Abstract

Background: Both soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are promising biomarkers associated with the adverse clinical outcomes of dialysis patients. Our research aims at exploring and comparing the roles of sST2 and NT-proBNP in predicting the short-term and long-term mortality of maintenance hemodialysis (MHD) patients.

Methods: A prospective cohort study was performed. Patients undergoing hemodialysis in July 2014 were enrolled from the Blood Purification Center of Ruijin Hospital. MHD patients were followed up for 3 years. The primary outcome was all-cause mortality at the 1-year and 3-year follow-up, while the secondary outcome was cardiovascular mortality. Serum sST2 level was detected by quantified ELISA kits. Clinical data were analyzed by SPSS 23.0 version.

Results: 205 patients were recruited. The median sST2 level was 15.99 (11.60, 20.49) ng/ml. After 3 years of follow-up, both all-cause and cardiovascular mortality in 1 year and all-cause and cardiovascular mortality in 3 years increased significantly with serum sST2. For short-term mortality, no significant difference was observed in patients with increasing NT-proBNP levels. Cox regression analysis indicated that only sST2 was independent in predicting the risk of short-term outcomes. For long-term mortality, both sST2 and NT-proBNP were independent risk factors, while a higher hazard ratio was observed for NT-proBNP.

Conclusions: Serum sST2 is a novel biomarker associated with adverse clinical outcomes in MHD patients. It was significant for both all-cause and cardiovascular mortality in MHD patients and may provide better prognostic value in short-term prognosis than the classic biomarker NT-proBNP.

摘要

背景：致瘤性2（sST2）和N端脑钠肽前体（NT-proBNP）的可溶性抑制都是与透析患者不良临床结局相关的有前途的生物标志物。我们的研究旨在探索和比较sST2和NT-proBNP在预测维持性血液透析（MHD）患者的短期和长期死亡率中的作用。

方法：进行一项前瞻性队列研究。2014年7月接受血液透析的患者来自瑞金医院血液净化中心。MHD患者随访3年。主要结果是在1年和3年随访中的全因死亡率，而次要结果是心血管疾病死亡率。通过定量ELISA试剂盒检测血清sST2水平。临床数据通过SPSS 23.0版进行分析。

结果：招募了205例患者。sST2中位数为15.99（11.60，20.49）ng / ml。经过3年的随访，血清sST2显着增加了1年全因和心血管死亡率，以及3年全因和心血管死亡率。对于短期死亡率，NT-proBNP水平升高的患者无明显差异。Cox回归分析表明，只有sST2在预测短期结果的风险中是独立的。对于长期死亡率，sST2和NT-proBNP都是独立的危险因素，而NT-proBNP的危险比更高。

结论：血清sST2是与MHD患者不良临床结局相关的新型生物标志物。与经典生物标志物NT-proBNP相比，它对MHD患者的全因死亡率和心血管死亡率均具有重要意义，并且可能在短期预后方面提供更好的预后价值。