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NDT Advance Access published online on June 26, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp315
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Associations of VEGF and its receptors sVEGFR-1 and -2 with cardiovascular disease and survival in prevalent haemodialysis patients

Qunying Guo2, Juan Jesús Carrero1, Xueqing Yu2, Peter Bárány1, Abdul Rashid Qureshi1, Monica Eriksson1, Björn Anderstam1, Michal Chmielewski1, Olof Heimbürger1, Peter Stenvinkel1, Bengt Lindholm1 and Jonas Axelsson1

1 Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden 2 Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

Correspondence and offprint requests to: Bengt Lindholm; E-mail: bengt.lindholm{at}ki.se



  Abstract

Background. Vascular endothelial growth factor (VEGF) was recently shown to predict survival in prevalent haemodialysis patients. Soluble VEGF receptors (sVEGFR)-1 and -2 are circulating endogenous modulators of VEGF activity. We thus studied the relationship between sVEGFR-1 and -2 and survival in a cohort of prevalent haemodialysis (HD) patients.

Methods. Components of the VEGF system were measured (ELISAs) in 185 prevalent HD patients and levels related to clinical characteristics, biochemical markers and survival. The patients were followed up prospectively for a median 31 (20–37) months.

Results. While ischaemic heart disease was independently associated with a lower sVEGFR-2 (OR = 2.75, P = 0.02), sVEGFR-1 was positively associated with IL-6 ({rho} = 0.22, P = 0.003) and white blood cell count ({rho} = 0.22, P = 0.002). In survival analysis, the patients with a high sVEGFR-1 level had a higher all-cause mortality (Kaplan–Meier Chi-Square = 5.6, P = 0.02) and a higher adjusted mortality risk (Cox HR = 1.93, P = 0.009) than those with low levels.

Conclusion. In the first clinical study of sVEGFR-1 and -2 in CKD, we found novel associations between the sVEGFRs and cardiac disease. This may be of clinical importance, as a high sVEGFR-1 was an independent risk factor for all-cause mortality.

Keywords: CKD; ischaemia; inflammation

Received for publication: 29.11.08
Accepted in revised form: 3. 6.09


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