PMID- 28941940
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1523-1755 (Electronic)
IS  - 0085-2538 (Linking)
VI  - 93
IP  - 1
DP  - 2018 Jan
TI  - Mortality prediction in stable hemodialysis patients is refined by YKL-40, a 
      40-kDa glycoprotein associated with inflammation.
PG  - 221-230
LID - S0085-2538(17)30540-9 [pii]
LID - 10.1016/j.kint.2017.07.010 [doi]
AB  - Chronic inflammation contributes to increased mortality in hemodialysis (HD) 
      patients. YKL-40 is a novel marker of inflammation, tissue remodeling, and highly 
      expressed in macrophages inside vascular lesions. Elevated levels of YKL-40 have 
      been reported for HD patients but how it integrates into the proinflammatory 
      mediator network as a predictor of mortality remains elusive. We studied serum 
      YKL-40, Interleukin-6 (IL-6), high-sensitivity C-reactive protein, monocyte 
      chemotactic protein-1 (MCP-1), and interferon-gamma induced protein-10 (IP-10) in 
      475 chronic hemodialysis patients. Patients were followed for mortality for a 
      median of 37 [interquartile range: 25-49] months and checked for interrelation of 
      the measured mediators. To plot cumulative incidence functions, patients were 
      stratified into terciles per YKL-40, IL-6, MCP-1, and IP-10 levels. Multivariable 
      Cox regression models were built to examine associations of YKL-40, IP-10, and 
      MCP-1 with all-cause and cause-specific mortality. Net reclassification 
      improvement was calculated for the final models containing YKL-40 and IL-6. 
      Increased YKL-40 was independently associated with age, IP-10, and IL-6 serum 
      levels. After adjustment for demographic and laboratory parameters, 
      comorbidities, and IL-6, only YKL-40 significantly improved risk prediction for 
      all-cause (hazard ratio 1.4; 95% confidence interval 1.1-1.8) and cardiovascular 
      mortality (hazard ratio 1.5; 95% confidence interval 1.03-2.2). Thus, in contrast 
      to other biomarkers of aberrant macrophage activation, YKL-40 reflects 
      inflammatory activity, which is not covered by IL-6. Mechanistic and prospective 
      studies are needed to test for causal involvement of YKL-40 and whether it might 
      qualify as a therapeutic target.
CI  - Copyright (c) 2017 International Society of Nephrology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Lorenz, Georg
AU  - Lorenz G
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany. Electronic address: Georg.lorenz.gl@gmail.com.
FAU - Schmalenberg, Michael
AU  - Schmalenberg M
AD  - Department of Clinical Chemistry, Klinikum rechts der Isar, Technical University 
      Munich, Munich, Germany.
FAU - Kemmner, Stephan
AU  - Kemmner S
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Haller, Bernhard
AU  - Haller B
AD  - Department of Medical Statistics and Epidemiology, Technical University Munich, 
      Munich, Germany.
FAU - Steubl, Dominik
AU  - Steubl D
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Pham, Dang
AU  - Pham D
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Schreiegg, Anita
AU  - Schreiegg A
AD  - Department of Clinical Chemistry, Klinikum rechts der Isar, Technical University 
      Munich, Munich, Germany.
FAU - Bachmann, Quirin
AU  - Bachmann Q
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Schmidt, Alina
AU  - Schmidt A
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Haderer, Sandra
AU  - Haderer S
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Huber, Monika
AU  - Huber M
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Angermann, Susanne
AU  - Angermann S
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Gunthner, Roman
AU  - Gunthner R
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Braunisch, Matthias
AU  - Braunisch M
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Hauser, Christine
AU  - Hauser C
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Reichelt, Anna-Lena
AU  - Reichelt AL
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Matschkal, Julia
AU  - Matschkal J
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Suttmann, Yana
AU  - Suttmann Y
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Moog, Philipp
AU  - Moog P
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Stock, Konrad
AU  - Stock K
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Kuchle, Claudius
AU  - Kuchle C
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Thurmel, Klaus
AU  - Thurmel K
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Renders, Lutz
AU  - Renders L
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Bauer, Axel
AU  - Bauer A
AD  - Department of Cardiology, Ludwig-Maximilian University, Munich, Germany.
FAU - Baumann, Marcus
AU  - Baumann M
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Heemann, Uwe
AU  - Heemann U
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany.
FAU - Luppa, Peter B
AU  - Luppa PB
AD  - Department of Clinical Chemistry, Klinikum rechts der Isar, Technical University 
      Munich, Munich, Germany.
FAU - Schmaderer, Christoph
AU  - Schmaderer C
AD  - Department of Nephrology, Klinikum rechts der Isar, Technical University Munich, 
      Munich, Germany. Electronic address: Christoph.schmaderer@mri.tum.de.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20170921
PL  - United States
TA  - Kidney Int
JT  - Kidney international
JID - 0323470
RN  - 0 (Biomarkers)
RN  - 0 (CHI3L1 protein, human)
RN  - 0 (Chitinase-3-Like Protein 1)
RN  - 0 (Inflammation Mediators)
SB  - IM
CIN - Kidney Int. 2018 Jan;93(1):21-22. PMID: 29291818
MH  - Aged
MH  - Biomarkers/blood
MH  - Chitinase-3-Like Protein 1/*blood
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Inflammation Mediators/*blood
MH  - Kidney Failure, Chronic/blood/diagnosis/*mortality/*therapy
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Renal Dialysis/adverse effects/*mortality
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - YKL-40
OT  - cardiovascular
OT  - chronic inflammation
OT  - hemodialysis
OT  - mortality
OT  - risk
EDAT- 2017/09/25 06:00
MHDA- 2018/12/12 06:00
CRDT- 2017/09/25 06:00
PHST- 2017/03/07 00:00 [received]
PHST- 2017/07/01 00:00 [revised]
PHST- 2017/07/13 00:00 [accepted]
PHST- 2017/09/25 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2017/09/25 06:00 [entrez]
AID - S0085-2538(17)30540-9 [pii]
AID - 10.1016/j.kint.2017.07.010 [doi]
PST - ppublish
SO  - Kidney Int. 2018 Jan;93(1):221-230. doi: 10.1016/j.kint.2017.07.010. Epub 2017 
      Sep 21.