Abstract:
BACKGROUND:Predicting the mortality risk of patients un-dergoing hemodialysis (HD) is challenging. Cell-free DNA (cfDNA) is released into circulation from dying cells, and its elevation is predictive of unfavorable outcome. In a pilot study, we found post-HD cfDNA level to be a predictor of all-cause mortality. Thus, the aim of this study was to confirm the prognostic power of cfDNA in a larger prospective cohort study conducted at 2 medical centers. METHODS:CfDNA levels were measured by a rapid fluorometric assay on sera obtained before and after 1 HD session. One hundred fifty-three patients were followed up to 46 months for mortality during which time 47 patients died. We compared the predictive value of cfDNA to age, comorbidities, and standard blood tests. RESULTS:Examining standard blood tests, only post-HD cfDNA levels were elevated in the non-survivor group compared to survivors (959 vs. 803 ng/mL, p = 0.04). Pre- and post-HD cfDNA levels correlated with age and diabetes. Patients with elevated cfDNA (>850 ng/mL) showed lower survival than those with normal levels. A Cox proportional hazard regression model demonstrated a significant hazard ratio of 1.92 for post-HD cfDNA levels. Logistic regression models showed that post-HD cfDNA was a significant predictor of mortality at 1-3 years with odd ratios of 4.61, 4.36, and 6.22, respectively. CONCLUSIONS:Post-HD cfDNA level was superior to standard blood tests and could serve as a biomarker to assist in decision-making for HD-treated patients.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Einbinder Y,Shnaider A,Ghanayem K,Basok A,Rogachev B,Lior Y,Haviv YS,Cohen-Hagai K,Nacasch N,Rozenberg I,Benchetrit S,Zitman-Gal T,Douvdevani Adoi
10.1159/000510771subject
Has Abstractpub_date
2020-01-01 00:00:00pages
852-860issue
11eissn
0250-8095issn
1421-9670pii
000510771journal_volume
51pub_type
杂志文章abstract:BACKGROUND:Henoch-Schönlein purpura (HSP) is a form of systemic vasculitis that can progress to Henoch-Schönlein purpura nephritis (HSPN), and the most effective treatment remains controversial. Our aim was to compare the effects of oral mycophenolate mofetil (MMF) with low-dose prednisone and the full-dose corticoster...
journal_title:American journal of nephrology
pub_type: 杂志文章
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abstract::Shortage of kidney donor is still a major limitation for renal transplantation programs. This review focuses on the emerging practices, adopted to increase transplant activities, of expanding the criteria for donor and recipient selection without exposing the recipient to the drawbacks of a graft with inadequate nephr...
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abstract:BACKGROUND:Henoch-Schönlein Purpura (HSP) is a common childhood vasculitis with manifestations in numerous organ systems, including glomerulonephritis. Patients with more severe HSP-associated glomerulonephritis may develop chronic renal failure. Currently, no widely accepted treatment protocols exist for patients with...
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更新日期:1998-01-01 00:00:00
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journal_title:American journal of nephrology
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166482
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更新日期:2008-01-01 00:00:00