Diastolic dysfunction is a common finding in end‑stage renal disease (ESRD) on
regular hemodialysis (HD). Galectin‑3 (Gal‑3) has emerged as an early biomarker
with diagnostic and prognostic values in cardiac dysfunction with reduced or
preserved ejection fraction. We aimed to assess the correlation between Gal‑3 levels
and diastolic dysfunction in children with ESRD on regular HD.
Materials and
Methods
: Gal‑3 levels were assessed in 67 patients on regular HD and 67 healthy controls.
Conventional echo‑Doppler imaging and tissue‑Doppler imaging were done to all
patients and control groups. Patients were split into two categories: with or without
diastolic dysfunction, based on the early diastolic transmitral velocity to early
diastolic mitral annular velocity (E/E’) whether more or less than 15, respectively
Results : Plasma Gal-3 levels in ng/ml were 16.7 (12.0–22.0) in healthy controls, 15.7
(10.5–22.0) in patients on HD without diastolic dysfunction, and 23.4 (13.4–25.0)
in patients on HD with diastolic dysfunction. Gal‑3 levels were significantly
higher in HD patients with left ventricular diastolic dysfunction (LVDD). Both
uni‑ and multivariate logistic regression analyses revealed that low left ventricular
Tei index, low early diastolic mitral annular velocity of lateral wall wave, low early
diastolic mitral annular velocity of septal wall wave, high septal early diastolic
transmitral velocity to early diastolic mitral annular velocity of lateral wall (E/E′)
ratio, and high Gal‑3 are significant predictors for LVDD in the whole study group.
Furthermore, there was a significant positive correlation between the Gal‑3 and the
grade of diastolic dysfunction. The cut of point of diagnostic accuracy of serum
Gal‑3 in diastolic dysfunction in HD children was 20.12 with a sensitivity of 93.3
and a specificity 78.4.
Conclusions : Gal‑3 is a potential early biomarker that can be used in early diagnosis and grading
of diastolic dysfunction in ESRD children on regular HD