#3642 SERUM APELIN AND RENAL PROGNOSIS IN PATIENTS WITH NON-DIALYSIS DEPENDENT CHRONIC KIDNEY DISEASE

Abstract

Abstract Background and Aims The apelin/APJ system is a novel pleiotropic system with an essential role in renal and cardiovascular physiology and disease. A role for the apelin/APJ system in diverse pathological states, including disorders of sodium and water balance, hypertension, heart failure, pre-eclampsia, acute kidney injury, sepsis and diabetic nephropathy, has recently been reported. Especially, the impact of apelin/APJ system on cardiovascular system has been attracting attention, but scarce data is available in chronic kidney disease (CKD). Method We measured serum apelin-36 by ELISA in 411 outpatients with non-dialysis dependent (NDD) CKD and analyzed factors associated with serum apelin. Furthermore, we examined the association of serum apelin with renal outcome (renal replacement therapy, RRT) using multivariate Cox proportional hazards model. Results Median age and eGFR were 71 years and 21.7 ml/min/1.73 m2, respectively and the prevalence of male gender and diabetes was 26.8% and 50.8%, respectively. Median serum apelin was 0.81pg/ml. There was no significant difference in serum apelin level between male and female patients, or those with and without diabetes. Moreover, serum apelin level had no significant association with age and eGFR; however, there was a significant relationship between serum apelin and brain natriutetic peptide. During the follow-up period of 38 months, 126 patients started RRT. eGFR and age were associated with the time to RRT induction. Serum apelin was not associated with renal outcome (HR, 1.05; 95%CI, 0.64-1.71; P,0.86); however, this association was interacted by diabetes and gender (P for interaction, 0.073 and 0.070, respectively). Conclusion Serum apelin could be a predictive marker of renal prognosis in male and non-diabetic CKD patients.