Effect of Hemodiafiltration on Pregnancy-Associated Plasma Protein A (PAPP-A) and Related Parameters

Figures & data

Table 1 PAPP-A and related parameters during hemodiafiltration and hemodialysis

	HDF				HD
Parameter (units)	Time 0	Time 15	Time 120	Time 240	Time 0	Time 15	Time 120	Time 240
PAPP-A (mU/l)**^††	24.3 (18.2–29.8)	53.9 (43.5–73.3)^‡‡	24.3 (18.7–31.3)^§§§	27.3 (24.0–32.7)^§	20.5 (13.9–26.4)	65.2 (52.3–93.4)^‡‡	22.7 (18.2–31.4)^§§§	26.3 (22.4–35.5)^§§
MMP-2 (ng/ml)***^††	236.7 (212.0–292.5)	244.5 (206.8–277.9)	232.6 (202.6–270.4)	217.0 (177.6–252.3)^‡‡§§§	257.1 (211.4–316.4)	239.9 (199.3–296.1)^‡	240.3 (198.1–305.5)^‡‡	216.2 (193.1–281.1)^‡‡§§
MMP-9 (ng/ml)^†	47.2 (34.5–55.9)	51.0 (39.6–68.1)	58.0 (44.6–79.4)	45.4 (36.8–69.4)	44.3 (36.2–61.4)	52.2 (40.4–68.2)	61.0 (41.1–69.2)	38.0 (30.2–44.1)^§§¶
IGFBP-4 (ug/l)	1282.5 (815.8–1759.3)	1507.0 (1108.3–1697.0)	1437.0 (944.5–1678.5)	1295.5 (1039.0–1406.3)	1645.5 (1282.3–2054.0)	1659.0 (1191.5–1875.0)	1576.5 (1291.0–2000.3)	1476.0 (1197.5–1913.8)
IGF-I (ug/l)	213.3 (142.7–301.4)	216.6 (131.9–284.3)	206.7 (141.4–280.3)	197.9 (131.3–257.8)	170.5 (136.9–309.3)	186.9 (131.7–277.9)	158.7 (113.7–251.0)	177.4 (103.0–284.5)

Results are expressed as medians (interquartile ranges).

Abbreviations: HD = hemodialysis, HDF = hemodiafiltration, IGF-1 = insulin-like growth factor-1, IGFBP-4 = insulin-like growth factor binding protein-4, MMP = matrix metalloproteinase, PAPP-A = pregnancy-associated plasma protein A.

*p < 0.05, **p < 0.001, ***p < 0.0001 effect of time, HDF; ANOVA or Friedman ANOVA, p < 0.05 HD vs. HDF, Mann-Whitney test.

^†p < 0.001, ^††p < 0.0001, effect of time, HD; ANOVA or Friedman ANOVA, p < 0.05 HD vs. HDF, Mann-Whitney test.

Post-tests (Tukey-Kramer test or Dunn´s multiple comparison test): ^‡p < 0.05, ^‡‡p < 0.001 vs. time 0; ^§p < 0.05, ^§§p < 0.01, ^§§§p < 0.001 vs. time 15; ^¶p < 0.001 vs. time 120.

Table 2 PAPP-A and related parameters during hemodiafiltration and hemodialysis. Correction for albumin content due to hemoconcentration

	HDF				HD
Parameter (units)	Time 0	Time 15	Time 120	Time 240	Time 0	Time 15	Time 120	Time 240
PAPP-A (mU/g alb.)***^††	0.61 (0.51–0.83)	1.37 (1.06–2.11)^‡‡‡	0.65 (0.48–0.83)^§§	0.66 (0.52–0.88)^§§	0.52 (0.36–0.67)	1.69 (1.30–2.31)^‡‡‡	0.63 (0.46–0.89)^§§	0.70 (0.53–0.89)^§§
MMP-2 (µg/g alb.)***^††	6.41 (5.47–8.12)	6.29 (5.24–7.51)	6.18 (5.16–7.40)	5.48 (4.59–6.68)^‡‡‡ §§¶¶	6.76 (5.57–8.43)	6.15 (5.32–7.79)^‡	6.24 (5.37–8.15)^‡	5.69 (5.07–7.65)^‡‡‡
MMP-9 (µg/g alb.)^†	1.21 (0.95–1.46)	1.27 (1.07–1.77)	1.52 (1.15–2.15)	1.12 (0.79–1.73)	1.18 (0.90–1.59)	1.29 (1.04–1.77)	1.45 (1.08–1.91)	0.91 (0.78–1.14)^§¶ ¶
IGFBP-4 (ug/g alb.)^#	32.18 (18.69–44.04)	37.77 (30.92–46.14)	38.77 (25.25–43.63)	28.62 (23.80–38.02)	42.38 (31.27–57.15)	41.35 (31.36–50.25)	42.13 (32.67–51.01)	38.98 (32.11–49.67)
IGF-I (ug/g alb.)**	5.82 (4.47–6.84)	5.46 (3.84–6.71)	5.19 (3.85–6.81)	4.46 (3.62–6.32)^‡‡§¶ ¶¶	4.83 (3.62–7.32)	5.18 (3.45–7.11)	4.38 (2.84–6.27)	4.52 (3.00–7.07)

Results are expressed as medians (interquartile ranges).

Abbreviations: HD = hemodialysis, HDF = hemodiafiltration, IGF-1 = insulin-like growth factor-1, IGFBP-4 = insulin-like growth factor binding protein-4, MMP = matrix metalloproteinase, PAPP-A = pregnancy-associated plasma protein A.

*p < 0.05, **p < 0.001, ***p < 0.0001 effect of time, HDF; ANOVA or Friedman ANOVA.

^†p < 0.01, ^††p < 0.0001 effect of time, HD; ANOVA or Friedman ANOVA.

^#p < 0.05 HD vs. HDF, Mann-Whitney test

Post-tests (Tukey-Kramer test or Dunn´s multiple comparison test): ^‡p < 0.05, ^‡‡p < 0.01, ^‡‡‡p < 0.001 vs. time 0; ^§p < 0.01, ^§§p < 0.001 vs. time 15; ^¶p < 0.05, ^¶¶p < 0.01, ^¶¶¶p < 0.001 vs. time 120.

Figure 1 Changes of IGFBP-4 × IGF-1 product during hemodiafiltration and hemodialysis. Abbreviations: HD = hemodialysis, HDF = hemodiafiltration, IGF-1 = insulin-like growth factor-1, IGFBP-4 = insulin-like growth factor binding protein-4.