Soluble Fas and Anemia in Patients With Chronic Kidney Disease

Patients with chronic kidney disease (CKD) commonly develop anemia. Anemia in CKD is related to levels of soluble Fas (sFas), which are associated with resistance to erythropoietin (EPO). Jessica Liara Felicio de Andrade and colleagues conducted a study designed to compare clinical data and serum levels of sFas, EPO, and proinflammatory markers between patients with nondialysis-dependent CKD and healthy individuals. The researchers also sought to assess the relationship of serum EPO and sFas in patients with and without anemia.

Results of the retrospective study were reported during a poster session at the American Society of Nephrology Kidney Week 2023. The poster was titled A Retrospective View of the Relationship of Soluble Fas With Anemia and Outcomes in CKD.

The study cohort included 58 CKD patients under conservative treatment and 20 healthy individuals. Values for complete blood count, renal function, serum EPO, sFas, and inflammatory markers (c-reactive protein, interleukin-6, and interferon gamma) were compared at baseline. Those variables were compared between patients who progressed to anemia and those without anemia. The frequency of outcomes in patients with elevated sFas levels were evaluated. Multivariate analysis of factors associated with anemia was performed.

Compared with healthy individuals, those with CKD had lower eGFR (35.7 mL/min/1.73 m² vs 89.7 mL/min/1.73 m²; P<.001) and lower hemoglobin (12.8 g/dL vs 14.4 g/dL; P=.003). Levels of major inflammatory markers also differed in those with CKD compared with healthy individuals (sFas, 2894 pg/mL vs 1136 pg/mL; P<.001 and EPO/hemoglobin (8.76 IU.mg/dL vs 4.09 IU/mg/dL; P=.003).

In patients with CKD and anemia, compared with patients with CKD without anemia, eGFR was lower (27.2 mL/min/1.73 m² vs 54.98 mL/min/1.73 m²; P<.001) and sFas was higher (150.98 vs 45.2; P<.001). In the multivariate analysis there was an independent association between serum sFas levels and long-term renal anemia sFas (odds ratio, 4.322; 95% CI, 1.464-12.753; P=.008).

“As an elective risk factor, serum sFas levels were independently associated with long-term renal anemia,” the authors concluded.

Source: Andrade JLF, Clemente OH, Silva, BM, Rodrigues A, Zarjou A, Goes MA. A retrospective view of the relationship of soluble Fas with anemia and outcomes in CKD. TH-PO951. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2023; November 2, 2023; Philadelphia, Pennsylvania.