Published Online
on May 10, 2004

A more recent version of this article appeared on May 18, 2004

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Submitted on March 4, 2004
Revised on March 25, 2004
Accepted on March 31, 2004

Relaxin Is an Independent Risk Factor Predicting Death in Male Patients With End-Stage Kidney Disease

Berthold Hocher MD^*, Reinhard Ziebig PhD, Rolfdieter Krause MD, Gernot Asmus MD, Hans-H. Neumayer MD, Lutz Liefeldt MD, and Johannes-Peter Stasch PhD

From the Center for Cardiovascular Research, Departments of Nephrology (B.H., H.-H.N., L.L.) and Laboratory Medicine (R.Z.), Charité, Berlin, Germany; KfH Dialysezentrum, Moabit, Berlin, Germany (R.K.); KfH Dialysezentrum Sonnenallee, Berlin, Germany (G.A.); and Institute of Cardiovascular Research (J.-P.S.), Bayer AG, Wuppertal, Germany.

^* To whom correspondence should be addressed. E-mail: berthold.hocher{at}charite.de.

Background--Patients with end-stage kidney disease (ESKD) have a reduced life expectancy mainly as the result of cardiovascular diseases. Relaxin has been implicated in the pathogenesis of cardiovascular diseases. We analyzed the impact of relaxin on death in patients with ESKD.

Methods and Results--Patients (n =245; 122 women, 123 men) on long-term hemodialysis were followed for 1140 days for death. Blood samples for analysis of relaxin, C-reactive protein, Troponin T, cholesterol, HDL, brain natriuretic peptide, and albumin were taken at study entry. Survival was compared by the Kaplan-Meier method and Cox regression analysis. One hundred seven patients died during the observation period; 66 died of cardiovascular diseases and 28 died of infectious diseases. Elevated serum relaxin concentrations (greater than median) predicted death in male but not in female patients with ESKD: All-cause death (men: relative risk, 2.63; 95% CI, 1.34 to 5.12; P=0.005; women: relative risk, 0.671; 95% CI, 0.33 to 1.35; P=0.262) and cardiovascular death (men: relative risk, 2.95; 95% CI, 1.20 to 7.21; P=0.018; women: relative risk, 0.639; 95% CI, 0.26 to 1.56; P=0.324).

Conclusions--Relaxin is an independent risk factor predicting death in male patients with ESKD on chronic hemodialysis.

Key words: cardiovascular diseases • kidney • risk factors • mortality

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