Cardiovascular risk are higher in those with end-stage kidney disease (ESKD). One of the key factors of cardiovascular disease (CVD) is chronic inflammation. It has been suggested that lipopolysaccharide connects systemic inflammation to CVD. For a study, researchers examined the relationship between cardiovascular events in ESKD and lipopolysaccharide-binding protein (LBP), a surrogate marker of lipopolysaccharide, and the ensuing inflammation.

They conducted a prospective cohort study of individuals receiving maintenance hemodialysis. For analysis, baseline serum LBP levels were divided into tertiles and were continuously modeled. The correlation between serum LBP levels and cardiovascular events was assessed using Cox regression techniques.

The analysis comprised 360 hemodialysis patients in total. About 90 patients (25.0%) had cardiovascular events after a median follow-up of 3.1 years. Independent of age, sex, hypertension, diabetes, CVD, vintage of dialysis, body mass index, non-high-density lipoprotein cholesterol, albumin, phosphorus, high-sensitivity C-reactive protein, and interleukin-6, patients in the upper tertile of serum LBP levels had a significantly higher risk of cardiovascular events [hazard ratio (HR) 4.87; 95% CI, 2.12-11.15] than those in the lower tertile. Whether competing risk of mortality was taken into consideration (subdistribution HR 4.87; 95% CI, 1.96-12.11 for upper vs. lower tertiles) or serum LBP was examined as a continuous variable (HR 1.30; 95% CI, 1.02-1.66 per 1 SD increase), the connection persisted.

In hemodialysis patients, serum LBP levels were independently related to cardiovascular events. A new biomarker for CVD in ESKD may be LBP.