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| Prognostic value of TNFR1 and TNFR2 in predicting of patients with maintenance hemodialysis |
| ZHONG Xiao-rong YANG Feng |
| Department of Nephrology, Fuzhou First Hospital, Fujian Province, Fuzhou 350009, China |
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Abstract Objective To investigate the value of tumor necrosis factor receptor 1 (TNFR1) and tumor necrosis factor receptor 2 (TNFR2) in predicting the risk of all-cause death and cardiovascular death in maintenance hemodialysis(MHD) patients. Methods A total of 300 MHD patients in the Blood Purification Center of Fuzhou First Hospital from March 1 to April 1, 2019 were prospectively followed up for 2 years. According to the endpoint survival and death, they were diveded into the survival group (245 cases) and the death group (55 cases). The baseline data were collected.TNFR1 and TNFR2 were measured by double antibody sandwich ABC-ELISA. The end points events were all-cause death and cardiovascular deaths. Cox regression analysis was used to analyze the independent risk factors of all-cause mortality and cardiovascular mortality. Receiver operating characteristic (ROC) curve and Youden index were used to evaluate the predictive value of TNFR1 and TNFR2 on all-cause death and cardiovascular death in MHD patients.Results The age of the death group was older than that of the survival group, the dialysis time of the death group was longer than that of the survival group, the levels of systolic blood pressure, TNFR1 and TNFR2 of the death group were higher than those of the survival group, and the level of albumin of the death group was lower than that of the survival group, the differences were statistically significant (P＜0.05). Among the 300 MHD patients, 55 cases (18.33%) died,included 20 (36.36%) from cardiovascular disease. Multivariate Cox regression analysis showed that TNFR1 (β=0.018,OR=1.018, 95%CI=11.015-1.021), TNFR2 (β=0.007, OR=1.007, 95%CI=1.005-1.009) were independent risk factors for all-cause death in MHD patients (P＜0.01); TNFR1 (β=0.016, OR=1.016, 95%CI=1.011-1.021), TNFR2 (β=0.007,OR=1.007, 95%CI=1.004-1.011) were independent risk factors for cardiovascular death in MHD patients (P＜0.01). The AUC of TNFR1 and TNFR2 predicting all-cause death in MHD patients were 0.970 and 0.938, respectively, and the AUC predicting cardiovascular death were 0.905 and 0.881, respectively. Conclusion The elevated concentrations of TNFR1 and TNFR2 are closely related to the prognosis of MHD patients, and which are of great value in judging the prognosis of MHD patients
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