Background: Cardiovascular disease is the leading cause of death in chronic kidney disease populations. The risk of major adverse cardiovascular events (MACE) is greater than that of progression to end-stage kidney disease. An exponential increase in mortality risk is associated with declining kidney function. This study aimed to review the current landscape of traditional and novel blood biomarkers in predicting MACE in ESKD patients.
Methods: The systematic review was registered on PROSPERO (CRD42024497403). Standard and extensive Cochrane search methods were used. The latest search date was July 2023. Participants were aged ≥18 years with end-stage kidney disease. Descriptive analysis was performed and data was presented in tabular form. The hazard ratio or odds ratio was presented for potential biomarkers discovered.
Results: Overall, 14 studies (4965 participants) were included for analysis; 12 focused on participants requiring haemodialysis and 2 on haemodialysis and peritoneal dialysis. The biomarkers analysed were Troponin I (
n = 3), Troponin T (
n = 3), B-type natriuretic peptide (
n = 2), N-Terminal Pro-Brain-Natriuretic Peptide (
n = 7), soluble receptors for advanced glycation end products (
n = 2), Galectin 3 (
n = 4), and the serum-soluble suppression of tumorigenicity-2 (
n = 2). Reported study outcomes included all-cause mortality (
n = 11), MACE (
n = 5), cardiac specific mortality (
n = 6), sudden cardiac death (
n = 2), and first cardiovascular event (
n = 3).
Conclusions: This review outlines the potential role of traditional and novel biomarkers in predicting MACE in end-stage kidney disease. Further larger-scale research is required to establish the validity of the study outcomes to develop new methods of cardiovascular risk prediction in this high-risk population.
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