@article {1349, title = {Kidney function decline in the elderly: impact of lipoprotein-associated phospholipase A(2).}, journal = {Am J Nephrol}, volume = {34}, year = {2011}, month = {2011}, pages = {512-8}, abstract = {

BACKGROUND: Whether lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) levels are associated with kidney function decline has not been well studied.

METHODS: We investigated associations of Lp-PLA(2) antigen and activity with kidney function decline and rapid decline over 5.7 years in the Cardiovascular Health Study (n = 4,359). We estimated kidney function by cystatin C (eGFRcys) in repeated measures, and defined rapid decline as >=3 ml/min/1.73 m(2) per year. We stratified by baseline preserved GFR (>=60 ml/min/1.73 m(2)).

RESULTS: Mean age was 72 {\textpm} 5 years. Average eGFRcys decline was -1.79 ml/min/1.73 m(2) (SD = 2.60) per year. Among persons with preserved GFR, compared to the lowest quartile of Lp-PLA(2) antigen, eGFRcys decline was faster among persons in the second, β -0.31 (95\% CI -0.52, -0.10), third -0.19 (-0.41, 0.02) and fourth quartiles -0.26 (-0.48, -0.04) after full adjustment. Persons in the highest quartile of Lp-PLA(2) antigen had increased odds of rapid decline 1.34 (1.03, 1.75), compared to the lowest. There was no significant association between levels of Lp-PLA(2) activity and eGFRcys decline or rapid decline. Associations were not statistically significant among persons with low eGFR (<60 ml/min/1.73 m(2)) at baseline.

CONCLUSION: Higher levels of Lp-PLA(2) antigen but not activity were significantly associated with faster rates of kidney function decline. These findings may suggest a novel vascular pathway for kidney disease progression.

}, keywords = {Aged, Cardiovascular Diseases, Creatinine, Cystatin C, Disease Progression, Female, Geriatrics, Glomerular Filtration Rate, Humans, Kidney, Kidney Diseases, Male, Middle Aged, Phospholipases A2, Risk Factors, Treatment Outcome}, issn = {1421-9670}, doi = {10.1159/000333045}, author = {Peralta, Carmen A and Katz, Ronit and Shlipak, Michael and Dubin, Ruth and DeBoer, Ian and Jenny, Nancy and Fitzpatrick, Annette and Koro, Carol and Kestenbaum, Bryan and Ix, Joachim and Sarnak, Mark and Cushman, Mary} }