1. Association Between Circulating Ketone Bodies and Worse Outcomes in Hemodialysis Patients
- Author
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Masaru Obokata, Kazuaki Negishi, Hiroaki Sunaga, Hideki Ishida, Kyoko Ito, Tetsuya Ogawa, Tatsuya Iso, Yoshitaka Ando, and Masahiko Kurabayashi
- Subjects
hemodialysis ,ketone body ,metabolism ,prognostic factor ,β‐hydroxybutyrate ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundCardiovascular disease is the leading cause of morbidity and mortality in patients receiving hemodialysis. Systemic metabolic perturbation is one of the hallmark abnormalities in patients at high cardiovascular risk. We sought to determine the relationship between circulating ketone body and clinical outcomes in patients with prevalent hemodialysis. Methods and ResultsWe retrospectively assessed the relationship between serum β‐hydroxybutyrate (βOHB), the most abundant ketone body in the circulation, and prognosis in 405 stable hemodialysis patients. During a mean follow‐up of 3.2±0.9 years, there were 54 major adverse cardiovascular events (defined as cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization attributed to heart failure) and 67 all‐cause deaths. Major adverse cardiovascular events rates increased from 11.1 per 1000 person‐years in the lowest βOHB quintile (409 μmol/L). After adjusting for demographic characteristics, coronary artery disease, and atrial fibrillation, the highest βOHB quintile was associated with increased risk of major adverse cardiovascular events compared with the lowest quintile (hazard ratio, 10.2; 95% confidence interval [3.35–44.0]; P
- Published
- 2017
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