Connective tissue growth factor is related to all-cause mortality in hemodialysis patients and is lowered by on-line hemodiafiltration: Results from the convective transport study

Claire H. den Hoedt, Maaike K. van Gelder, Muriel P. Grooteman, Menso J. Nubé, Peter J. Blankestijn, Roel Goldschmeding, Robbert Jan Kok, Michiel L. Bots, Marinus A. van den Dorpel, Karin G. F. Gerritsen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Connective tissue growth factor (CTGF) plays a key role in the pathogenesis of tissue fibrosis. The aminoterminal fragment of CTGF is a middle molecule that accumulates in chronic kidney disease. The aims of this study are to explore determinants of plasma CTGF in hemodialysis (HD) patients, investigate whether CTGF relates to all-cause mortality in HD patients, and investigate whether online-hemodiafiltration (HDF) lowers CTGF. Data from 404 patients participating in the CONvective TRAnsport STudy (CONTRAST) were analyzed. Patients were randomized to low-flux HD or HDF. Pre-dialysis CTGF was measured by sandwich ELISA at baseline, after six and 12 months. CTGF was inversely related in multivariable analysis to glomerular filtration rate (GFR) (p < 0.001) and positively to cardiovascular disease (CVD) (p = 0.006), dialysis vintage (p < 0.001), interleukin-6 (p < 0.001), beta-2-microglobulin (p = 0.045), polycystic kidney disease (p < 0.001), tubulointerstitial nephritis (p = 0.002), and renal vascular disease (p = 0.041). Patients in the highest quartile had a higher mortality risk compared to those in the lowest quartile (HR 1.7, 95% CI: 1.02–2.88, p = 0.043). HDF lowered CTGF with 4.8% between baseline and six months, whereas during HD, CTGF increased with 4.9% (p < 0.001). In conclusion, in HD patients, CTGF is related to GFR, CVD and underlying renal disease and increased the risk of all-cause mortality. HDF reduces CTGF.
Original languageEnglish
Article number268
JournalToxins
Volume11
Issue number5
DOIs
Publication statusPublished - 2019

Cite this

den Hoedt, Claire H. ; van Gelder, Maaike K. ; Grooteman, Muriel P. ; Nubé, Menso J. ; Blankestijn, Peter J. ; Goldschmeding, Roel ; Kok, Robbert Jan ; Bots, Michiel L. ; van den Dorpel, Marinus A. ; Gerritsen, Karin G. F. / Connective tissue growth factor is related to all-cause mortality in hemodialysis patients and is lowered by on-line hemodiafiltration: Results from the convective transport study. In: Toxins. 2019 ; Vol. 11, No. 5.
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title = "Connective tissue growth factor is related to all-cause mortality in hemodialysis patients and is lowered by on-line hemodiafiltration: Results from the convective transport study",
abstract = "Connective tissue growth factor (CTGF) plays a key role in the pathogenesis of tissue fibrosis. The aminoterminal fragment of CTGF is a middle molecule that accumulates in chronic kidney disease. The aims of this study are to explore determinants of plasma CTGF in hemodialysis (HD) patients, investigate whether CTGF relates to all-cause mortality in HD patients, and investigate whether online-hemodiafiltration (HDF) lowers CTGF. Data from 404 patients participating in the CONvective TRAnsport STudy (CONTRAST) were analyzed. Patients were randomized to low-flux HD or HDF. Pre-dialysis CTGF was measured by sandwich ELISA at baseline, after six and 12 months. CTGF was inversely related in multivariable analysis to glomerular filtration rate (GFR) (p < 0.001) and positively to cardiovascular disease (CVD) (p = 0.006), dialysis vintage (p < 0.001), interleukin-6 (p < 0.001), beta-2-microglobulin (p = 0.045), polycystic kidney disease (p < 0.001), tubulointerstitial nephritis (p = 0.002), and renal vascular disease (p = 0.041). Patients in the highest quartile had a higher mortality risk compared to those in the lowest quartile (HR 1.7, 95{\%} CI: 1.02–2.88, p = 0.043). HDF lowered CTGF with 4.8{\%} between baseline and six months, whereas during HD, CTGF increased with 4.9{\%} (p < 0.001). In conclusion, in HD patients, CTGF is related to GFR, CVD and underlying renal disease and increased the risk of all-cause mortality. HDF reduces CTGF.",
author = "{den Hoedt}, {Claire H.} and {van Gelder}, {Maaike K.} and Grooteman, {Muriel P.} and Nub{\'e}, {Menso J.} and Blankestijn, {Peter J.} and Roel Goldschmeding and Kok, {Robbert Jan} and Bots, {Michiel L.} and {van den Dorpel}, {Marinus A.} and Gerritsen, {Karin G. F.}",
year = "2019",
doi = "10.3390/toxins11050268",
language = "English",
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journal = "Toxins",
issn = "2072-6651",
number = "5",

