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Kidney function decline in the elderly: impact of lipoprotein-associated phospholipase A(2).
Tuesday,2012-11-06 12:26 America/Los_Angeles — eenright
| Title | Kidney function decline in the elderly: impact of lipoprotein-associated phospholipase A(2). |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Peralta, CA, Katz, R, Shlipak, M, Dubin, R, DeBoer, I, Jenny, N, Fitzpatrick, A, Koro, C, Kestenbaum, B, Ix, J, Sarnak, M, Cushman, M |
| Journal | Am J Nephrol |
| Volume | 34 |
| Issue | 6 |
| Pagination | 512-8 |
| Date Published | 2011 |
| ISSN | 1421-9670 |
| 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 |
| Abstract | <p><b>BACKGROUND: </b>Whether lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) levels are associated with kidney function decline has not been well studied.</p><p><b>METHODS: </b>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)).</p><p><b>RESULTS: </b>Mean age was 72 ± 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.</p><p><b>CONCLUSION: </b>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.</p> |
| DOI | 10.1159/000333045 |
| Alternate Journal | Am. J. Nephrol. |
| PubMed ID | 22056971 |
| PubMed Central ID | PMC3225232 |
| Grant List | T32 DK007219 / DK / NIDDK NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States R01 AG 027002 / AG / NIA NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States K23SK082793 / / PHS HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States R01 AG027002 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States KL2 RR025015 / RR / NCRR NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States UL1 TR000423 / TR / NCATS NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States |