Protein C and protein S deficiencies may be related to survival among hemodialysis patients

Mayuri Ichinose, Naru Sasagawa, Tetsuo Chiba, Katsuhide Toyama, Yuzo Kayamori, Dongchon Kang

Research output: Contribution to journalArticle

Abstract

Background: Thrombophilia due to protein C (PC) and protein S (PS) deficiencies is highly prevalent among patients with stage 5 chronic kidney disease and is reported to arise due to extracorporeal circulation during hemodialysis (HD). This study aimed to evaluate the relationship between HD treatment and thrombophilia. Methods: A total of 114 Japanese patients on maintenance HD (62 men, 52 women) were followed during 2008-2011. Their survival rates were compared against the duration of HD. Prior to each HD, coagulation/fibrinolysis parameters and PC and PS activities were measured using standard techniques. The patients were divided into two groups: Group 1, with PC and/or PS deficiencies (n = 32), and Group 2, without PC and PS deficiencies (n = 82). The influence of such deficiencies and duration of dialysis on survival was examined. Time-to-event analysis was applied using Kaplan-Meier estimates, and the log-rank test was proposed to test the equivalence of relative survival data. Hazard ratios and 95% confidence intervals (CI) were calculated. Results: Of the 114 patients, 37 died (Group 1, 22; Group 2, 15). The hazard ratio (95% CI) was higher (p = 0.004) in Group 1 than Group 2. Gene analyses of PC and PS were performed in 14 patients from Group 1. No mutations in either protein were observed. We analyzed the causes of death in both groups; however, the estimated thrombophilia-related incidence of death could not be determined due to small sample size of HD patients. Conclusions: Our results suggest that PC and PS deficiencies may be related to survival in HD patients. However, this finding warrants additional research.

Original languageEnglish
Article number191
JournalBMC Nephrology
Volume20
Issue number1
DOIs
Publication statusPublished - May 28 2019

Fingerprint

Protein S Deficiency
Protein C
Renal Dialysis
Survival
Thrombophilia
Protein S
Confidence Intervals
Extracorporeal Circulation
Kaplan-Meier Estimate
Fibrinolysis
Chronic Renal Insufficiency
Sample Size
Dialysis
Cause of Death
Proteins
Survival Rate
Maintenance
Mutation
Incidence

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Protein C and protein S deficiencies may be related to survival among hemodialysis patients. / Ichinose, Mayuri; Sasagawa, Naru; Chiba, Tetsuo; Toyama, Katsuhide; Kayamori, Yuzo; Kang, Dongchon.

In: BMC Nephrology, Vol. 20, No. 1, 191, 28.05.2019.

Research output: Contribution to journalArticle

Ichinose, Mayuri ; Sasagawa, Naru ; Chiba, Tetsuo ; Toyama, Katsuhide ; Kayamori, Yuzo ; Kang, Dongchon. / Protein C and protein S deficiencies may be related to survival among hemodialysis patients. In: BMC Nephrology. 2019 ; Vol. 20, No. 1.
@article{9560ffda3ca04fbc8ac8f1e65b34c380,
title = "Protein C and protein S deficiencies may be related to survival among hemodialysis patients",
abstract = "Background: Thrombophilia due to protein C (PC) and protein S (PS) deficiencies is highly prevalent among patients with stage 5 chronic kidney disease and is reported to arise due to extracorporeal circulation during hemodialysis (HD). This study aimed to evaluate the relationship between HD treatment and thrombophilia. Methods: A total of 114 Japanese patients on maintenance HD (62 men, 52 women) were followed during 2008-2011. Their survival rates were compared against the duration of HD. Prior to each HD, coagulation/fibrinolysis parameters and PC and PS activities were measured using standard techniques. The patients were divided into two groups: Group 1, with PC and/or PS deficiencies (n = 32), and Group 2, without PC and PS deficiencies (n = 82). The influence of such deficiencies and duration of dialysis on survival was examined. Time-to-event analysis was applied using Kaplan-Meier estimates, and the log-rank test was proposed to test the equivalence of relative survival data. Hazard ratios and 95{\%} confidence intervals (CI) were calculated. Results: Of the 114 patients, 37 died (Group 1, 22; Group 2, 15). The hazard ratio (95{\%} CI) was higher (p = 0.004) in Group 1 than Group 2. Gene analyses of PC and PS were performed in 14 patients from Group 1. No mutations in either protein were observed. We analyzed the causes of death in both groups; however, the estimated thrombophilia-related incidence of death could not be determined due to small sample size of HD patients. Conclusions: Our results suggest that PC and PS deficiencies may be related to survival in HD patients. However, this finding warrants additional research.",
author = "Mayuri Ichinose and Naru Sasagawa and Tetsuo Chiba and Katsuhide Toyama and Yuzo Kayamori and Dongchon Kang",
year = "2019",
month = "5",
day = "28",
doi = "10.1186/s12882-019-1344-8",
language = "English",
volume = "20",
journal = "BMC Nephrology",
issn = "1471-2369",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Protein C and protein S deficiencies may be related to survival among hemodialysis patients

