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Biomarkers of Cardiovascular Fibrosis in Relation to Mortality in Hemodialysis Patients

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    By Katherine Kozlowski, medical author and contributor to Vein News and veinsveinsveins.com

    Key Words:
    biomarkers = substance that can be measured in the body which is related to a specific disease, infection, etc. In this case, the biomarkers measured were in the blood.
    fibrosis = tissue scarring caused by deposition of connective tissue or collagen.
    prognosis = prediction of a disease, prediction of mortality, etc.

    The leading cause of death in patients on dialysis are cardiovascular diseases. The aim of this study is to investigate the relationship between mortality in hemodialysis patients and two biomarkers that are known to be related to cardiovascular fibrosis.
    The presence of two biomarkers, Procollagen type I C-terminal pro-peptide (PICP) and galectin-3 (Gal-3), are relevant biomarkers of vascular disease, and may indicate active generation of fibrotic tissue in the cardiovascular system.
    Researchers investigated the presence of PICP and Gal-3 in hemodialysis patients to determine the relationship between biomarkers of fibrosis and mortality in dialysis patients.
    2773 patients on hemodialysis were included in the study. Median follow-up period = 3.8 years.
    The prognostic value of PICP and Gal-3 serum levels was determined over time.
    Statins are shown to inhibit the amount of cardiac fibrotic growth (Fan & Guan 2016). In the study population, the effect of rosuvastatin on cardiovascular outcomes and mortality was also looked at.
    Serum concentrations of PICP and Gal-3 were significantly related to cardiovascular death and all-cause mortality (p<.001).
    PICP and Gal-3 showed to have a synergistic effect in relation to cardiovascular and all-cause mortality, suggesting that there is a relationship between fibrotic biomarkers and death in hemodialysis patients.

    Higher mortality rate in hemodialysis patients is related to a concomitant increase in PICP and Gal-3 concentrations in blood, suggesting that increased levels of PICP and Gal-3 together may indicate that there is active generation of cardiovascular fibrotic tissue. This could be beneficial in determining prognosis of patients on hemodialysis in relation to cardiovascular and all-cause mortality.
    These results raise the question as to whether or not antifibrotic therapy such as the use of statins or other drugs would be beneficial for patients on hemodialysis to protect them from cardiovascular fibrogenesis, but further investigation is warranted.
    Salib M, Girerd S, Girerd N et al. Serum markers of fibrosis, cardiovascular and all-cause mortality in hemodialysis patients: the AURORA trial. Clin Res Cardiol 2021; 1-13.
    Fan Z & Guan J. Antifibrotic therapies to control cardiac fibrosis. Biomater Res 2016;20(1): 1-13.