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Presepsin Level Correlates with the Development of Moderate Coronary Artery Calcifications in Hemodialysis Patients: A Preliminary Cross-Section Design Study

Authors Elhabashi AF, Sulaibeekh L, Seddiq N, Alali S, Abdulmajeed AK, Perez NS

Received 26 May 2020

Accepted for publication 22 July 2020

Published 3 August 2020 Volume 2020:13 Pages 999—1006


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Professor Marco Carotenuto

Ahmed F Elhabashi, Leena Sulaibeekh, Nahed Seddiq, Salman Alali, Amjad K Abdulmajeed, Nuria S Perez

Bahrain Defense Force Hospital, Royal Medical Services, Riffa, Kingdom of Bahrain

Correspondence: Ahmed F Elhabashi
Bahrain Defense Force Hospital, Royal Medical Services, Riffa, Kingdom of Bahrain

Purpose: End-stage renal disease patients have a high mortality rate linked to cardiovascular complications, and one of these complications is vascular calcification. This study was performed to test if presepsin, an inflammatory marker, is a predictor of coronary artery calcification (CAC) in hemodialysis (HD) patients.
Patients and Methods: This study was a cross-sectional design involving 48 HD patients and 13 control subjects. Coronary artery calcification score (CACs) was evaluated by a high resolution, ECG synchronized computed tomography of the heart using a CT calcium scoring. Presepsin and other laboratory analyses were performed on blood samples drawn before HD.
Results: Presepsin levels in HD patients were 14 times higher than healthy controls (P< 0.01). Also, all laboratory tests except for vitamin D were significantly different than controls. Presepsin, phosphorus levels, and calcium-phosphate product were positively correlated with increasing CACs within groups of zero to moderate calcifications (p< 0.05, R=0.459 and < 0.01, R=0.591, respectively). These correlations were not seen with eGFR, PTH, calcium, vitamin D, CRP, or ESR levels. Furthermore, the log-transformed data of presepsin correlated with 1– 15 months of HD vintage (p< 0.05, R=0.482), whereas CACs data correlated with 1– 20 months of HD vintage (p< 0.05, R=0.425).
Conclusion: Although this study is preliminary and has a limited number of patients, it shows that presepsin, as an inflammatory marker, correlates with the development of moderate CAC in HD patients and may predict CAC development. Therefore, measuring presepsin and managing inflammation before and during the early phases of HD may lower coronary calcification development. However, more clinical studies in this direction are essential.

Keywords: presepsin, hemodialysis, end-stage renal disease, coronary arterial calcification

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