Key result
Elevated serum MMP-7 is linked to ~60% higher heart failure risk in peritoneal dialysis patients.
Why the study?
Matrix metalloproteinase-7 (MMP7) is markedly expressed in chronic kidney disease, but its dialysate expression and role in peritoneal dialysis patients have not been well established.
Are high baseline MMP7 levels associated with an increased risk of congestive heart failure in patients undergoing peritoneal dialysis?
Cohort (n=283)
No
Are high baseline MMP7 levels associated with an increased risk of congestive heart failure in patients undergoing peritoneal dialysis?
Hazard Ratio: 1.595 (95% CI 1.023–2.488)
p-value: p=0.04
Elevated serum and dialysate MMP7 levels are significantly associated with an increased risk of developing congestive heart failure in patients undergoing peritoneal dialysis, suggesting its potential utility as an early biomarker.
May inform CHF risk stratification in peritoneal dialysis; hypothesis-generating, requiring prospective validation before clinical adoption.
Background: Matrix metalloproteinase-7 (MMP7) is markedly expressed in patients with chronic kidney disease; its expression in dialysate and role in patients undergoing peritoneal dialysis (PD) have not been well established. Methods: Participants undergoing PD from June 1st, 2015, to June 30th, 2020, were involved and were followed up every 3 months for the first year and every 6 months thereafter until death, PD withdrawal, or the end of the study. Data at each follow-up point were collected and analyzed for the association with congestive heart failure (CHF), PD withdrawal, and combined endpoint. Results: A total of 283 participants were included in this study. During a median follow-up of 21 months, 20 (7%) participants died, 93 (33%) withdrew from PD, and 105 (37%) developed CHF. A significantly increased level of serum and dialysate MMP7 was observed at baseline. Dialysate MMP7 presented a good linearity with serum MMP7. Baseline serum and dialysate MMP7 levels were associated with CHF in multivariable Cox proportional hazards regression models. After categorization, participants with high baseline MMP7 levels had a higher incidence of CHF (42%), and the hazard ratios (95% confidence intervals) were 1.595 (1.023-2.488). Interestingly, participants with higher serum MMP7 levels were trended to use dialysate with higher glucose concentration. However, the ultrafiltration volumes were not significantly increased. Higher MMP7 levels were also positively associated with PD withdrawal and combined endpoint. Conclusions: The expression of MMP7 in serum and dialysate was markedly increased and was tightly associated with the risk of CHF in PD patients. This finding suggests that the measurement of MMP7 may inform strategies for managing CHF at an earlier stage.
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Xiao et al. (2023) conducted a cohort in End-stage renal disease undergoing peritoneal dialysis (n=283). High baseline serum Matrix metalloproteinase-7 (MMP7) levels (>4.80 ng/ml) vs. Low baseline serum MMP7 levels (≤4.80 ng/ml) was evaluated on Episode of congestive heart failure (CHF) requiring hospitalization (HR 1.595, 95% CI 1.023-2.488, p=0.04). High baseline serum matrix metalloproteinase-7 levels were associated with a significantly increased risk of developing congestive heart failure in peritoneal dialysis patients (adjusted HR 1.595).
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