Serum endothelin-1 predicts aortic stiffness in maintenance hemodialysis: A cross-sectional study

 

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https://storage.unitedwebnetwork.com/files/1099/2d162244a2a7fdc0aa806a7c27ba15da.pdf
Serum endothelin-1 predicts aortic stiffness in maintenance hemodialysis: A cross-sectional study

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Bang-Gee
Hsu
Tsung-Jui Wu ahreiwu@gmail.com Division of Nephrology, Department of Medicine Hualien Armed Forces General Hospital Hualien Taiwan -
Yu-Li Lin nomo8931126@gmail.com Division of Nephrology Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Hualien Taiwan -
Chih-Hsien Wang wangch33@gmail.com Division of Nephrology Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Hualien Taiwan -
Bang-Gee Hsu gee.lily@msa.hinet.net Division of Nephrology Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation Hualien Taiwan *
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Aortic stiffness is common in patients receiving maintenance hemodialysis (HD) and contributes to adverse cardiovascular outcomes. We investigated whether circulating endothelin-1 (ET-1), a potent vasoconstrictor and endothelial mediator, is associated with aortic stiffness measured by carotid–femoral pulse wave velocity (cfPWV) in HD patients.

Blood samples were obtained from 134 chronic HD patients who had received standard 4-hour dialysis 3 times per week. Patients with cfPWV values of >10 m/s were classified in the aortic stiffness group, whereas those with cfPWV values of ≤ 10 m/s were assigned to the control group. Serum ET-1 levels were quantified using commercially available enzyme-linked immunosorbent assays.

Fifty HD patients (37.3%) who belonged to the aortic stiffness group were generally older (P = 0.014), higher incidence of diabetes mellitus (P = 0.025), hypertension (P = 0.001), higher systolic blood pressures (SBP, P < 0.001), diastolic blood pressure (P < 0.001), higher serum glucose (P = 0.033), and ET-1 levels (P < 0.001) than the control group. In multivariable logistic regression, ET-1 (per 0.01 pmoL/L) (odds ratio [OR]: 1.066, 95% confidence interval [CI]: 1.035–1.099, P < 0.001) was independently associated with aortic stiffness after adjusting for clinical cofounders. In stepwise linear regression, logarithmically transformed ET-1 (log-ET-1, β = 0.451, P < 0.001), SBP (β = 0.362, P < 0.001), and age (β = 0.187, P = 0.004) was positively associated with cfPWV values in patients with chronic HD. ET-1 discriminated aortic stiffness with an area under the curve of 0.790 (95% CI: 0.716–0.864, P < 0.001).

Among HD patients, serum ET-1 levels are found to be positively correlated with cfPWV values, and higher circulating ET-1 levels are independently associated with aortic stiffness, beyond age and blood pressure.

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