Next Article in Journal
Isolation of a Novel Microcystin-Degrading Bacterium and the Evolutionary Origin of mlr Gene Cluster
Next Article in Special Issue
Selective Transport of Protein-Bound Uremic Toxins in Erythrocytes
Previous Article in Journal
Endothelial Microparticles in Uremia: Biomarkers and Potential Therapeutic Targets
Previous Article in Special Issue
Uremic Toxin Concentrations are Related to Residual Kidney Function in the Pediatric Hemodialysis Population
Open AccessArticle

Connective Tissue Growth Factor Is Related to All-cause Mortality in Hemodialysis Patients and Is Lowered by On-line Hemodiafiltration: Results from the Convective Transport Study

1
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht 3584 CX, The Netherlands
2
Department of Internal Medicine, Maasstad Hospital, Rotterdam 3079 DZ, The Netherlands
3
Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, Nephrology, Amsterdam 1081 HV, The Netherlands
4
Department of Pathology, University Medical Center Utrecht, Utrecht 3584 CX, The Netherlands
5
Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht 3584 CG, The Netherlands
6
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, 3508 GA Utrecht, The Netherlands
*
Author to whom correspondence should be addressed.
Both authors contributed equally.
Toxins 2019, 11(5), 268; https://doi.org/10.3390/toxins11050268
Received: 5 April 2019 / Revised: 26 April 2019 / Accepted: 8 May 2019 / Published: 13 May 2019
(This article belongs to the Special Issue Disposition of Uremic Toxins: The Challenges in Uremia)
Connective tissue growth factor (CTGF) plays a key role in the pathogenesis of tissue fibrosis. The aminoterminal fragment of CTGF is a middle molecule that accumulates in chronic kidney disease. The aims of this study are to explore determinants of plasma CTGF in hemodialysis (HD) patients, investigate whether CTGF relates to all-cause mortality in HD patients, and investigate whether online-hemodiafiltration (HDF) lowers CTGF. Data from 404 patients participating in the CONvective TRAnsport STudy (CONTRAST) were analyzed. Patients were randomized to low-flux HD or HDF. Pre-dialysis CTGF was measured by sandwich ELISA at baseline, after six and 12 months. CTGF was inversely related in multivariable analysis to glomerular filtration rate (GFR) (p < 0.001) and positively to cardiovascular disease (CVD) (p = 0.006), dialysis vintage (p < 0.001), interleukin-6 (p < 0.001), beta-2-microglobulin (p = 0.045), polycystic kidney disease (p < 0.001), tubulointerstitial nephritis (p = 0.002), and renal vascular disease (p = 0.041). Patients in the highest quartile had a higher mortality risk compared to those in the lowest quartile (HR 1.7, 95% CI: 1.02–2.88, p = 0.043). HDF lowered CTGF with 4.8% between baseline and six months, whereas during HD, CTGF increased with 4.9% (p < 0.001). In conclusion, in HD patients, CTGF is related to GFR, CVD and underlying renal disease and increased the risk of all-cause mortality. HDF reduces CTGF. View Full-Text
Keywords: Connective tissue growth factor; CCN intercellular signalling proteins; haemodialysis; haemodiafiltration; convection; end stage kidney disease; cardiovascular disease; mortality Connective tissue growth factor; CCN intercellular signalling proteins; haemodialysis; haemodiafiltration; convection; end stage kidney disease; cardiovascular disease; mortality
Show Figures

Figure 1

MDPI and ACS Style

den Hoedt, C.H.; van Gelder, M.K.; Grooteman, M.P.; Nubé, M.J.; Blankestijn, P.J.; Goldschmeding, R.; Kok, R.J.; Bots, M.L.; van den Dorpel, M.A.; Gerritsen, K.G.F. Connective Tissue Growth Factor Is Related to All-cause Mortality in Hemodialysis Patients and Is Lowered by On-line Hemodiafiltration: Results from the Convective Transport Study. Toxins 2019, 11, 268.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop