A cohort study of insulin-like growth factor 1 and mortality in haemodialysis patients

Clinical Kidney Journal
Erik NilssonPeter Stenvinkel

Abstract

Protein-energy wasting (PEW) is highly prevalent in haemodialysis (HD) patients and associated with increased mortality and cardiovascular disease (CVD). Insulin-like growth factor 1 (IGF-1) correlates to markers of PEW and CVD. Disturbances in the growth hormone axis in end-stage renal disease (ESRD) could have an impact on survival through increased PEW and CVD. A cohort of 265 incident HD patients (median age 68 years, 59% males) was followed for 3 years. Subjects were categorized according to IGF-1 levels at dialysis initiation. Outcome and comorbidity data were retrieved from national registers. The Kaplan-Meier diagram and Cox proportional hazards model were used for the analysis of survival. Patients with IGF-1 levels in the lowest tertile were characterized by female sex, low creatinine, hypoalbuminemia and high C-reactive protein (CRP) levels. IGF-1 levels within the lowest tertile were associated with increased mortality [hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.7-3.4]. This association persisted when corrected for demographic factors (age, sex) and comorbidities (diabetes mellitus, CVD, heart failure) in multivariable analysis. Including high-sensitivity C-reactive protein (hs-CRP) and serum creatinine i...Continue Reading

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Citations

Jun 18, 2016·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Bojan KnapŽeljka Večerić-Haler
Dec 8, 2017·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Vladimir PrelevicNikolina Basic-Jukic
Mar 29, 2019·European Journal of Clinical Investigation·Towe StrålbergErik Nilsson
Jun 15, 2019·International Urology and Nephrology·Elżbieta Cecerska-HeryćBarbara Dołęgowska
Mar 25, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Garland A CampbellWarren K Bolton

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Methods Mentioned

BETA
coronary artery bypass
enzyme-linked immunosorbent assay

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