Von Willebrand factor, ADAMTS13 and mortality in dialysis patients

Abstract Background Von Willebrand Factor (VWF) multimers are cleaved into smaller and less coagulant forms by the metalloprotease ADAMTS13. The aim of this study was to investigate the association between VWF and ADAMTS13 and mortality in dialysis patients. Methods We prospectively followed 956 dia...

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Main Authors: Gurbey Ocak, Mark Roest, Marianne C. Verhaar, Maarten B. Rookmaaker, Peter J. Blankestijn, Willem Jan W. Bos, Rob Fijnheer, Nathalie C. Péquériaux, Friedo W. Dekker
Format: Article
Language:English
Published: BMC 2021-06-01
Series:BMC Nephrology
Subjects:
Online Access:https://doi.org/10.1186/s12882-021-02420-z
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author Gurbey Ocak
Mark Roest
Marianne C. Verhaar
Maarten B. Rookmaaker
Peter J. Blankestijn
Willem Jan W. Bos
Rob Fijnheer
Nathalie C. Péquériaux
Friedo W. Dekker
author_facet Gurbey Ocak
Mark Roest
Marianne C. Verhaar
Maarten B. Rookmaaker
Peter J. Blankestijn
Willem Jan W. Bos
Rob Fijnheer
Nathalie C. Péquériaux
Friedo W. Dekker
author_sort Gurbey Ocak
collection DOAJ
description Abstract Background Von Willebrand Factor (VWF) multimers are cleaved into smaller and less coagulant forms by the metalloprotease ADAMTS13. The aim of this study was to investigate the association between VWF and ADAMTS13 and mortality in dialysis patients. Methods We prospectively followed 956 dialysis patients. VWF levels and ADAMTS13 activity were measured. Cox proportional hazard analyses were used to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs) to investigate the association between quartiles of VWF levels and ADAMTS13 activity and all-cause mortality. HRs were adjusted for age, sex, body mass index, cardiovascular disease, dialysis modality, primary kidney disease, use of antithrombotic medication, systolic blood pressure, albumin, C-reactive protein and residual GFR. Results Of the 956 dialysis patients, 288 dialysis patients died within three years (mortality rate 151 per 1000 person-years). The highest quartile of VWF as compared with lower levels of VWF was associated with a 1.4-fold (95 %CI 1.1–1.8) increased mortality risk after adjustment. The lowest quartile of ADAMTS13 activity as compared with other quartiles was associated with a 1.3-fold (95 %CI 1.0-1.7) increased mortality risk after adjustment. The combination of the highest VWF quartile and lowest ADAMTS13 quartile was associated with a 2.0-fold (95 %CI 1.3-3.0) increased mortality risk as compared with the combination of the lowest VWF quartile and highest ADAMTS13 quartile. Conclusions High VWF levels and low ADAMTS13 activity were associated with increased mortality risks in dialysis patients.
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spelling doaj.art-ea26eec955a84e69841cb0bcf0a6601e2022-12-21T18:41:54ZengBMCBMC Nephrology1471-23692021-06-012211910.1186/s12882-021-02420-zVon Willebrand factor, ADAMTS13 and mortality in dialysis patientsGurbey Ocak0Mark Roest1Marianne C. Verhaar2Maarten B. Rookmaaker3Peter J. Blankestijn4Willem Jan W. Bos5Rob Fijnheer6Nathalie C. Péquériaux7Friedo W. Dekker8Department of Internal Medicine, Sint Antonius HospitalSynapse Research Institute, Cardiovascular Research InstituteDepartment of Nephrology and Hypertension, University Medical Center UtrechtDepartment of Nephrology and Hypertension, University Medical Center UtrechtDepartment of Nephrology and Hypertension, University Medical Center UtrechtDepartment of Internal Medicine, Sint Antonius HospitalDepartment of Internal Medicine, Meander Medical CenterDepartment of Clinical Chemistry and Hematology, Jeroen Bosch HospitalDepartment of Clinical Epidemiology, Leiden University Medical CenterAbstract Background Von Willebrand Factor (VWF) multimers are cleaved into smaller and less coagulant forms by the metalloprotease ADAMTS13. The aim of this study was to investigate the association between VWF and ADAMTS13 and mortality in dialysis patients. Methods We prospectively followed 956 dialysis patients. VWF levels and ADAMTS13 activity were measured. Cox proportional hazard analyses were used to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs) to investigate the association between quartiles of VWF levels and ADAMTS13 activity and all-cause mortality. HRs were adjusted for age, sex, body mass index, cardiovascular disease, dialysis modality, primary kidney disease, use of antithrombotic medication, systolic blood pressure, albumin, C-reactive protein and residual GFR. Results Of the 956 dialysis patients, 288 dialysis patients died within three years (mortality rate 151 per 1000 person-years). The highest quartile of VWF as compared with lower levels of VWF was associated with a 1.4-fold (95 %CI 1.1–1.8) increased mortality risk after adjustment. The lowest quartile of ADAMTS13 activity as compared with other quartiles was associated with a 1.3-fold (95 %CI 1.0-1.7) increased mortality risk after adjustment. The combination of the highest VWF quartile and lowest ADAMTS13 quartile was associated with a 2.0-fold (95 %CI 1.3-3.0) increased mortality risk as compared with the combination of the lowest VWF quartile and highest ADAMTS13 quartile. Conclusions High VWF levels and low ADAMTS13 activity were associated with increased mortality risks in dialysis patients.https://doi.org/10.1186/s12882-021-02420-zDialysisVon Willebrand FactorADAMTS13MortalityEpidemiology
spellingShingle Gurbey Ocak
Mark Roest
Marianne C. Verhaar
Maarten B. Rookmaaker
Peter J. Blankestijn
Willem Jan W. Bos
Rob Fijnheer
Nathalie C. Péquériaux
Friedo W. Dekker
Von Willebrand factor, ADAMTS13 and mortality in dialysis patients
BMC Nephrology
Dialysis
Von Willebrand Factor
ADAMTS13
Mortality
Epidemiology
title Von Willebrand factor, ADAMTS13 and mortality in dialysis patients
title_full Von Willebrand factor, ADAMTS13 and mortality in dialysis patients
title_fullStr Von Willebrand factor, ADAMTS13 and mortality in dialysis patients
title_full_unstemmed Von Willebrand factor, ADAMTS13 and mortality in dialysis patients
title_short Von Willebrand factor, ADAMTS13 and mortality in dialysis patients
title_sort von willebrand factor adamts13 and mortality in dialysis patients
topic Dialysis
Von Willebrand Factor
ADAMTS13
Mortality
Epidemiology
url https://doi.org/10.1186/s12882-021-02420-z
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