CHEMERIN AS A PREDICTOR OF POOR OUTCOME IN KIDNEY TRANSPLANT RECIPIENTS-IS THERE A RELATIONSHIP WITH ANEMIA?

Abstract BACKGROUND AND AIMS Chemerin is an adipokine and novel biomarker of cardiovascular disease in patients with chronic kidney disease, which has been associated with renal, metabolic and inflammatory parameters. Data on chemerin in transplant patients are scarce. METHOD One hundred twenty-seven kidney transplant recipients were enrolled in the present study. Biochemical testing of serum samples was performed at baseline, and subsequent follow-up of kidney function was performed. Subjects were followed for a median of 58 months (Q1, Q3; 32, 63) during which a composite primary endpoint of hemodialysis or all-cause death was assessed. RESULTS Patients were stratified according to low or high chemerin concentrations based on median values of 94.43 ng/mL (Q1, Q3; 83.4, 122.2). In patients with high chemerin, estimated mean glomerular filtration (eGFR) was significantly reduced (50.7 versus 62.7, P = 0.004), while mean hemoglobin concentrations were significantly lower (12.63 versus 14.78, P < 0.001). There was a weak correlation between chemerin and IL-6 (R = 0.26; P = 0.003). Cardiometabolic comorbidities, body mass index, waist–hip ratio, sex and age did not differ across groups. In a multiple linear regression model including eGFR and IL-6, only hemoglobin concentration (P < 0.001) was significantly associated with chemerin concentrations. All-cause survival was poor in the group of patients with high chemerin at baseline (see Figure 1). Thirty-three patients met the primary endpoint in the high chemerin group, as opposed to 14 low chemerin subjects (52.4% versus 21.9%, P < 0.001). CONCLUSION The findings of the present study are in line with earlier reports in chronic kidney disease cohorts. Serum chemerin concentrations remain significantly tied not only to kidney function but also, surprisingly, hemoglobin levels. It remains to be established whether pathogenic pathways that lead to anemia are tied to chemerin concentrations and may translate into poor outcome following kidney transplant.