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J Am Heart Assoc DOI:10.1161/JAHA.113.000542

A plasma long-chain acylcarnitine predicts cardiovascular mortality in incident dialysis patients.

Publication TypeJournal Article
Year of Publication2013
AuthorsKalim, S, Clish, CB, Wenger, J, Elmariah, S, Yeh, RW, Deferio, JJ, Pierce, K, Deik, A, Gerszten, RE, Thadhani, R, Rhee, EP
JournalJ Am Heart Assoc
Date Published2013 Dec 05
KeywordsAged, Aged, 80 and over, Biomarkers, Cardiovascular Diseases, Carnitine, Case-Control Studies, Chi-Square Distribution, Chromatography, Liquid, Female, Humans, Kidney Failure, Chronic, Logistic Models, Male, Mass Spectrometry, Metabolomics, Middle Aged, Multivariate Analysis, Odds Ratio, Prospective Studies, Renal Dialysis, Risk Factors, Time Factors, Treatment Outcome, Uremia

BACKGROUND: The marked excess in cardiovascular mortality that results from uremia remains poorly understood.

METHODS AND RESULTS: In 2 independent, nested case-control studies, we applied liquid chromatography-mass spectrometry-based metabolite profiling to plasma obtained from participants of a large cohort of incident hemodialysis patients. First, 100 individuals who died of a cardiovascular cause within 1 year of initiating hemodialysis (cases) were randomly selected along with 100 individuals who survived for at least 1 year (controls), matched for age, sex, and race. Four highly intercorrelated long-chain acylcarnitines achieved the significance threshold adjusted for multiple testing (P

CONCLUSIONS: Our data highlight clinically meaningful alterations in acylcarnitine homeostasis at the time of dialysis initiation, which may represent an early marker, effector, or both of uremic cardiovascular risk.


Alternate JournalJ Am Heart Assoc
PubMed ID24308938
PubMed Central IDPMC3886735
Grant ListK08 DK090142 / DK / NIDDK NIH HHS / United States
K24 DK094872 / DK / NIDDK NIH HHS / United States
K08-DK-090142 / DK / NIDDK NIH HHS / United States
R21-DK-071674 / DK / NIDDK NIH HHS / United States