Does Hemodialysis Weaken GDF-15 Impairing Pulmonary Hypertension in Chronic Kidney Failure?

Background: Pulmonary hypertension (PH) is a common complication of chronic renal failure (CRF) and contributes to mortality. However, the occurrence of mechanism or risk factors in CRF complicated with PH remains unclear. Methods: One hundred and twenty subjects were prospectively recruited and divided into CRF group (n=79) and control group (n=41). The CRF group were subsequently divided into the pre-hemodialysis group (n=41) and the hemodialysis group (n=38). The GDF-15 levels of all subjects were tested by ELISA. The levels of GDF-15 in groups were compared each other. The association between GDF-15 and other clinical parameters was analyzed as well as the association between pulmonary artery pressure (PAP) and other factors with the stepwise regression analysis. Results: GDF-15 levels in CRF group were significantly higher than that in control group. There was no difference between pre-hemodialysis and hemodialysis groups. Positive correlations between GDF-15 and PAP, urea, creatinine, or uric acid (UA) were found with or without adjusting for age, sex, and body mass index (BMI). Additionally, GDF-15 was positively associated with PAP or creatinine. Moreover, PAP was positively associated with hypertension other than GDF-15, while negatively with total bilirubin (TBIL) or glucose (GLU). Conclusion: GDF-15 is significantly elevated and positively associated with PAP in CRF patients. GDF-15 may be a therapeutic target for PH in CRF. Hemodialysis can’t weaken GDF-15 impairing PH because there is no difference in plasma levels of GDF-15 between pre-hemodialysis and hemodialysis patients with CRF. Moreover, PAP is negatively associated with TBIL or GLU in CRF. Funding: Government Support – Non-U.S.