Year: 2019
Type: article
Abstract: BACKGROUND: Increases in cardiac and stress biomarkers may be associated with loss of kidney function through shared mechanisms involving cardiac and kidney injury. We evaluated the associations of cardiac and stress biomarkers [N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hsTnT), growth differentiation factor 15 (GDF-15), soluble ST-2 (sST-2)] with progression of chronic kidney disease (CKD). METHODS: We included 3664 participants with CKD from the Chronic Renal Insufficiency Cohort study. All biomarkers were measured at entry. The primary outcome was CKD progression, defined as progression to end-stage renal disease (ESRD) or 50% decline in estimated glomerular filtration rate (eGFR). Cox models tested the association of each biomarker with CKD progression, adjusting for demographics, site, diabetes, cardiovascular disease, eGFR, urine proteinuria, blood pressure, body mass index, cholesterol, medication use, and mineral metabolism. RESULTS: There were 1221 participants who had CKD progression over a median (interquartile range) follow-up of 5.8 (2.4-8.6) years. GDF-15, but not sST2, was significantly associated with an increased risk of CKD progression [hazard ratios (HRs) are per SD increase in log-transformed biomarker]: GDF-15 (HR, 1.50; 95% CI, 1.35-1.67) and sST2 (HR, 1.07; 95% CI, 0.99-1.14). NT-proBNP and hsTnT were also associated with increased risk of CKD progression, but weaker than GDF-15: NT-proBNP (HR, 1.24; 95% CI, 1.13-1.36) and hsTnT (HR, 1.11; 95% CI, 1.01-1.22). CONCLUSIONS: Increases in GDF-15, NT-proBNP, and hsTnT are associated with greater risk for CKD progression. These biomarkers may inform mechanisms underlying kidney injury.
Source: Clinical Chemistry
Institutions: University of Washington, University of California, San Francisco, Tulane University, University of Maryland, Baltimore, University of Pennsylvania, Inova Health System, University of Illinois Chicago, Wake Forest University Health Sciences, Wake Forest University, Kaiser Permanente, Kaiser Permanente Northern California
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Abbott Laboratories, Beckman Coulter Foundation, Roche, Kaiser Permanente, University of Pennsylvania, Johns Hopkins University, University of Maryland, Center for Clinical and Translational Science, University of Illinois at Chicago, Deutsches Krebsforschungszentrum, Kaiser Permanente Washington Health Research Institute, Georgia Clinical and Translational Science Alliance, Siemens Healthineers, National Institutes of Health, University of Illinois at Urbana-Champaign, Perelman School of Medicine, University of Pennsylvania, University of California, San Francisco, Michigan Institute for Clinical and Health Research, Clinical and Translational Science Collaborative of Cleveland, School of Medicine, Case Western Reserve University, National Institute of General Medical Sciences, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Environmental Health Sciences, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: G1022778538, Clinical and Translational Science Institute, G1668154545, Heart failure and atrial arrhythmias in CKD, G1904494867, G198381471, Hispanic Chronic Renal Insufficiency Cohort(CRIC) Study, Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study, G2597979934, GENERAL CLINICAL RESEARCH CENTER, G3340927746, General Clinical Research Center, G3595354007, G37449730, G3779191537, G4186386621, G5612975547, G56570703, G5749521925, Center for Clinical and Translational Science, G642672552, G6677863498, G673888933, Michigan Institute for Clinical and Health Research (MCHR), Institute for Clinical and Translational Research, Institutional Clinical and Translational Science Award, Clinical and Translational Science Award, G7958222963, G8144171051, G8287218166, Clinical and Translational Science Collaborative of Cleveland, G8534382735, G8564602329, G8660623442, G8676708184, Clinical and Translational Science Collaborative of Cleveland, G9000281326, Clinical and Translational Science Collaborative of Northern Ohio, Catalyzing Linkages for Everyone's Health (CLE Health), Tulane COBRE for Clinical and Translational Research in Cardiometabolic Diseases, A pilot trial of an intervention to support initial type 2 diabetes selfmanagement among younger adults with children., Prospective renal insufficiency cohort evaluation: PRICE, Chronic Renal Insufficiency Cohort (CRIC) Study Clinical Center, Continuation of the Chronic Renal Insufficiency Cohort (CRIC), Continuation of the University of Illinois Chicago CRIC Clinical Center, Limited Competition for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Hopkins Clinical Center, Tulane Clinical Center for Chronic Renal Insufficiency Cohort Study, Chronic Renal Insufficiency Cohort Limited competition continuation, Chronic Renal Insufficiency Cohort (CRIC) Study
OpenAlex ID: W2978558169