AU - Ichinose, Mayuri

AU - Sasagawa, Naru

AU - Chiba, Tetsuo

AU - Toyama, Katsuhide

AU - Kayamori, Yuzo

AU - Kang, Dongchon

PY - 2019/5/28

Y1 - 2019/5/28

N2 - Background: Thrombophilia due to protein C (PC) and protein S (PS) deficiencies is highly prevalent among patients with stage 5 chronic kidney disease and is reported to arise due to extracorporeal circulation during hemodialysis (HD). This study aimed to evaluate the relationship between HD treatment and thrombophilia. Methods: A total of 114 Japanese patients on maintenance HD (62 men, 52 women) were followed during 2008-2011. Their survival rates were compared against the duration of HD. Prior to each HD, coagulation/fibrinolysis parameters and PC and PS activities were measured using standard techniques. The patients were divided into two groups: Group 1, with PC and/or PS deficiencies (n = 32), and Group 2, without PC and PS deficiencies (n = 82). The influence of such deficiencies and duration of dialysis on survival was examined. Time-to-event analysis was applied using Kaplan-Meier estimates, and the log-rank test was proposed to test the equivalence of relative survival data. Hazard ratios and 95% confidence intervals (CI) were calculated. Results: Of the 114 patients, 37 died (Group 1, 22; Group 2, 15). The hazard ratio (95% CI) was higher (p = 0.004) in Group 1 than Group 2. Gene analyses of PC and PS were performed in 14 patients from Group 1. No mutations in either protein were observed. We analyzed the causes of death in both groups; however, the estimated thrombophilia-related incidence of death could not be determined due to small sample size of HD patients. Conclusions: Our results suggest that PC and PS deficiencies may be related to survival in HD patients. However, this finding warrants additional research.

AB - Background: Thrombophilia due to protein C (PC) and protein S (PS) deficiencies is highly prevalent among patients with stage 5 chronic kidney disease and is reported to arise due to extracorporeal circulation during hemodialysis (HD). This study aimed to evaluate the relationship between HD treatment and thrombophilia. Methods: A total of 114 Japanese patients on maintenance HD (62 men, 52 women) were followed during 2008-2011. Their survival rates were compared against the duration of HD. Prior to each HD, coagulation/fibrinolysis parameters and PC and PS activities were measured using standard techniques. The patients were divided into two groups: Group 1, with PC and/or PS deficiencies (n = 32), and Group 2, without PC and PS deficiencies (n = 82). The influence of such deficiencies and duration of dialysis on survival was examined. Time-to-event analysis was applied using Kaplan-Meier estimates, and the log-rank test was proposed to test the equivalence of relative survival data. Hazard ratios and 95% confidence intervals (CI) were calculated. Results: Of the 114 patients, 37 died (Group 1, 22; Group 2, 15). The hazard ratio (95% CI) was higher (p = 0.004) in Group 1 than Group 2. Gene analyses of PC and PS were performed in 14 patients from Group 1. No mutations in either protein were observed. We analyzed the causes of death in both groups; however, the estimated thrombophilia-related incidence of death could not be determined due to small sample size of HD patients. Conclusions: Our results suggest that PC and PS deficiencies may be related to survival in HD patients. However, this finding warrants additional research.

UR - http://www.scopus.com/inward/record.url?scp=85066411876&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066411876&partnerID=8YFLogxK

U2 - 10.1186/s12882-019-1344-8

DO - 10.1186/s12882-019-1344-8

M3 - Article

C2 - 31138132

AN - SCOPUS:85066411876

VL - 20

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

IS - 1

M1 - 191

ER -