Tuegel C, et al. - Researchers investigated the association of growth differentiation factor 15 (GDF-15), galectin 3 (Gal-3), and soluble ST2 (sST2) with all-cause mortality, hospitalization for physician-adjudicated heart failure and the atherosclerotic cardiovascular disease (CVD) events of myocardial infarction and cerebrovascular accident in patients with chronic kidney disease (CKD). Among adult CKD patients, greater mortality was reported in those who exhibited higher circulating GDF-15, Gal-3, and sST2 concentrations. Also, a correlation was observed between elevated GDF-15 concentration and an increased rate of heart failure.

Methods

• This observational cohort study included individuals with CKD enrolled in either of 2 multicenter CKD cohort studies: the Seattle Kidney Study or C-PROBE (Clinical Phenotyping and Resource Biobank Study).
• Circulating GDF-15, Gal-3, and sST2 measured at baseline were included as exposures.
• All-cause mortality was the primary outcome, and hospitalization for physician-adjudicated heart failure and the atherosclerotic CVD events of myocardial infarction and cerebrovascular accident were secondary outcomes.
• Researchers used Cox proportional hazards models adjusted for demographics, CVD risk factors, and kidney function to assess the association of each biomarker with each outcome.

Results

• They found a mean estimated glomerular filtration rate of 49 ± 19 mL/min/1.73 m² among 883 participants.
• Higher GDF-15 (adjusted HR [aHR] per 1-SD higher, 1.87; 95% CI, 1.53-2.29), Gal-3 (aHR per 1-SD higher, 1.51; 95% CI, 1.36-1.78), and sST2 (aHR per 1-SD higher, 1.36; 95% CI, 1.17-1.58) concentrations had a significant association with mortality.
• They observed that only GDF-15 level was also related to heart failure events (HR per 1-SD higher, 1.56; 95% CI, 1.12-2.16).
• Findings demonstrated no detectable links between GDF-15, Gal-3, or sST2 concentrations and atherosclerotic CVD events.