A new predictor of mortality in hemodialysis patients; Tenascin-C

Aim: Cardiovascular disease is the most frequent cause of mortality in hemodialysis patients. There are a number of inconsistencies in terms of cardiovascular risk factors in these patients. Tenascin C (TN-C) is a matricellular protein which may be a prognostic predictor after myocardial infarction and many cardiac diseases. The purpose of this study was to determine TN-C levels in hemodialysis patients and to evaluate the association between TN-C levels and cardiac mortality. Main methods: In this multicenter prospective observational research, blood specimens were collected at the start of the study for the measurement of TN-C and other biochemical parameters. After 2 years' follow-up we investigated the association between TN-C and other biochemical and demographic parameters and cardiac and all-cause mortality. Key findings: Two hundred thirty-eight patients and 25 healthy individuals were enrolled. TN-C levels in the hemodialysis group were higher than those in the control group (p < 0.001). All-cause mortality was observed in 47 (19%) patients and cardiac mortality in 39 (15%). At multivariate Cox regression analysis, TN-C, age and systolic blood pressure were identified as independent predictors of cardiac mortality. The Kaplan-Meier survival curve revealed greater all-cause and cardiac mortality rates in the high TN-C group (Log rank p < 0.001 and p < 0.05 respectively). Significance: TN-C levels were higher than those in the control group, and our results suggest that it may be a predictor of cardiac mortality in hemodialysis patients. If further studies support our research, TN-C may be a useful biomarker for detecting cardiac mortality risk. (C) 2015 Elsevier Inc. All rights reserved.