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Observational Study
. 2015 Sep 16;10(9):e0138159.
doi: 10.1371/journal.pone.0138159. eCollection 2015.

Serum Gamma-Glutamyltransferase Levels Predict Clinical Outcomes in Hemodialysis Patients

Woo Yeong Park  1 , Eun Sil Koh  1 , Su-Hyun Kim  2 , Young Ok Kim  1 , Dong Chan Jin  1 , Ho Chul Song  1 , Euy Jin Choi  1 , Yong-Lim Kim  3 , Yon-Su Kim  4 , Shin-Wook Kang  5 , Nam-Ho Kim  6 , Chul Woo Yang  1 , Yong Kyun Kim  7
Affiliations
Observational Study

Serum Gamma-Glutamyltransferase Levels Predict Clinical Outcomes in Hemodialysis Patients

Woo Yeong Park et al. PLoS One. .

Abstract

Background: Gamma-glutamyltransferase (GGT) is a biomarker of liver injury. GGT has also been reported to be a marker of oxidative stress and a predictor of mortality in the general population. Hemodialysis (HD) patients suffer from oxidative stress. The aim of our study was to investigate the relationship between serum GGT levels and clinical outcomes in HD patients.

Methods: A total of 1,634 HD patients were enrolled from the Clinical Research Center registry for end-stage renal disease, a prospective cohort in Korea. Patients were categorized into three groups by tertiles of serum GGT levels. The primary outcome was all-cause, cardiovascular, or infection-related mortality and hospitalization.

Results: During the median follow-up period of 30 months, the highest tertile of serum GGT levels had a significantly higher risk for all-cause mortality (hazard ratio (HR) 2.39, 95% confidence interval (CI), 1.55-3.69, P<0.001), cardiovascular mortality (HR 2.14, 95% CI, 1.07-4.26, P = 0.031) and infection-related mortality (HR 3.07, 95% CI, 1.30-7.25, P = 0.011) using tertile 1 as the reference group after adjusting for clinical variables including liver diseases. The highest tertile also had a significantly higher risk for first hospitalization (HR 1.22, 95% CI, 1.00-1.48, P = 0.048) and cardiovascular hospitalization (HR 1.42, 95% CI, 1.06-1.92, P = 0.028).

Conclusions: Our data demonstrate that high serum GGT levels were an independent risk factor for all-cause, cardiovascular, and infection-related mortality, as well as cardiovascular hospitalization in HD patients. These findings suggest that serum GGT levels might be a useful biomarker to predict clinical outcomes in HD patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Kaplan-Meier survival curve for all-cause, cardiovascular, infection-related mortality according to serum GGT tertiles.
Fig 2
Fig 2. Kaplan-Meier survival curve for all-cause, cardiovascular, infection-related hospitalization according to serum GGT tertiles.
See this image and copyright information in PMC

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