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
- Cardiovascular mortality
- Pregnancy-associated plasma protein A
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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 firstname.lastname@example.org
Received: March 18, 2011
Accepted: August 23, 2011
Published online: November 25, 2011
Number of Print Pages : 10
Number of Figures : 3, Number of Tables : 3, Number of References : 37
Kidney and Blood Pressure Research
Vol. 35, No. 3, Year 2012 (Cover Date: April 2012)
Journal Editor: Tesar V. (Prague)
ISSN: 1420-4096 (Print), eISSN: 1423-0143 (Online)
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