SDC4 and congestive heart failure: The prognostic utility of syndecan-4 for predicting all-cause as well as cardiac death in HD patients is in concordance with some previous studies that have documented that syndecan-4 is a useful biomarker for predicting cardiac death for patients with chronic heart failure [17] as well as for predicting adverse left ventricle remodeling in patients with dilated cardiomyopathy [21].The pathophysiological mechanism of the association between syndecan-4 and HD patients mortality remains unknown.