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Klotho and lean mass as novel cardiovascular risk factors in hemodialysis patients

2023-12Artigo científico Acesso aberto
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dc.contributor.authorMartins, Ana Rita
dc.contributor.authorAzeredo-Lopes, Sofia
dc.contributor.authorPereira, Sofia Azeredo
dc.contributor.authorSA, Pereira
dc.contributor.authorMoreira, Inês
dc.contributor.authorWeigert, André Luíz
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutioniNOVA4Health - pólo NMS
dc.contributor.pblOxford University Press
dc.date.accessioned2023-12-12T22:51:16Z
dc.date.available2023-12-12T22:51:16Z
dc.date.issued2023-12
dc.description.abstractBACKGROUND: Patients with chronic kidney disease (CKD) present a higher risk of cardiovascular (CV) morbidity and mortality compared with the general population. While there are several well-established traditional CV risk factors, few studies have addressed novel potential risk factors such as α-Klotho, asymmetric dimethylarginine (ADMA) and lean mass. METHODS: This was an observational, prospective, single-center, cohort study that included prevalent hemodialysis (online hemodiafiltration) adult patients. By univariate logistic regression models, univariate and multivariate Cox proportional hazards models, and Kaplan-Meier analysis, we evaluated the association between the levels of α-Klotho, ADMA and lean mass, with the risk of peripheral vascular disease (PVD), CV events and all-cause mortality in these patients. RESULTS: A total of 200 HD patients was included. We found that increased levels of log-α-Klotho were significantly associated with decreased odds of both PVD [odds ratio (OR) 0.521, 95% confidence interval (CI) 0.270-0.954, P = .034] and CV events (OR 0.415, 95% CI 0.203-0.790, P = .01), whereas increased levels of log-ADMA were only significantly associated with increased odds of PVD (OR 13.482, 95% CI 5.055-41.606, P < .001). We also found that the levels of log-α-Klotho (HR 0.357, 95% CI 0.140-0.906, P < .05) and lean mass (HR 0.187, 95% CI 0.042-0.829, P < .05), but not log-ADMA, were significantly associated with the risk of all-cause mortality, even after adjusting for possible confounding variables. CONCLUSIONS: Novel long-term clinical associations were generated that support α-Klotho and lean mass as novel CV risk factors in hemodialysis patients.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent10
dc.format.extent961758
dc.identifier.doi10.1093/ckj/sfad166
dc.identifier.issn2048-8505
dc.identifier.otherPURE: 77751111
dc.identifier.otherPURE UUID: 0160e002-cd6a-4c15-97d9-2ac76ce97caa
dc.identifier.otherPubMed: 38046042
dc.identifier.otherPubMedCentral: PMC10689163
dc.identifier.otherORCID: /0000-0002-8456-9995/work/151411445
dc.identifier.otherScopus: 85184770526
dc.identifier.urihttp://hdl.handle.net/10362/161161
dc.language.isoeng
dc.peerreviewedyes
dc.subjectADMA
dc.subjectbioimpedance
dc.subjectbiomarkers
dc.subjectmortality
dc.subjectperipheral vascular disease
dc.titleKlotho and lean mass as novel cardiovascular risk factors in hemodialysis patientsen
dc.typejournal article
degois.publication.firstPage2587
degois.publication.issue12
degois.publication.lastPage2596
degois.publication.titleClinical kidney journal
degois.publication.volume16
dspace.entity.typePublication
person.familyNamede Azeredo Pereira
person.givenNameSofia
person.identifier562223
person.identifier.ciencia-id6B13-7601-73A2
person.identifier.orcid0000-0002-8456-9995
person.identifier.ridM-2976-2019
person.identifier.scopus-author-id35190948700
rcaap.rightsopenAccess
relation.isAuthorOfPublicationf4809377-832b-40b5-92ca-0bb1c6fe14f3
relation.isAuthorOfPublication.latestForDiscoveryf4809377-832b-40b5-92ca-0bb1c6fe14f3

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