You are here

Urine Collagen Fragments and CKD Progression-The Cardiovascular Health Study.

TitleUrine Collagen Fragments and CKD Progression-The Cardiovascular Health Study.
Publication TypeJournal Article
Year of Publication2015
AuthorsIx, JH, Biggs, ML, Mukamal, K, Djoussé, L, Siscovick, D, Tracy, R, Katz, R, Delaney, JA, Chaves, P, Rifkin, DE, Hughes-Austin, JM, Garimella, PS, Sarnak, MJ, Shlipak, MG, Kizer, JR
JournalJ Am Soc Nephrol
Volume26
Issue10
Pagination2494-503
Date Published2015 Oct
ISSN1533-3450
KeywordsAged, Cardiovascular Diseases, Case-Control Studies, Disease Progression, Female, Heart Failure, Humans, Kidney Failure, Chronic, Male, Peptide Fragments, Procollagen, Prospective Studies, Renal Insufficiency, Chronic
Abstract<p>Tubulointerstitial fibrosis is common with ageing and strongly prognostic for ESRD but is poorly captured by eGFR or urine albumin to creatinine ratio (ACR). Higher urine levels of procollagen type III N-terminal propeptide (PIIINP) mark the severity of tubulointerstitial fibrosis in biopsy studies, but the association of urine PIIINP with CKD progression is unknown. Among community-living persons aged ≥65 years, we measured PIIINP in spot urine specimens from the 1996 to 1997 Cardiovascular Health Study visit among individuals with CKD progression (30% decline in eGFR over 9 years, n=192) or incident ESRD (n=54) during follow-up, and in 958 randomly selected participants. We evaluated associations of urine PIIINP with CKD progression and incident ESRD. Associations of urine PIIINP with cardiovascular disease, heart failure, and death were evaluated as secondary end points. At baseline, mean age (±SD) was 78±5 years, mean eGFR was 63±18 ml/min per 1.73 m(2), and median urine PIIINP was 2.6 (interquartile range, 1.4-4.2) μg/L. In a case-control study (192 participants, 231 controls), each doubling of urine PIIINP associated with 22% higher odds of CKD progression (adjusted odds ratio, 1.22; 95% confidence interval, 1.00 to 1.49). Higher urine PIIINP level was also associated with incident ESRD, but results were not significant in fully adjusted models. In a prospective study among the 958 randomly selected participants, higher urine PIIINP was significantly associated with death, but not with incident cardiovascular disease or heart failure. These data suggest higher urine PIIINP levels associate with CKD progression independently of eGFR and ACR in older individuals.</p>
DOI10.1681/ASN.2014070696
Alternate JournalJ. Am. Soc. Nephrol.
PubMed ID25655067
PubMed Central IDPMC4587692
Grant ListHHSN268200800007C / / PHS HHS / United States
HHSN268201200036C / / PHS HHS / United States
N01-HC55222 / HC / NHLBI NIH HHS / United States
N01-HC85079 / HC / NHLBI NIH HHS / United States
N01-HC85080 / HC / NHLBI NIH HHS / United States
N01-HC85081 / HC / NHLBI NIH HHS / United States
N01-HC85082 / HC / NHLBI NIH HHS / United States
N01-HC85083 / HC / NHLBI NIH HHS / United States
N01-HC85086 / HC / NHLBI NIH HHS / United States
R01 DK098234 / DK / NIDDK NIH HHS / United States
R01-AG023629 / AG / NIA NIH HHS / United States
R01-AG027002 / AG / NIA NIH HHS / United States
R01-DK098234 / DK / NIDDK NIH HHS / United States
R01-HL094555 / HL / NHLBI NIH HHS / United States
U01-HL080295 / HL / NHLBI NIH HHS / United States