Serum Surfactant Protein D is Associated with Atherosclerosis of the Carotid Artery in Patients on Maintenance Hemodialysis.

Abstract

Surfactant protein-D (SP-D) is an inflammatory modulator that has been associated with cardiovascular disease-related mortality, estimated glomerular filtration rate, and major adverse cardiac events in patients with chronic kidney disease. The aim of this study was to investigate the link between SP-D level and atherosclerosis in patients on hemodialysis. A total of 116 patients undergoing maintenance hemodialysis were recruited to this cross-sectional study. As a marker of atherosclerosis, the carotid artery intima-media thickness (CA-IMT) was measured by high-resolution ultrasonography, and the coronary artery calcification (CAC) score was determined by multislice computed tomography. Serum SP-D levels were measured by a commercial enzyme-linked immunosorbent assay kit. In patients on long-term hemodialysis, the mean serum SP-D level was 192.9 +/- 89.6 pg/mL (range: 89-537 pg/mL). The serum SP-D level exhibited positive correlations with CA-IMT (r = 0.497, p < 0.0001) and severe CAC (r = 0.352, p = 0.02), which persisted after multivariate adjustment. The SP-D level showed positive correlations with carotid CA-IMT and CAC in patients on long-term hemodialysis. Therefore, SP-D may be a novel marker of atherosclerosis in patients with hemodialysis.