To explore the cross-sectional associations between serum syndecan-1 (SDC1), coronary artery calcification (CAC) severity, and intradialytic hypotension (IDH) in elderly maintenance hemodialysis (MHD) patients, highlighting potential clinical implications.
Approach:
Key Findings:
Serum SDC1 levels were significantly higher in MHD patients compared to controls (P < 0.001).
Strong correlation between SDC1 and CACS (r = 0.75, P < 0.001), with progressive increase across CAC severity strata.
Elevated SDC1 independently associated with greater CAC severity (Adjusted OR = 1.148, 95% CI 1.096–1.202, P < 0.001).
Exploratory ROC analysis yielded AUC of 0.920 (95% CI 0.867–0.974).
SDC1 threshold of 33.5 pg/mL identified a phenotype with higher CAC prevalence (86.9% vs. 7.4%, P < 0.001) and more frequent IDH episodes (P < 0.001).
Interpretation:
Elevated serum SDC1 is independently associated with CAC severity and IDH incidence in elderly MHD patients, indicating potential as a biomarker for vascular and hemodynamic instability, while acknowledging the exploratory nature of the study.
Limitations:
Exploratory nature of the study necessitates further prospective validation in independent cohorts.
Single-center study may limit generalizability, particularly to diverse populations.
Conclusion:
Findings suggest that SDC1 may serve as a potential indicator of vascular and hemodynamic instability in elderly MHD patients.
