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Plasma gelsolin and circulating actin correlate with hemodialysis mortality.

Publication ,  Journal Article
Lee, P-S; Sampath, K; Karumanchi, SA; Tamez, H; Bhan, I; Isakova, T; Gutierrez, OM; Wolf, M; Chang, Y; Stossel, TP; Thadhani, R
Published in: J Am Soc Nephrol
May 2009

Plasma gelsolin (pGSN) binds actin and bioactive mediators to localize inflammation. Low pGSN correlates with adverse outcomes in acute injury, whereas administration of recombinant pGSN reduces mortality in experimental sepsis. We found that mean pGSN levels of 150 patients randomly selected from 10,044 starting chronic hemodialysis were 140 +/- 42 mg/L, 30 to 50% lower than levels reported for healthy individuals. In a larger sample, we performed a case-control analysis to evaluate the relationship of pGSN and circulating actin with mortality; pGSN levels were significantly lower in 114 patients who died within 1 yr of dialysis initiation than in 109 survivors (117 +/- 38 mg/L versus 147 +/- 42 mg/L, P < 0.001). pGSN levels had a graded, inverse relationship with 1-yr mortality, such that patients with pGSN < 130 mg/L experienced a > 3-fold risk for mortality compared with those with pGSN > or = 150 mg/L. The 69% of patients with detectable circulating actin had lower pGSN levels than those without (127 +/- 45 mg/L versus 141 +/- 36 mg/L, P = 0.026). Compared with patients who had elevated pGSN and no detectable actin, those with low pGSN levels and detectable actin had markedly increased mortality (odds ratio 9.8, 95% confidence interval 2.9 to 33.5). Worsening renal function correlated with pGSN decline in 53 subjects with CKD not on dialysis. In summary, low pGSN and detectable circulating actin identify chronic hemodialysis patients at highest risk for 1-yr mortality.

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Published In

J Am Soc Nephrol

DOI

EISSN

1533-3450

Publication Date

May 2009

Volume

20

Issue

5

Start / End Page

1140 / 1148

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Survivors
  • Survival Analysis
  • Renal Dialysis
  • Reference Values
  • Kaplan-Meier Estimate
  • Humans
  • Gelsolin
  • Case-Control Studies
 

Citation

APA
Chicago
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Lee, P.-S., Sampath, K., Karumanchi, S. A., Tamez, H., Bhan, I., Isakova, T., … Thadhani, R. (2009). Plasma gelsolin and circulating actin correlate with hemodialysis mortality. J Am Soc Nephrol, 20(5), 1140–1148. https://doi.org/10.1681/ASN.2008091008
Lee, Po-Shun, Kartik Sampath, S Ananth Karumanchi, Hector Tamez, Ishir Bhan, Tamara Isakova, Orlando M. Gutierrez, et al. “Plasma gelsolin and circulating actin correlate with hemodialysis mortality.J Am Soc Nephrol 20, no. 5 (May 2009): 1140–48. https://doi.org/10.1681/ASN.2008091008.
Lee P-S, Sampath K, Karumanchi SA, Tamez H, Bhan I, Isakova T, et al. Plasma gelsolin and circulating actin correlate with hemodialysis mortality. J Am Soc Nephrol. 2009 May;20(5):1140–8.
Lee, Po-Shun, et al. “Plasma gelsolin and circulating actin correlate with hemodialysis mortality.J Am Soc Nephrol, vol. 20, no. 5, May 2009, pp. 1140–48. Pubmed, doi:10.1681/ASN.2008091008.
Lee P-S, Sampath K, Karumanchi SA, Tamez H, Bhan I, Isakova T, Gutierrez OM, Wolf M, Chang Y, Stossel TP, Thadhani R. Plasma gelsolin and circulating actin correlate with hemodialysis mortality. J Am Soc Nephrol. 2009 May;20(5):1140–1148.

Published In

J Am Soc Nephrol

DOI

EISSN

1533-3450

Publication Date

May 2009

Volume

20

Issue

5

Start / End Page

1140 / 1148

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Survivors
  • Survival Analysis
  • Renal Dialysis
  • Reference Values
  • Kaplan-Meier Estimate
  • Humans
  • Gelsolin
  • Case-Control Studies