cardiovascular mortality, or all-cause hospitalization. Of note, fT3 was lower in patients who died (p = 0.001).
  
  
  CONCLUSIONS
  Even though pGSN was inversely correlated with age, CRP and IL-6, suggesting that inflammation may influence pGSN, lower pGSN levels were not associated with hospitalization, all-cause and cardio-vascular mortality in this patient population.
authors.affiliation: Department of Nephrology, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico.
authors.forename: Cesar
authors.initials: C
authors.lastname: Flores Gama
authors.forename: Laura M
authors.initials: LM
authors.lastname: Rosales
authors.forename: Georges
authors.initials: G
authors.lastname: Ouellet
authors.forename: Yanna
authors.initials: Y
authors.lastname: Dou
authors.forename: Stephan
authors.initials: S
authors.lastname: Thijssen
authors.forename: Len
authors.initials: L
authors.lastname: Usvyat
authors.forename: Hanjie
authors.initials: H
authors.lastname: Zhang
authors.forename: Viktoriya
authors.initials: V
authors.lastname: Kuntsevich
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Levin
authors.forename: Peter
authors.initials: P
authors.lastname: Kotanko
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D018260:Gelsolin / Q000097:blood*; D006760:Hospitalization; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009026:Mortality; D006435:Renal Dialysis / Q000401:mortality; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis
chemical_list: D018260:Gelsolin; C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein