Clinical Significance of Adropin and Salusins Circulating Levels in End-Stage Kidney Disease Patients With Cardiovascular Events.

Introduction: Patients with end-stage kidney disease (ESKD) face a significantly increased risk of cardiovascular disease (CVD). Effective management of these patients necessitates the early identification and continuous monitoring of cardiovascular complications. This study aimed to evaluate the clinical utility of circulating adropin, salusin-α (Sal-α), and salusin-β (Sal-β) levels in ESKD patients, with and without co-occurring CVD.

Methods: We enrolled 149 participants, categorized into three groups: healthy controls (n = 50), ESKD patients without CVD (n = 50), and ESKD patients with CVD (n = 49). We measured anthropometric parameters, markers of kidney and cardiac function, and circulating levels of adropin, Sal-α, and Sal-β.

Results: Serum adropin and Sal-α levels were significantly lower in ESKD patients with CVD compared to both healthy controls and ESKD patients without CVD. Conversely, ESKD patients with CVD exhibited significantly higher Sal-β levels and a higher Sal-β/Sal-α ratio when compared to controls and ESKD patients without CVD. Furthermore, high circulating adropin levels were associated with a decreased risk of CVD, whereas elevated circulating Sal-β levels and an increased Sal-β/Sal-α ratio were associated with an increased CVD risk. The Sal-β level and Sal-β/Sal-α ratio demonstrated the highest diagnostic efficacy in differentiating ESKD patients with CVD from those without CVD. Combining these parameters further improved diagnostic efficacy.

Conclusion: Adropin insufficiency and an imbalance in salusin levels (specifically an elevated Sal-β/Sal-α ratio) may play a role in the pathogenesis of CVD in ESKD patients. The circulating levels of adropin and Sal-β, along with the Sal-β/Sal-α ratio, appear to be valuable diagnostic biomarkers for CVD in this high-risk population.