The expression levels and prognostic value of serum DcR3 and GSDMD in uremic hemodialysis patients

Guo Bohui; Li Yi; Yang Wei; Tian Yufei; Zhang Yiting; Mi Xue

doi:10.3969/j.issn.1671-6450.2025.05.012

Abstract：Objective To investigate the expression levels and prognostic value of serum decoy receptor 3(DcR3)and gasdermin D(GSDMD)in uremic hemodialysis patients.Methods From January 2022 to June 2023,170 patients with uremia hemodialysis admitted to the Department of Nephrology,Hanzhong 321 Hospital were selected as uremia group,and 170 patients with non-uremia chronic kidney disease(CKD)admitted to the same period were selected as control group.Uremic hemodialysis patients were divided into poor prognosis subgroup(62 cases)and good prognosis subgroup(108 cases)according to whether major adverse cardiovascular events(MACE)occurred after 1 year.Serum DcR3 and GSDMD levels were detected by enzyme-linked immunosorbent assay.Multivariate unconditional Logistic regression analy-sis was used to analyze the relationship between serum DcR3 and GSDMD levels and poor prognosis of uremic hemodialy-sis patients,the receiver operating characteristic curve was used to analyze the evaluation value of serum DcR3 and GSDMD levels.Results Compared with the control group,the levels of serum DcR3 and GSDMD in the uremia group were in-creased(t/P=11.414/＜0.001,12.994/＜0.001).The poor prognosis rate of 170 uremic hemodialysis patients was 36.47％(62/170).Compared with the good prognosis subgroup,the serum DcR3 and GSDMD levels in the poor prognosis sub-group were increased(t/P=7.598/＜0.001,7.287/＜0.001).Age,long dialysis age,high intact parathyroid hormone,high DcR3,and high GSDMD were independent risk factors for poor prognosis in uremic hemodialysis patients[OR(95％CI)=1.120(1.042-1 205),1.061(1.027-1.096),1.002(1.001-1.003),5.349(2.499-11.447),1.894(1.419-2.527)].The area under the curve of serum DcR3,GSDMD levels and the combination of the two in evaluating the poor prognosis of uremic hemodialysis patients were 0.783,0.789 and 0.871,respectively.The AUC of the combination of the two was greater than that of serum DcR3 and GSDMD levels alone(Z/P=3.492/0.001,2.997/0.003).Conclusion The levels of serum DcR3 and GSDMD in uremic hemodialysis patients are increased,which is closely related to the poor prognosis.The combined evaluation of serum DcR3 and GSDMD levels is of high value in evaluating the poor prognosis of uremic hemodialysis pa-tients.