Soluble Fas: a useful marker of inflammation and cardiovascular diseases in uremic patients

Inflammation has been associated with atherosclerotic cardiovascular disease (CVD) and anemia in patients with end-stage renal disease (ESRD) which may lead to left ventricular impairment via myocardial hypertrophy and/or ischemia. We therefore sought to investigate serum levels of sFas in uremic patients and its correlation with known markers of inflammation and CVD. The study included 30 patients on hemodialysis, 30 patients with chronic kidney disease (CKD), and 30 normal control subjects. We measured serum levels of sFas, C-reactive protein (CRP), and albumin. We also investigated the association of serum sFas levels with the presence of CVD by echocardiographic assessment before and after 1 year. Levels of sFas were elevated in CKD and ESRD patients compared to controls. sFas levels correlated positively with serum creatinine and negatively with serum albumin. In the dialysis patients, we observed that sFas levels were higher among those with CVD. Compared with baseline, after 1 year of follow-up there was a significant decrease in left ventricular (LV) ejection fraction, increases in LV end-diastolic dimension and LV end-systolic dimension, and myocardial ischemic changes. These results suggest that sFas may be a marker of inflammation in CKD and ESRD patients.