Serum Endocan as a Predictor of Survival and Cardiovascular Events in Patients Without Diabetic Kidney Disease on Chronic Haemodialysis: A Prospective, Observational Study

<i data-eusoft-scrollable-element="1">Background and Objectives</i>: Chronic kidney disease (CKD) is an increasingly significant global public health issue, with cardiovascular disease being the leading cause of mortality. Endothelial dysfunction plays a critical role, but diag...

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Main Authors: Mario Šafer, Ivan Feldi, Ines Šahinović, Ivana Tolj, Marko Pirić, Dunja Šojat, Eduard Oštarijaš, Dubravka Mihaljević
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Language:English
Published: MDPI AG 2025-05-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/6/991
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author Mario Šafer
Ivan Feldi
Ines Šahinović
Ivana Tolj
Marko Pirić
Dunja Šojat
Eduard Oštarijaš
Dubravka Mihaljević
author_facet Mario Šafer
Ivan Feldi
Ines Šahinović
Ivana Tolj
Marko Pirić
Dunja Šojat
Eduard Oštarijaš
Dubravka Mihaljević
author_sort Mario Šafer
collection DOAJ
description <i data-eusoft-scrollable-element="1">Background and Objectives</i>: Chronic kidney disease (CKD) is an increasingly significant global public health issue, with cardiovascular disease being the leading cause of mortality. Endothelial dysfunction plays a critical role, but diagnostic tools have certain limitations. Endocan, a soluble proteoglycan, emerged as a promising endothelial dysfunction marker and potential major adverse cardiovascular event (MACE) predictor in haemodialysis (HD) patients. <i data-eusoft-scrollable-element="1">Materials and Methods</i>: In this single-centre, observational, prospective study, non-diabetic HD patients without prior MACEs were monitored. A total of 75 participants met the inclusion criteria. We measured serum endocan, standard biochemical and anthropometric parameters, and parameters of peripheral and central haemodynamics before and after HD in all participants. <i data-eusoft-scrollable-element="1">Results</i>: Patients with higher endocan were older, had elevated CRP and reduced albumin concentrations, and often had a tunnelled central venous catheter (TCVC) for vascular access. Higher serum endocan levels were independently associated with an increased risk of MACEs (aHR = 4.09, 95%-CI: 1.72–9.74), MACE-related mortality (aHR = 2.64, 95%-CI: 1.23–5.66), and all-cause mortality (aHR = 1.86, 95%-CI: 1.07–3.23), both before and after adjusting for predefined confounders, with the highest endocan tercile exhibiting the shortest event-free survival. <i data-eusoft-scrollable-element="1">Conclusions</i>: Endocan is a valuable marker of inflammation and endothelial dysfunction in non-diabetic HD patients. Its elevated concentration indicates an increased cardiovascular risk and more frequent MACEs. Future multicentre studies with repeated endocan assessments should validate its prognostic and diagnostic utility, particularly in long-term patient follow-up.
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spelling doaj-art-688d824dc97e409fafa051776627d5cc2025-08-20T03:27:33ZengMDPI AGMedicina1010-660X1648-91442025-05-0161699110.3390/medicina61060991Serum Endocan as a Predictor of Survival and Cardiovascular Events in Patients Without Diabetic Kidney Disease on Chronic Haemodialysis: A Prospective, Observational StudyMario Šafer0Ivan Feldi1Ines Šahinović2Ivana Tolj3Marko Pirić4Dunja Šojat5Eduard Oštarijaš6Dubravka Mihaljević7Department of Internal Medicine, General Hospital Virovitica, Lj. Gaja 21, 33000 Virovitica, CroatiaFaculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, CroatiaFaculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, CroatiaFaculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, CroatiaFaculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, CroatiaFaculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, CroatiaDoctoral School of Clinical Medical Sciences, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, HungaryFaculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia<i data-eusoft-scrollable-element="1">Background and Objectives</i>: Chronic kidney disease (CKD) is an increasingly significant global public health issue, with cardiovascular disease being the leading cause of mortality. Endothelial dysfunction plays a critical role, but diagnostic tools have certain limitations. Endocan, a soluble proteoglycan, emerged as a promising endothelial dysfunction marker and potential major adverse cardiovascular event (MACE) predictor in haemodialysis (HD) patients. <i data-eusoft-scrollable-element="1">Materials and Methods</i>: In this single-centre, observational, prospective study, non-diabetic HD patients without prior MACEs were monitored. A total of 75 participants met the inclusion criteria. We measured serum endocan, standard biochemical and anthropometric parameters, and parameters of peripheral and central haemodynamics before and after HD in all participants. <i data-eusoft-scrollable-element="1">Results</i>: Patients with higher endocan were older, had elevated CRP and reduced albumin concentrations, and often had a tunnelled central venous catheter (TCVC) for vascular access. Higher serum endocan levels were independently associated with an increased risk of MACEs (aHR = 4.09, 95%-CI: 1.72–9.74), MACE-related mortality (aHR = 2.64, 95%-CI: 1.23–5.66), and all-cause mortality (aHR = 1.86, 95%-CI: 1.07–3.23), both before and after adjusting for predefined confounders, with the highest endocan tercile exhibiting the shortest event-free survival. <i data-eusoft-scrollable-element="1">Conclusions</i>: Endocan is a valuable marker of inflammation and endothelial dysfunction in non-diabetic HD patients. Its elevated concentration indicates an increased cardiovascular risk and more frequent MACEs. Future multicentre studies with repeated endocan assessments should validate its prognostic and diagnostic utility, particularly in long-term patient follow-up.https://www.mdpi.com/1648-9144/61/6/991endothelial dysfunctionhaemodialysisendocanMACE
spellingShingle Mario Šafer
Ivan Feldi
Ines Šahinović
Ivana Tolj
Marko Pirić
Dunja Šojat
Eduard Oštarijaš
Dubravka Mihaljević
Serum Endocan as a Predictor of Survival and Cardiovascular Events in Patients Without Diabetic Kidney Disease on Chronic Haemodialysis: A Prospective, Observational Study
Medicina
endothelial dysfunction
haemodialysis
endocan
MACE
title Serum Endocan as a Predictor of Survival and Cardiovascular Events in Patients Without Diabetic Kidney Disease on Chronic Haemodialysis: A Prospective, Observational Study
title_full Serum Endocan as a Predictor of Survival and Cardiovascular Events in Patients Without Diabetic Kidney Disease on Chronic Haemodialysis: A Prospective, Observational Study
title_fullStr Serum Endocan as a Predictor of Survival and Cardiovascular Events in Patients Without Diabetic Kidney Disease on Chronic Haemodialysis: A Prospective, Observational Study
title_full_unstemmed Serum Endocan as a Predictor of Survival and Cardiovascular Events in Patients Without Diabetic Kidney Disease on Chronic Haemodialysis: A Prospective, Observational Study
title_short Serum Endocan as a Predictor of Survival and Cardiovascular Events in Patients Without Diabetic Kidney Disease on Chronic Haemodialysis: A Prospective, Observational Study
title_sort serum endocan as a predictor of survival and cardiovascular events in patients without diabetic kidney disease on chronic haemodialysis a prospective observational study
topic endothelial dysfunction
haemodialysis
endocan
MACE
url https://www.mdpi.com/1648-9144/61/6/991
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