ArticleFrontiers in cardiovascular medicine2026
Serum syndecan-1 correlates with coronary artery calcification severity and intradialytic hypotension in elderly hemodialysis patients.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objectives: Cardiovascular disease is the leading mortality cause in elderly maintenance hemodialysis (MHD) patients, driven by coronary artery calcification (CAC). Elevated serum syndecan-1 (SDC1), a biomarker of endothelial glycocalyx degradation, indicates vascular dysfunction. This study explored the cross-sectional associations between serum SDC1, CAC severity, and intradialytic hypotension (IDH) in this population. Materials and methods: This cross-sectional study enrolled 88 elderly MHD patients and 30 healthy controls. Serum SDC1 was quantified, and CAC severity was assessed via computed tomography coronary artery calcium scores (CACS). IDH episodes were retrospectively reviewed from 3-month standardized dialysis records. Associations were analyzed using Spearman's correlation and multivariable ordinal logistic regression with a clinically prespecified sequential adjustment strategy. The discriminative stability of SDC1 was internally validated using the bootstrap resampling method. Results: Serum SDC1 was significantly higher in MHD patients than controls ( Conclusions: Elevated serum SDC1 is independently associated with CAC severity and IDH incidence in elderly MHD patients. These findings suggest that SDC1, reflecting endothelial glycocalyx degradation, may serve as a potential indicator of vascular and hemodynamic instability. However, its exploratory role in risk assessment requires further prospective validation in independent cohorts before clinical application.
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