Mitochondrial Peptide MOTS-c Predicts Mortality and Heart Risk in Dialysis Patients

Chronic hemodialysis patients face a significantly elevated risk of all-cause mortality and cardiovascular disease, which remains a major challenge in clinical management. Current risk stratification tools often lack precision, making it difficult to identify individuals most in need of aggressive interventions. This study investigates whether MOTS-c, a novel mitochondrial-derived peptide, can improve the prediction of these adverse outcomes in this vulnerable population.

The study revealed a strong inverse correlation between MOTS-c levels and adverse outcomes. Patients with lower circulating MOTS-c concentrations exhibited significantly higher risks for both mortality and cardiovascular events. > The lowest tertile of MOTS-c levels was independently associated with a 2.8-fold increased risk of all-cause mortality (HR 2.8, 95% CI 2.1-3.7, p<0.001) compared to the highest tertile. For major adverse cardiovascular events, individuals in the lowest MOTS-c tertile faced a 2.1-fold higher risk (HR 2.1, 95% CI 1.5-2.9, p=0.003). Importantly, adding MOTS-c to conventional risk prediction models significantly enhanced their discriminatory power, improving the C-index by 0.04 for mortality and 0.03 for MACE, demonstrating its robust independent predictive capability.