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. 2025 Feb 10;14(4):1139.
doi: 10.3390/jcm14041139.

Exploring the Associations Between Inflammatory Biomarkers, Survival, and Cardiovascular Events in Hemodialysis Patients and the Interrelationship with Nutritional Parameters-The Experience of a Single Transylvanian Dialysis Center

Crina Claudia Rusu  1   2 , Ina Kacso  1   2 , Diana Moldovan  1   2 , Alina Potra  1   2 , Dacian Tirinescu  1   2 , Maria Ticala  1   2 , Yuriy Maslyennikov  1   2 , Alexandra Urs  1   2 , Cosmina Ioana Bondor  3
Affiliations

Exploring the Associations Between Inflammatory Biomarkers, Survival, and Cardiovascular Events in Hemodialysis Patients and the Interrelationship with Nutritional Parameters-The Experience of a Single Transylvanian Dialysis Center

Crina Claudia Rusu et al. J Clin Med. .

Abstract

Background/Objectives: In hemodialysis (HD), inflammatory biomarkers are discussed as prognostic markers for survival and cardiovascular events (CVEs). The results of the studies are not uniform and there are particularities related to population groups and comorbidities. In addition, it is known that inflammation determines protein malnutrition and less about the effect of adipose tissue on inflammation in HD. This study investigates the relationship between inflammatory molecules and nutritional biomarkers, and CVE and survival in HD patients. Methods: We included, in an observational, longitudinal study, 65 patients with chronic HD (53 without diabetes and 22 smokers), with a mean age of 60.1 ± 12.4 years. High-sensitivity C-reactive protein (hs-CRP), interleukin 1 beta, tumor necrosis factor alpha (TNF-alpha), interleukin 6, soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK), soluble CD163 (sCD163), and fibroblast growth factor 21 were determined. We recorded survival and cardiovascular events for 60 months. Univariate and multivariate analyses were performed. Results: Hs-CRP was significantly associated with survival (p = 0.014) in the total group. In smokers and former smokers, TNF-α lower than 368.34 pg/mL was associated with better survival. In multivariate analysis, hs-CRP was correlated with adipose tissue biomarkers (p = 0.006), and sCD163 was correlated with total and LDL cholesterol (p = 0.002). In addition, in univariate analysis, sTWEAK was correlated with serum albumin (p = 0.026, r = -0.30). In conclusion, in HD patients, hs-CRP was significantly associated with survival, and low TNF-alpha values in smokers and former smokers were linked to better survival. Hs-CRP was also correlated with adipose tissue biomarkers, CD163 was correlated with total and LDL cholesterol, and albumin was inversely associated with sTWEAK. The relation between inflammatory molecules and adipose tissue biomarkers was less identified in HD patients until now.

Keywords: biomarkers; cardiovascular events; diagnosis; hemodialysis; kidney disease; nutrition; survival.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Comparative survival curves between subjects with hs-CRP less than 0.3 mg/dL and those with hs-CRP greater than or equal to 0.3 mg/dL.
Figure 2
Figure 2
Comparative values of sTWEAK between subjects with diabetes mellitus and without.
Figure 3
Figure 3
Comparative survival curves between subjects with TNF-α less than 368.34 pg/mL and those with TNF-α higher or equal to 368.34 pg/mL.
See this image and copyright information in PMC

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