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3-methylhistidine and clinical outcomes in maintenance hemodialysis patients

Abstract : INTRODUCTION: Chronic kidney disease is an important contributor to morbidity and mortality. 3-methylhistidine (3-MH) is the by-product of actin and myosin degradation reflecting skeletal muscle turnover. Markedly elevated 3-MH levels have already been documented in uremic patients, but the interpretation of high 3-MH concentration in maintenance hemodialysis (MHD) patients remains unclear. Indeed, it is not known whether elevated serum 3-MH levels is a marker of excessive muscle catabolism or a better lean tissue mass. Here, we evaluated the association between serum-3-MH levels and clinical outcomes in these patients. METHODS: Serum 3-MH concentration was measured by reverse-phase liquid chromatography/tandem mass spectrometry in a cohort of MHD patients. We analyzed the relationships between various clinical/laboratory indices, lean tissue mass measured by bioimpedance spectroscopy, mortality and cardiovascular (CV) events. RESULTS: Serum 3-MH concentration was positively correlated with serum albumin, normalized protein catabolic rate (nPCR), simplified creatinine index (SCI) and lean tissue mass. Out of 291 MHD patients, during a mean follow-up of 847 days, 91 patients died and 101 patients experienced a CV event. Survival was significantly better in patients with high 3-MH concentrations (p = 0.002). Higher level of 3-MH was also associated with a lower CV mortality and lower incidence of CV events (p = 0.015 and p \textless 0.001, respectively). Low serum 3-MH levels remained significantly associated with CV events but not with mortality after adjustment for demographic, metabolic and CV risk factors. CONCLUSION: Elevated serum 3-MH concentration appears to be a marker of better lean tissue mass and nutritional status. Low serum 3-MH is a robust and independent predictor of CV events in the MHD population.
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Submitted on : Friday, August 19, 2022 - 12:09:58 PM
Last modification on : Wednesday, August 31, 2022 - 3:42:08 AM


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E. Bres, C. Pagan, A. Bouchara, M. Pastural, S. Granjon, et al.. 3-methylhistidine and clinical outcomes in maintenance hemodialysis patients. Nephrology Dialysis Transplantation, Oxford University Press, 2022, pp.gfac050. ⟨10.1093/ndt/gfac050⟩. ⟨inserm-03754183⟩



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