Abstract 11743: Galectin-3 and Outcomes in Patients with End-Stage Renal Disease: Data from the German Diabetes and Dialysis Study
Background - Galectin-3 is involved in fibrosis and inflammation and has emerged as a biomarker in heart failure. Experimental data suggest that galectin-3 is also linked to renal fibrosis associated with renal failure. Galectin-3 targeted therapy may inhibit this process. We evaluated if plasma galectin-3 levels are associated with poor outcome in patients with end stage renal disease (ESRD).
Methods - This study examined the association of galectin-3 with clinical outcomes in 1255 diabetic hemodialysis patients participating in the German Diabetes and Dialysis Study. Galectin-3 was measured in baseline blood samples by ELISA. During a median follow-up of 4 years, 617 patients died (49%). By Cox regression analysis, we assessed the association of galectin-3 with the development of all cause mortality, death due to infection, sudden cardiac death, death due to heart failure, cardiovascular (CV) events, myocardial infarction, and stroke. The analyses were adjusted for known predictors of adverse outcome including age, gender, smoking status, blood pressure, BMI, LDL and HDL cholesterol and atorvastatin treatment.
Results - Study participants had an average age of 66±8 years, systolic blood pressure of 146±22 mmHg and 54% were male. Mean Galectin-3 levels were 54±20 ng/mL, being highly elevated. Patients with higher galectin-3 levels more often were female, had left ventricular hypertrophy, peripheral vascular disease and higher circulating levels of potassium, phosphate and NT-proBNP. Galectin-3 level, as a continuous variable, independently predicted all cause mortality (adjusted hazard ratio: 1.35 [95%CI 1.06-1.71]). Similarly, with each unit increase in Galectin-3 (log transformed), the risk of CV events increased by 45% (HR 1.45 [1.11-1.91]), and the riks of stroke more than doubled (HR 2.15 [1.18-3.94]). High galectin-3 levels significantly predicted deaths due to infection (HR 1.80 [1.07-3.03]), this was particularly strong in female subjects (HR 2.88 [1.21-6.83]).
Conclusions - High Galectin-3 is an independent predictor of poor outcome in patients with ESRD, being associated with all-cause and infectious mortality, stroke and CV events. The precise role of galectin-3 in the pathophysiology of renal disease warrants further study.
- © 2011 by American Heart Association, Inc.