Association between plasma concentrations of galectin 3, growth differentiation factor 15, soluble suppression of tumourigenicity 2, and cystatin C and clinical parameters and survival in patients with end-stage renal disease undergoing haemodialysis

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Abstract
The treatment of chronic kidney disease is based mainly on haemodialysis. During this procedure, cardiovascular haemodynamic parameters change, which can lead to complications in the circulatory system and shorten patient survival. Currently, new biomarkers are being sought that could predict survival in haemodialysis patients. The aim of this study was to evaluate whether Gal-3, GDF-15, sST2, and CysC could be useful biomarkers in patients with end-stage renal failure undergoing haemodialysis in predicting the patient survival. This study included 76 patients with end-stage kidney disease treated with haemodialysis. We assessed the variability in the plasma concentrations of these proteins; evaluated correlations between Gal-3, GDF-15, and sST2 concentrations and selected haemodialysis parameters; and determined the relationship between the risk of death and Gal-3, GDF-15, sST2, and CysC concentrations. There was a decrease in the Gal-3 plasma concentrations and an increase in the GDF-15 and sST2 plasma concentrations during haemodialysis. Among the studied proteins, only the sST2 concentrations differed significantly between the patients who survived and died. The logarithm of the sST2 concentrations, both before and after haemodialysis, was an independent mortality risk factor in univariate analysis (respectively: hazard ratio [HR] 3.179, 95% confidence interval [CI] 1.492–6.777, p = 0.0027, and HR 3.011, 95% CI 1.447–6.264, p = 0.0032) and multivariate analysis, which also included age, male gender, and body mass index (respectively: HR 2.776, 95% CI 1.306–5.903, p = 0.0080, and HR 2.496, 95% CI 1.224–5.090, p = 0.012). These results suggest the use of sST2 in clinical practice to identify patients at higher risk of death.

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