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Table of Contents
Vol. 35, No. 3, 2012
Issue release date: April 2012
Section title: Original Paper
Kidney Blood Press Res 2012;35:192–201

Pregnancy-Associated Plasma Protein A as an Independent Mortality Predictor in Long-Term Hemodialysis Patients

Kalousová M.a · Benáková H.a · Kuběna A.A.a · Dusilová-Sulková S.c · Tesař V.b · Zima T.a
aInstitute of Clinical Biochemistry and Laboratory Diagnostics and bDepartment of Nephrology, First Faculty of Medicine, Charles University and General University Hospital, and cDepartment of Nephrology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
email Corresponding Author

Prof. Marta Kalousova, MD, PhD

Institute of Clinical Biochemistry and Laboratory Diagnostics

First Faculty of Medicine, Charles University and General University Hospital

Na Bojišti 3, CZ–121 08 Prague 2 (Czech Republic)

Tel. +420 224 964 212, E-Mail marta.kalousova@seznam.cz

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Background/Aims: Pregnancy-associated plasma protein A (PAPP-A) is a biomarker related to vascular damage. The aim of the study was to focus on PAPP-A and related parameters and their relationship to the prognosis of long-term hemodialysis (HD) patients. Methods: This is a prospective observational cohort study which included 261 long-term HD patients followed up for 5 years and 66 healthy subjects. PAPP-A, placental growth factor (PlGF), matrix metalloproteinase 2 and 9 (MMP-2, MMP-9), insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein-4 (IGFBP-4), and cardiac, nutritional and inflammatory parameters were measured at the beginning of the study and tested as predictors of mortality. Results: PAPP-A, PlGF, IGF-1, IGFBP-4 and MMP-2 were significantly increased in HD patients compared to controls (PAPP-A 27.6 ± 15.5 mIU/l in HD vs. 9.4 ± 2.5 mIU/l in controls, p < 0.001). Increased PAPP-A was a significant independent predictor of overall mortality and mortality due to infection in the multivariate Cox analysis [HR (95% CI): 1.237 (1.060–1.444), p = 0.007, and 1.416 (1.115–1.798), p = 0.004, per standard deviation, respectively]. PAPP-A was not related to cardiovascular mortality. Conclusion: Increased PAPP-A is a significant independent predictor of overall mortality and mortality due to infection but it was not related to cardiovascular mortality in this study.

© 2011 S. Karger AG, Basel

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 18, 2011
Accepted: August 23, 2011
Published online: November 25, 2011
Issue release date: April 2012

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 3

ISSN: 1420-4096 (Print)
eISSN: 1423-0143 (Online)

For additional information: http://www.karger.com/KBR

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