Plasma Biomarkers and Incident CKD Among Individuals Without Diabetes

被引：0

作者：

Le, Dustin ^{[1
]}

Chen, Jingsha ^{[2
]}

Shlipak, Michael G. ^{[3
,4
,5
]}

Ix, Joachim H. ^{[6
,7
,8
]}

Sarnak, Mark J. ^{[9
]}

Gutierrez, Orlando M. ^{[10
]}

Schelling, Jeffrey R. ^{[11
]}

Bonventre, Joseph V. ^{[12
]}

Sabbisetti, Venkata S. ^{[12
,17
,18
]}

Schrauben, Sarah J. ^{[13
,14
]}

Coca, Steven G. ^{[15
]}

Kimmel, Paul L. ^{[16
]}

Vasan, Ramachandran S.

Grams, Morgan E. ^{[19
]}

Parikh, Chirag ^{[1
]}

Coresh, Josef ^{[2
]}

Rebholz, Casey M. ^{[1
,2
]}

机构：

[1] Johns Hopkins Sch Med, Dept Med, Div Nephrol, Baltimore, MD 21287 USA

[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21287 USA

[3] San Francisco VA Med Ctr, Kidney Hlth Res Collaborat, San Francisco, CA USA

[4] Univ Calif San Francisco, San Francisco, CA USA

[5] San Francisco VA Med Ctr, Div Gen Internal Med, San Francisco, CA USA

[6] Univ Calif San Diego, Dept Med, Div Nephrol & Hypertens, San Diego, CA USA

[7] Vet Affairs San Diego Healthcare Syst, Nephrol Sect, La Jolla, CA USA

[8] Kidney Res Innovat Hub San Diego, San Diego, CA USA

[9] Tufts Med Ctr, Dept Med, Div Nephrol, Boston, MA USA

[10] Univ Alabama Birmingham, Sch Med, Dept Med, Div Nephrol, Birmingham, AL USA

[11] Case Western Reserve Univ, Sch Med, Dept Physiol & Biophys & Med, Cleveland, OH USA

[12] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Div Renal Med, Boston, MA USA

[13] Univ Penn, Perelman Sch Med, Renal Electrolyte & Hypertens Div, Philadelphia, PA USA

[14] Univ Penn, Ctr Clin Epidemiol & Biostat, Perelman Sch Med, Philadelphia, PA USA

[15] Icahn Sch Med Mt Sinai, Dept Med, Div Nephrol, New York, NY USA

[16] NIDDKD, Div Kidney Urol & Hematol Dis, NIH, Bethesda, MD USA

[17] NHLBI, Framingham Heart Study, Framingham, MA USA

[18] Boston Univ, Sch Med, Framingham, MA USA

[19] NYU, Dept Med, Div Precis Med, New York, NY USA

来源：

KIDNEY MEDICINE | 2023年 / 5卷 / 11期

基金：

美国国家卫生研究院;

关键词：

KIDNEY INJURY MOLECULE-1; TNF RECEPTORS 1; FUNCTION DECLINE; CYSTATIN-C; CARDIOVASCULAR-DISEASE; TRANSPLANT RECIPIENTS; ATHEROSCLEROSIS RISK; INFLAMMATION; PROGRESSION; MARKERS;

D O I：

10.1016/j.xkme.2023.100719

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Rationale & Objective: Biomarkers of kidney disease progression have been identified in individuals with diabetes and underlying chronic kidney disease (CKD). Whether or not these markers are associated with the development of CKD in a general population without diabetes or CKD is not well established. Study Design: Prospective observational cohort. Setting & Participants: In the Atherosclerosis Risk in Communities) study, 948 participants were studied. Exposures: The baseline plasma biomarkers of kidney injury molecule-1 (KIM-1), monocyte chemoattractant protein-1 (MCP-1), soluble urokinase plasminogen activator receptor (suPAR), tumor necrosis factor receptor 1 (TNFR-1), tumor necrosis factor receptor 2 (TNFR-2), and human cartilage glycoprotein-39 (YKL-40) measured in 1996-1998. Outcome: Incident CKD after 15 years of follow-up defined as >= 40% estimated glomerular filtration rate decline to <60 mL/min/1.73 m(2) or dialysis dependence through United States Renal Data System linkage. Analytical Approach Logistic regression and C statistics. Results: There were 523 cases of incident CKD. Compared with a random sample of 425 controls, there were greater odds of incident CKD per 2-fold higher concentration of KIM-1 (OR, 1.49; 95% CI, 1.25-1.78), suPAR (OR, 2.57; 95% CI, 1.74-3.84), TNFR-1 (OR, 2.20; 95% CI, 1.58-3.09), TNFR-2 (OR, 2.03; 95% CI, 1.37-3.04). After adjustment for all biomarkers, KIM-1 (OR, 1.42; 95% CI, 1.19-1.71), and suPAR (OR, 1.86; 95% CI, 1.18-2.92) remained associated with incident CKD. Compared with traditional risk factors, the addition of all 6 biomarkers improved the C statistic from 0.695-0.731 (P < 0.01) and using the observed risk of 12% for incident CKD, the predicted risk gradient changed from 5%-40% (for the 1st-5th quintile) to 4%-44%. Limitations: Biomarkers and creatinine were measured at one time point. Conclusions: Higher levels of KIM-1, suPAR, TNFR-1, and TNFR-2 were associated with higher odds of incident CKD among individuals without diabetes.

引用

页数：11

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