Circulating levels of CD34+ cells predict long-term cardiovascular outcomes in patients on maintenance hemodialysis


Autoři: Ahmad Baseer Kaihan aff001;  Manabu Hishida aff001;  Takahiro Imaizumi aff001;  Masaki Okazaki aff001;  Ahmad Naseer Kaihan aff002;  Takayuki Katsuno aff004;  Akihiko Taguchi aff005;  Yoshinari Yasuda aff001;  Naotake Tsuboi aff001;  Tomoki Kosugi aff001;  Shoichi Maruyama aff001
Působiště autorů: Department of Nephrology, Graduate School of Medicine, Nagoya University, Nagoya, Japan aff001;  Faculty of Medicine, Balkh University, Mazar-i-Sharif, Afghanistan aff002;  Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America aff003;  Department of Nephrology and Rheumatology, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan aff004;  Department of Regenerative Medicine Research, Institute of Biomedical Research and Innovation, Kobe, Japan aff005;  Department of Nephrology, Fujita Health University Graduate School of Medicine, Toyoake, Japan aff006
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223390

Souhrn

CD34+ cells maintain vascular homeostasis and predict cardiovascular outcomes. We previously evaluated the association of CD34+ cells with cardiovascular disease (CVD) events over 23 months, but long-term CVD outcomes in relation to levels of CD34+ cells in patients on maintenance hemodialysis are unclear. Herein, we analyzed the long-term predictive potential levels of CD34+ cells for CVD outcomes and all-cause mortality. Between March 2005 and May 2005, we enrolled 215 patients on maintenance hemodialysis at Nagoya Kyoritsu Hospital and followed them up to 12.8 years. According to the CD34+ cell counts, patients were classified into the lowest, medium, and highest tertiles. Levels of CD34+ cells were analyzed in association with four-point major adverse CV events (MACEs), CVD death, and all-cause mortality. In univariate analysis age, smoking habit, lower geriatric nutrition risk index, lower calcium × phosphate product, and lower intact parathyroid hormone were significantly associated with the lowest tertile. Whereas, in multivariate analysis, age and smoking habit were significantly associated with the lowest tertile. Among 139 (64.7%) patients who died during a mean follow-up period of 8.0 years, 39 (28.1%) patients died from CVD. Patients in the lowest tertile had a significantly lower survival rate than those in the medium and highest tertiles (p ≤ 0.001). Using multivariable analyses, the lowest tertile was significantly associated with four-point MACEs (hazard ratio 1.80, p = 0.023) and CVD death (hazard ratio 2.50, p = 0.011). In conclusion, our long-term observational study revealed that a low level of CD34+ cells in the circulation predicts CVD outcomes among patients on maintenance hemodialysis.

Klíčová slova:

C-reactive proteins – Cardiovascular diseases – Diabetes mellitus – Hemoglobin – Hypertension – Medical dialysis – Medical risk factors – Smoking habits


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