The risk of dialysis access thrombosis is related to the transforming growth factor-β1 production haplotype and is modified by polymorphisms in the plasminogen activator inhibitor-type 1 gene

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Abstract

Transforming growth factor-β1 (TGF-β1) and plasminogen activator inhibitor-type 1 (PAI-1) might play a role in the development of fibrosis and stenosis of hemodialysis vascular accesses. We studied polymorphisms in the TGFβ1 (869T>C; 915G>C), and PAI-1 (4G/5G) genes in 416 hemodialysis patients (107 access thrombosis cases, 309 controls), to determine if they are related to vascular access thrombosis. Three TGF-β1 production haplotypes (low, intermediate, and high) were defined according to the combination of polymorphisms found. The adjusted odds ratio (OR) and 95% confidence interval (CI) for access thrombosis in low TGF-β1 producers was 7.31 (2.15-24.88; P = .001). The interaction between low TGF-β1 production haplotype and the 4G/4G PAI-1 genotype was strongly associated with access thrombosis (adjusted OR 19.3; 95% CI 2.82-132.40; P = .003). Mean access thrombosis-free survival times in years (95% CI) were 14.65 (12.05-17.25), 11.96 (8.67-15.25), and 4.94 (3.06-6.83) in high, intermediate, and low TGF-β1 producers, respectively (P = .044). Analysis of the synergy index and the case-only cross-product supported the presence of an interaction. We concluded that low TGF-β1 production haplotype is a risk factor for hemodialysis access thrombosis and that in the presence of the 4G/4G PAI-1 genotype there is an additional increase in risk. © 2006 by The American Society of Hematology.

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Lazo-Langner, A., Knoll, G. A., Wells, P. S., Carson, N., & Rodger, M. A. (2006). The risk of dialysis access thrombosis is related to the transforming growth factor-β1 production haplotype and is modified by polymorphisms in the plasminogen activator inhibitor-type 1 gene. Blood, 108(13), 4052–4058. https://doi.org/10.1182/blood-2006-06-028902

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