Original article

Fetuin-A Thr256Ser gene polymorphism as a mortality predictor in patients with chronic kidney disease on maintenance haemodialysis in Medan, Indonesia

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Abstract

Aim: To investigate an impact of Fetuin-A Thr256Ser gene polymorphism on the mortality rate of chronic kidney disease on maintenance haemodialysis patients in Indonesia.

Methods: This is an analytic-longitudinal observational study using survival analysis with nine-month follow up on 106 maintenance haemodialysis patients. The PCR-RFLP is used to determine Fetuin-A Thr256Ser gene polymorphism and Fetuin-A serum level measured by using ELISA methods. We use time-independent cox regression analysis to investigate factors that contribute to patient survival.

Results: The mean survival time of this study is 8.49±1.53 months, with a median survival of 9 months (range 1-9 months). Among 12 (11.3%) deceased patients, most of them carried GG genotype with 8.87 times risk of mortality compared to those with CC+CG genotype (p=0.005). The group of patients with IL-6 level ?86.9 pg/mL had higher mortality with 3.64 times greater risk compared to those with IL-6 level, <86.9 pg/mL (p=0.03).

Conclusion: This study revealed a significant dominance independent impact of the Fetuin-A Thr256Ser gene polymorphism on the survival rate of maintenance haemodialysis patients. These results suggest that genotype variation of Fetuin-A gene could be a potential marker to identify high mortality risk in Indonesia's maintenance haemodialysis patients, especially in Medan.

Keywords: alpha-2-HS-glycoprotein, haemodialysis, mortality

How to Cite:

Muzasti, R. A., Suhardjono, D., Purwanto, B. & Sembiring, R. J., (2019) “Fetuin-A Thr256Ser gene polymorphism as a mortality predictor in patients with chronic kidney disease on maintenance haemodialysis in Medan, Indonesia”, Medicinski glasnik 17(1), 22-29. doi: https://doi.org/10.17392/1085-20