Cachexia and protein-energy wasting are potent predictors of higher
mortality risk in dialysis-dependent chronic kidney disease (CKD)
patients. The novel cachexia marker, GDF15, is a protein associated
with inflammation, cardiovascular disease, and decreased survival in
patients with underlying malignancy. However, the impact of GDF15
on the survival of CKD patients is unknown. Among 203 prevalent
hemodialysis patients enrolled in the prospective MADRAD study over
the period of 10/2011-8/2014, we examined the association of GDF15
levels with all-cause mortality risk. Associations between GDF15
categorized into tertiles with mortality were estimated using unadjusted
and case-mix adjusted Cox models. Compared with the lowest GDF15
tertile, the highest GDF15 tertile was associated with higher mortality
risk in unadjusted and case-mix adjusted models: HR (95%CI) 3.19
(1.35-7.55) and 2.45 (1.00-6.00), respectively, p-for-trend 0.03 (Figure
1A). Higher circulating GDF15 levels in hemodialysis patients are
associated with higher all-cause mortality. Future studies are needed to
determine whether modulation of GDF15 levels and subsequent
correction of cachexia improves survival in this population
