Evaluation of Serum Galectin-3 Levels Across Chronic Kidney Disease Stages and Its Association with Cardiovascular Complications in Maintenance Hemodialysis Patients

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Background: Cardiovascular complications majorly drive mortality across the spectrum of chronic kidney disease (CKD). This study evaluated serum Galectin-3 levels across chronic kidney disease (CKD) stages and their association with microinflammation and cardiac dysfunction in MHD patients. Methods: This cross-sectional study included 206 patients (CKD stages 3–5 non-dialysis [ND], MHD, and post-kidney transplantation) and 70 healthy controls. Serum Galectin-3 was measured using a Chemiluminescent Microparticle Immunoassay. Results: Median Galectin-3 levels increased progressively from stage 3 (29.50 ng/mL) to stage 4 (39.85 ng/mL), reached the highest levels in stage 5ND (52.70 ng/mL) and MHD (65.15 ng/mL), but plunged post-transplantation (19.45 ng/mL). In the MHD group, patients with high Galectin-3 (>65.15 ng/mL) exhibited significantly higher CRP levels compared to those with low Galectin-3 (2.39 vs. 1.22 mg/L, p = 0.013). Galectin-3 correlated positively with troponin T (r = 0.266, p = 0.037). ROC analysis showed that Galectin-3 discriminated left ventricular systolic dysfunction (EF < 50%) with an AUC of 0.557 (95% CI: 0.401–0.714), yielding an optimal cut-off of ≥52.85 ng/mL (sensitivity: 86.7%, specificity: 31.9%). Conclusions: Serum Galectin-3 is elevated in MHD patients and correlates with systemic microinflammation (CRP), but its association with myocardial injury lost statistical significance after multivariable adjustment (p = 0.057). Furthermore, an exploratory cut-off of ≥52.85 ng/mL did not demonstrate statistically significant discrimination for left ventricular systolic dysfunction (p = 0.506), highlighting the complex, multifactorial nature of uremic cardiomyopathy.