Hepatocyte growth factor as a long‑term predictor for total and cardiovascular mortality in patients on peritoneal dialysis

Abstract

Hepatocyte growth factor (HGF) is a regenerative protein involved in tissue protection and endothelial repair in response to injury. The aim of the study was to assess the effect of increased HGF levels on total and cardiovascular (CV) mortality in patients on peritoneal dialysis (PD) during 6‑year follow‑up. The study included 55 patients (mean age, 53 years; median duration of PD, 24 months). The ejection fraction (EF) and calcium score (CaSc) were measured. White blood cell (WBC) count and albumin, calcium (Ca), phosphorus (Pi), intact parathormone (iPTH), and high‑sensitivity C‑reactive protein (hsCRP) levels were measured. Serum levels of HGF, interleukin (IL) 6, and IL‑18 were determined using enzyme‑linked immunosorbent assays. Of all patients, 45% died within 6 years, including 80% from CV complications. HGF significantly correlated with the total (hazard ratio [HR], 1.97; P = 0.03) and CV (HR, 2.04; P = 0.04) mortality in a univariate Cox regression model. This was confirmed by a multiple model including age, dialysis duration, residual renal function (RRF), albumin, Ca × Pi, EF, and CaSc (HR, 2.24; P = 0.02 and HR, 2.58; P = 0.02 for total and CV mortality, respectively). Factors negatively affecting patients' survival included WBC count, hsCRP, IL‑6, and CaSc, while higher albumin levels and EF were associated with longer overall survival. HGF positively correlated with WBC count (r = 0.30, P = 0.01), hsCRP (r = 0.25, P = 0.04), IL‑6 (r = 0.46, P = 0.0004), CaSc (r = 0.29, P = 0.03), and mean arterial pressure (r = 0.25; P = 0.04) and negatively with RRF (r = -0.31, P = 0.02). Increased concentrations of proinflammatory cytokines and an association between HGF levels and CaSc may indicate higher total and CV mortality in patients on PD.