Prognostic value of soluble ST2 and soluble LR11 on mortality and cardiovascular events in peritoneal dialysis patients

Abstract

Background: Although the soluble form of suppression of tumorigenicity 2 (sST2) and soluble low-density lipoprotein receptor relative with 11 ligand-binding repeats (sLR11) have emerged as novel cardiovascular biomarkers in patients with cardiovascular disease, their prognostic value has not been fully investigated in peritoneal dialysis (PD) patients. Methods: We included 74 prevalent PD patients from a prospective cohort and measured serum sST2 and sLR11 concentrations by an enzyme-linked immunosorbent assay. The association of these biomarkers and all-cause mortality and major adverse cardiac and cerebrovascular events (MACCEs) was evaluated. Results: During a follow-up of 38.5 months, all-cause deaths and MACCEs were observed in 13 (17.6%) patients and 23 (31.3%) patients. Multivariable Cox analyses demonstrated that greater sST2 was independently associated with higher risk of all-cause mortality (≥75.8 ng/mL; hazard ratio [HR] = 5.551; 95% confidence interval [CI] = 1.360-22.660) and MACCEs (≥72.5 ng/mL; HR = 4.609; 95% CI = 1.608-13.208). Furthermore, sST2 showed additive predictive value for mortality to the base model including traditional risk factors (net reclassification index = 0.598, P = 0.04). sLR11 was not significantly associated with all-cause mortality or MACCE. Conclusions: sST2, but not sLR11, indicated a significant prognostic value for all-cause mortality and cardiovascular events in PD patients. Further research is needed to validate emerging biomarkers in these populations.

Prognostic Value of Soluble Suppression of Tumorigenicity 2 in Chronic Kidney Disease Patients: A Meta-Analysis

“…Among the 15 studies, eight studies specifically reported dialysis patients [ 9 , 13 , 14 , 17 – 19 , 22 , 24 ], five studies specifically reported predialysis [ 8 , 15 , 20 , 21 , 23 ], and two studies specifically reported kidney transplant patients [ 16 , 25 ]. The main characteristics are summarized in Table 1 .…”

“…Study individuals ranged from 74 to 3,314 with a total of 11,063, and the mean or median follow-up years ranged from 1.7 to 16.2. Six studies were conducted in European countries [ 8 , 13 , 15 , 18 , 22 , 25 ], five from Asian countries [ 9 , 14 , 17 , 19 , 24 ], and the other four were carried out in America [ 16 , 20 , 21 , 23 ]. In addition, the quality of five studies was high, and another ten studies was moderate ( Table 2 ).…”

“…Nine studies evaluated the prognostic value of sST2 for all-cause mortality [ 9 , 13 , 14 , 17 – 20 , 24 , 25 ]. Among the nine studies, sensitivity analysis showed results from Wang et al [ 9 ] that contributed great heterogeneity to both all-cause mortality and CVD mortality.…”

“…Nine studies evaluated the prognostic value of sST2 for total CVD events [ 8 , 13 – 16 , 19 , 20 , 24 , 25 ]. When pooling data of total CVD events, we found that high sST2 levels increased the risk of total CVD events (HR: 1.88; 95% CI: 1.26-2.80; p = 0.002; Figure 4(a) ) with heterogeneity ( I 2 : 89.5%, p ≤ 0.001) in CKD patients.…”

Osteoprotegerin and Inflammation in Incident Peritoneal Dialysis Patients

“…In hemodialysis patients, plasma IL-1RL1 (sST2) level is generally elevated and correlates with the risk of cardiovascular events and all-cause mortality observed in a one-year and three-year perspective [34]. The impact of IL-1RL1 (sST2) on cardiovascular mortality in patients treated with peritoneal dialysis was investigated by Choi et al The authors suggested that a higher IL-1RL1 (sST2) level was an independent predictor of cardiovascular mortality in this group [35]. A 2021 meta-analysis of studies conducted in CKD patients confirmed those findings [36].…”