SUN-072 PROGNOSTIC VALUE OF SOLUBLE ST2 AND SOLUBLE LR11 ON MORTALITY AND CARDIOVASCULAR EVENT IN PERITONEAL DIALYSIS PATIENTS

Abstract

Because end-stage renal disease (ESRD) patients are at high risk of cardiovascular (CV) disease, developing a biomarker for CV risk stratification has clinical importance. Soluble form of suppression of tumorigenicity 2 (sST2) and soluble low-density lipoprotein receptor relative with 11 ligand-binding repeats (sLR11) are emerging CV biomarkers, however, to date, the prognostic value of those has not been investigated in patients undergoing peritoneal dialysis (PD). We determined serum sST2 and sLR11 concentrations using enzyme-linked immunosorbent assay, and evaluated the association of those biomarkers with all-cause mortality and major adverse cardiac and cerebrovascular event (MACCE) in 74 prevalent PD patients. The median (interquartile range) concentrations of sST2 and sLR11 were 70.9 (57.8-89.8) ng/mL and 15.2 (12.3-19.6) ng/mL, respectively. During a median follow-up of 38.5 months, 13 (17.6%) patients died and MACCE was observed in 23 (31.3%) patients. When patients were dichotomized by the median value of sST2 and sLR11, Kaplan-Meier analyses showed that higher sST2 group was significantly associated with lower event-free survival rates (log-rank test; P=0.002 for all-cause death; P=0.01 for MACCE). In multivariable Cox analyses, higher sST2 was independent risk factor for all-cause mortality (per 1 standard deviation [SD] increase; hazard ratio [HR]=1.947; 95% confidence interval [CI]=1.124-3.371) and MACCE (per 1 SD increase; HR=1.647; 95% CI=1.079-2.516). In contrast, sLR11 did not have a significant association with all-cause mortality or MACCE. Furthermore, only sST2 provided a significant predictive value for all-cause mortality (AUC=0.699; P=0.03). sST2, not sLR11, was independently associated with greater risk of all-cause mortality and CV outcome in prevalent PD patients. Additional studies are needed to confirm these findings and examine underlying mechanism between new biomarkers and CV disease in ESRD populations