INTRODUCTION: Periostin is a matricellular protein. Elevated serum concentrations of periostin have been reported in patients with various cardiovascular diseases, including heart failure. Patients with end-stage renal disease have a substantially increased risk for cardiovascular diseases. However, there is a lack of clinical studies to clarify the prognostic significance of systemic periostin on all-cause mortality in patients with end-stage renal disease on hemodialysis. METHODS: 313 stable end-stage renal disease patients were recruited and followed for 5 years concerning all-cause mortality. At baseline, we collected blood samples and clinical data. Serum periostin concentrations were measured using a certified ELISA. RESULTS: The optimal cut-off value for serum periostin regarding all-cause mortality, calculated through receiver operating characteristic analysis, was 777.5 pmol/L. Kaplan-Meier survival analysis using this cut-off value demonstrated that higher periostin concentrations are linked to higher all-cause mortality (log-rank test: p = 0.002). Subgroup analysis revealed that serum periostin concentrations only affected all-cause mortality in male but not in female patients (p = 0.002 in male patients and p = 0.474 in female patients). Multivariate Cox regression analyses, adjusted for confounding factors, likewise showed that elevated serum periostin concentrations were positively associated with all-cause mortality in male (p = 0.028) but not in female patients on hemodialysis (p = 0.313). CONCLUSION: Baseline serum periostin is an independent risk factor for all-cause mortality in male patients with chronic renal disease on hemodialysis.

2nd Medical Faculty Charles University of Prague Prague Czechia

5th Department of Medicine University Medical Centre Mannheim University of Heidelberg Mannheim Germany

Biomedica Slovakia s r o Bratislava Slovakia

Department of Medicine Charité Universitätsmedizin Berlin Berlin Germany

Department of Nephrology Odense University Hospital Odense Denmark

European Center for Angioscience ECAS Medical Faculty Mannheim of the University of Heidelberg Mannheim Germany

HMU Health and Medical University Potsdam Germany

Institute of Medical Diagnostics IMD Berlin Potsdam Berlin Germany

Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province School of Medicine Hunan Normal University Changsha China

Reproductive and Genetic Hospital of CITIC Xiangya Changsha China

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