Title:Relation between Soluble CD14 Levels, Inflammation, Subclinical Atherosclerosis
and Mortality in Hemodialysis Patients
Volume: 23
Issue: 6
Author(s): Amany Mohamed Abdallah, Heba Elhakeem, Mohamed Basiouny Yahia*, Eman Mohy Ibrahim Youssef, Nashwa El-Khouly, Ghada Fathy Elmohaseb, Eman Abu-Elnasr Awad, Marwa Mohamed Hassan, Esam Mohamed Ghamry, Mohamed Rashed Abdelhamed, Essam Kotb and Tamer Mohamed Mahmoud
Affiliation:
- Clinical Pathology Department, Al-Azhar University Cairo, Egypt
Keywords:
Chronic kidney disease, hemodialysis, soluble CD14, atherosclerosis, inflammation, hsCRP.
Abstract:
Background and Aim: Chronic kidney disease (CKD) is characterized by persistent lowgrade
inflammation. Soluble CD14 (sCD14) is involved in many pathological conditions, including
inflammation and atherosclerosis. The present study aimed to assess the relationship between
sCD14 levels, subclinical atherosclerosis (SCA), inflammation and mortality in Egyptian hemodialysis
(HD) patients.
Patients and Methods: The present longitudinal study included 62 HD patients. All patients were
submitted to careful history taking, thorough clinical examination and laboratory assessment for
high-sensitivity C-reactive protein (hsCRP) and sCD14. Carotid intima-media thickness (CIMT)
was also assessed. Patients were followed for a maximum of 18 months. The primary outcome is
patients’ mortality. Data were statistically analyzed using standard descriptive, comparative, correlative
and regression methods.
Results: The present study was conducted on 62 HD patients. They comprised 34 males and 28
females with an age of 54.6 ± 9.0 years. At the end of follow-up, 12 patients (19.4 %) died. It was
shown that survivors had significantly lower hsCRP levels (104.2 ± 38.2 versus 134.1 ± 15.3 mg/dL,
p < 0.001), lower sCD14 levels (32.7 ± 10.3 versus 47.4 ± 18.4 μg/mL, p = 0.02) and lower CIMT
(1.32 ± 0.5 versus 1.5 ± 0.2 mm, p = 0.049). sCD14 levels were significantly correlated with hsCRP
(r = 0.4, p = 0.001) and CIMT (r = 0.31, p = 0.013). Multivariate analysis identified HD duration
[HR (95% CI): 1.02 (1.0-1.04), p = 0.021] and sCD14 levels [HR (95% CI): 1.06 (1.0-1.12), p =
0.026] as significant predictors of patients’ survival.
Conclusions: sCD14 levels in this cohort of HD patients are well-correlated with hsCRP levels and
CIMT. In addition, they are significant predictors of patients’ mortality.