Telomere shortening in patients on long-term hemodialysis

Yucheng Wang; Siyu Chen; Shi Feng; Cuili Wang; Hong Jiang; Song Rong; Haller Hermann; Jianghua Chen; Ping Zhang

doi:10.1016/j.cdtm.2021.07.003

Telomere shortening in patients on long-term hemodialysis

Chronic Dis Transl Med. 2021 Aug 25;7(4):266-275. doi: 10.1016/j.cdtm.2021.07.003. eCollection 2021 Dec.

Authors

Yucheng Wang^{1

2

3

4

5}, Siyu Chen^{1

2

3

4

5}, Shi Feng^{1

2

3

4

5}, Cuili Wang^{1

2

3

4

5}, Hong Jiang^{1

2

3

4

5}, Song Rong⁶, Haller Hermann⁶, Jianghua Chen^{1

2

3

4

5}, Ping Zhang^{1

2

3

4

5}

Affiliations

¹ Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
² Key Laboratory of Nephropathy, Hangzhou, Zhejiang 310003, China.
³ Kidney Disease Immunology Laboratory, The Third-Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, Zhejiang 310003, China.
⁴ Key Laboratory of Multiple Organ Transplantation, Ministry of Health of China, Hangzhou, Zhejiang 310003, China.
⁵ Institute of Nephropathy, Zhejiang University, Hangzhou, Zhejiang 310003, China.
⁶ Clinic for Kidney and Hypertension Diseases, Hannover Medical School, Lower Saxony, 30625, Germany.

Abstract

Background: Leukocyte telomere length shortening is a characteristic of premature senescence, a process that can be accelerated by oxidative stress. In general, patients with end-stage renal disease undergoing regular hemodialysis (HD) are repeatedly exposed to oxidative stress. Patients undergoing HD tend to have cardiovascular diseases associated with oxidative stress and inflammation. Therefore, we assumed that telomere length is associated with HD vintage and the degree of vascular calcification.

Methods: A total of 144 patients undergoing regular HD before kidney transplantation and 62 patients on hemodialysis, but not undergoing kidney transplantation, were enrolled. We measured common laboratory values, such as calcium, phosphate, and hemoglobin levels, and assessed the degree of vascular calcification in the patients. The leukocyte telomere length was measured using reverse transcription polymerase chain reaction, and Spearman correlation was used for correlation analysis.

Results: The leukocyte telomere length was negatively associated with age (rho = -0.306, P＜0.01); it was shorter in middle-aged patients than in young patients (13.48 ± 4.80 vs. 15.86 ± 4.51, P < 0.01). The telomere length was significantly different among patients aged 52-74 years in groups with different HD vintages. Additionally, the telomere length was positively associated with serum hemoglobin (Hb) levels in all patients (rho = 0.290, P < 0.01). There was a significant difference among patients divided into three groups according to the degree of anemia (17.09 ± 5.64 vs. 14.40 ± 4.07 vs. 13.99 ± 3.95, P < 0.01). Further, a significant difference was observed in the telomere length among patients with different degrees of vascular calcification (16.79 ± 4.91 vs. 13.61 ± 2.82 vs. 14.62 ± 3.63 vs. 10.71 ± 3.74, P < 0.01). The telomere length was shorter in the patients on hemodialysis who did not receive a kidney transplant than in the surgical patients (8.12 ± 1.83 vs. 14.33 ± 4.63, P < 0.01).

Conclusion: This study demonstrated that the telomere length was significantly correlated with HD vintage in patients of a certain age group. The telomere length was shorter in patients on hemodialysis who matched for age and dialysis vintage with kidney transplant patients. It was also associated with vascular calcification and serum Hb levels in all patients undergoing HD.

Keywords: Cardiovascular disease; Chronic kidney disease; Hemodialysis; Hemoglobin; Telomere length.