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Connective tissue growth factor is related to all-cause mortality in hemodialysis patients and is lowered by on-line hemodiafiltration: Results from the convective transport study. / den Hoedt, Claire H.; van Gelder, Maaike K.; Grooteman, Muriel P.; Nubé, Menso J.; Blankestijn, Peter J.; Goldschmeding, Roel; Kok, Robbert Jan; Bots, Michiel L.; van den Dorpel, Marinus A.; Gerritsen, Karin G. F.

In: Toxins, Vol. 11, No. 5, 268, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Connective tissue growth factor is related to all-cause mortality in hemodialysis patients and is lowered by on-line hemodiafiltration: Results from the convective transport study

AU - den Hoedt, Claire H.

AU - van Gelder, Maaike K.

AU - Grooteman, Muriel P.

AU - Nubé, Menso J.

AU - Blankestijn, Peter J.

AU - Goldschmeding, Roel

AU - Kok, Robbert Jan

AU - Bots, Michiel L.

AU - van den Dorpel, Marinus A.

AU - Gerritsen, Karin G. F.

PY - 2019

Y1 - 2019

N2 - Connective tissue growth factor (CTGF) plays a key role in the pathogenesis of tissue fibrosis. The aminoterminal fragment of CTGF is a middle molecule that accumulates in chronic kidney disease. The aims of this study are to explore determinants of plasma CTGF in hemodialysis (HD) patients, investigate whether CTGF relates to all-cause mortality in HD patients, and investigate whether online-hemodiafiltration (HDF) lowers CTGF. Data from 404 patients participating in the CONvective TRAnsport STudy (CONTRAST) were analyzed. Patients were randomized to low-flux HD or HDF. Pre-dialysis CTGF was measured by sandwich ELISA at baseline, after six and 12 months. CTGF was inversely related in multivariable analysis to glomerular filtration rate (GFR) (p < 0.001) and positively to cardiovascular disease (CVD) (p = 0.006), dialysis vintage (p < 0.001), interleukin-6 (p < 0.001), beta-2-microglobulin (p = 0.045), polycystic kidney disease (p < 0.001), tubulointerstitial nephritis (p = 0.002), and renal vascular disease (p = 0.041). Patients in the highest quartile had a higher mortality risk compared to those in the lowest quartile (HR 1.7, 95% CI: 1.02–2.88, p = 0.043). HDF lowered CTGF with 4.8% between baseline and six months, whereas during HD, CTGF increased with 4.9% (p < 0.001). In conclusion, in HD patients, CTGF is related to GFR, CVD and underlying renal disease and increased the risk of all-cause mortality. HDF reduces CTGF.

AB - Connective tissue growth factor (CTGF) plays a key role in the pathogenesis of tissue fibrosis. The aminoterminal fragment of CTGF is a middle molecule that accumulates in chronic kidney disease. The aims of this study are to explore determinants of plasma CTGF in hemodialysis (HD) patients, investigate whether CTGF relates to all-cause mortality in HD patients, and investigate whether online-hemodiafiltration (HDF) lowers CTGF. Data from 404 patients participating in the CONvective TRAnsport STudy (CONTRAST) were analyzed. Patients were randomized to low-flux HD or HDF. Pre-dialysis CTGF was measured by sandwich ELISA at baseline, after six and 12 months. CTGF was inversely related in multivariable analysis to glomerular filtration rate (GFR) (p < 0.001) and positively to cardiovascular disease (CVD) (p = 0.006), dialysis vintage (p < 0.001), interleukin-6 (p < 0.001), beta-2-microglobulin (p = 0.045), polycystic kidney disease (p < 0.001), tubulointerstitial nephritis (p = 0.002), and renal vascular disease (p = 0.041). Patients in the highest quartile had a higher mortality risk compared to those in the lowest quartile (HR 1.7, 95% CI: 1.02–2.88, p = 0.043). HDF lowered CTGF with 4.8% between baseline and six months, whereas during HD, CTGF increased with 4.9% (p < 0.001). In conclusion, in HD patients, CTGF is related to GFR, CVD and underlying renal disease and increased the risk of all-cause mortality. HDF reduces CTGF.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85066280339&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31086050

U2 - 10.3390/toxins11050268

DO - 10.3390/toxins11050268

M3 - Article

VL - 11

JO - Toxins

JF - Toxins

SN - 2072-6651

IS - 5

M1 - 268

ER -